Executive Summary: Driven by the terrible failings in care at Mid-Staffordshire NHS Foundation Trust, and informed by Sir Robert Francis QC’s Inquiry Report, the need for transparency and accountability within our NHS has never been more evident. In 2014, we launched MyNHS, bringing together almost 400,000 pieces of comparable data from across the health and care system to the public domain, to improve transparency, inspire NHS professionals, and empower the public.
By April 2015, we will see changes to the way hospitals are inspected, with the introduction of new fundamental standards. Failure to meet these standards, and an inability to meet the high standards patients expect and deserve, will result in decisive action to protect patients. It is also of upmost importance to promote a culture of openness within our NHS, which we hope to achieve through the introduction of the duty of candour.
We need to close the gap between physical and mental health, and we believe that the NHS Constitution should make it clear that both are of equal importance. We also want to recognise the role Armed Forces have in keeping us safe, by enshrining the Armed Forces Covenant in the NHS Constitution.
We believe that these important policies deserve to take their place amongst the core principles, values and responsibilities of the NHS – and should be set out clearly in the rights and pledges we make to patients.
The NHS Constitution sets out the enduring character of the NHS as a comprehensive and equitable health service. It empowers patients, staff and the public to know and exercise their rights in order to help drive improvements in quality, efficiency and responsiveness throughout the NHS. Sir Robert Francis QC highlighted the NHS Constitution as being central to promoting the correct values within the NHS. Any changes made to the NHS Constitution should therefore be clear and compelling – and should have the support of the public. This is why we are seeking views on how best to reflect these changes in the NHS Constitution.
Over the coming weeks, the Department of Health would like to hear from a wide range of patients and service users. The NHS Constitution applies to all those who use its many services. During this consultation exercise, we want to hear from people across this broad spectrum, to help us define and enshrine the values of the NHS for years to come.
We look forward to hearing from patients, NHS staff, the public and our partners, on the proposals set out in this document – and will use the feedback from the consultation to work out how best to reflect these changes in the Constitution.
Chapter 1: Introduction
Purpose of the consultation
1. Sir Robert Francis QC was clear in his Inquiry report1 that the principal message of the NHS Constitution should be that patients2 and their safety come first. In Hard Truths,3 the Department of Health made a commitment to increasing the impact of the NHS Constitution so that patients and the public understand their rights and responsibilities. We have also identified a number of policy developments that could make the Constitution more tangible and meaningful to patients.
2. This consultation seeks views on our proposals to update the NHS Constitution. There are four key ways in which we propose to amend the Constitution:
- to give greater prominence to mental health;
- in response to recommendations made by Sir Robert Francis QC;
- to reflect the importance of access to transparent and comparable data; and
- to include the Armed Forces Covenant.
3. The NHS Constitution is designed to be an enduring document. The threshold for making changes to the Constitution should be high. Any changes should be clear and compelling. That is why the Health Act 2009 requires there to be a public consultation on all changes to the content of the Constitution, and for any changes to the principles of the NHS to be laid as a Statutory Instrument before Parliament.
4. The changes set out in this consultation document build on earlier amendments to the NHS Constitution. In 2013, the Constitution was strengthened in the following areas:
- patient involvement;
- feedback;
- candour;
- end of life care;
- integrated care;
5. We are seeking views on a limited package of further changes intended to strengthen the NHS Constitution and better reflect Government policy.
6. Subject to the outcome of this consultation, the Government plans to publish an updated Constitution during 2015. The Department also intends to publish a revised NHS Constitution Handbook.
