In his first speech since taking up the post, the Health Secretary, Andrew Lansley, said he would put his heart and soul into the improvement of health outcomes by making patients the driving force of improvements to the NHS.

Not just as beneficiaries of care but as participants, with shared decision-making.

As part of his broader plans to align payments with the quality of patient care, the Health Secretary said that hospitals should be responsible for reducing the number of emergency readmissions following treatment, and support treatment at home, as part of a single payment.

Making hospitals responsible for a patient’s ongoing care after discharge will create more joined-up working between hospitals and community services. This will improve quality and performance and shift the focus to the outcome for the patient, rather than the volume of activity paid to the hospital.

Speaking to an audience of patients, carers and staff at an event at the Bromley by Bow Centre in London, hosted by the Patients Association and National Voices, the Health Secretary challenged the NHS to:

• make a cultural shift. From a culture responsive mainly to orders from the top-down, to one responsive to patients, in which patient safety is put first.

• devolve power through the unleashing of meaningful information to patients. Comparative data about standards and patient experience will drive up standards, as the data will influence patient choice. A transparent NHS is a safer NHS.

• engage people in their care so that, “no decision is made about me, without me”, and give patients the opportunity to provide feedback in real time, reflecting the experience of their care.

• embrace leadership by setting NHS professionals free from a target-centred and bureaucratic system that compromises patient care, to one focussed on the quality, innovation, productivity and safety required to improve patient outcomes.

• adopt a holistic approach by looking at the entire patient pathway from preventative health and well-being measures, through to hospital and community care.

• align payments in the NHS to drive up the quality of care that patients receive. In the first instance, through introducing payments which encapsulate a more integrated care pathway by giving hospitals responsibility for a patient’s care for 30 days after they are discharged.

Health Secretary Andrew Lansley said:

“My ambition is for health outcomes and health services to be as good as any in the world. The previous government’s bureaucratic approach of perpetual interference, coupled with the imposition of top-down process targets, has failed patients. It has left us lagging behind our European counterparts on outcomes that matter to patients, such as how long they will survive after a cancer diagnosis.

“We need a cultural shift in the NHS. From a culture responsive mainly to orders from the top-down, to one responsive to patients, in which patient safety is put first. This can only be achieved if patients are put in the driving seat and are informed and engaged in the delivery of their care. That way the NHS will be focussed on what matters to patients – safe, reliable, effective care for each patient, and the best outcomes for all patients.”

Jeremy Taylor, Chief Executive of National Voices said:

“Culture shift is the key challenge for the NHS.  Despite significant improvements in recent years, there has been too much management by fear, too much inertia from professional vested interests, and too little opportunity for patients and families to be heard.  National Voices calls for an open, human, responsive and collaborative culture that puts people first.   Incentives play an important part in this but we need to understand the whole mix of carrots and sticks, and we look forward to seeing more detail from the government.” 

Katherine Murphy, Director of the Patients Association said:

"We have always campaigned for patient safety to be at the forefront of services and withholding payment to fix poor outcomes and giving patients more information to help them make informed decisions about their care are significant steps towards this.  We welcome a much greater emphasis on the patient experience and a focus on patient needs and helping patients play a bigger role in shaping their health service."
Further proposals to implement the vision for the NHS will be published soon. These will not be top-down reforms – the local NHS will be empowered to work with doctors and nurses to make the changes they need to improve the quality of patient care.