Department of Health
Tuesday, 24 November, 2015

The mandate to NHS England sets the government’s objectives for NHS England, as well as its budget. In doing so, the mandate sets direction for the NHS, and helps ensure the NHS is accountable to Parliament and the public.

In accordance with the Health and Social Care Act 2012, the Secretary of State must publish a mandate each year, to ensure that NHS England’s objectives remain up to date.

A new mandate to NHS England is due to be published following the completion of the Spending Review, to take effect from April 2016. This consultation document sets out how the government proposes to set the mandate to NHS England for this Parliament. The final mandate will be subject to the outcome of the government’s Spending Review.

1. Introduction

A mandate to NHS England

1.1. NHS England is responsible for arranging the provision of health services in England. The mandate to NHS England sets the Government’s objectives for NHS England, as well as its budget.i In doing so, the mandate sets direction for the NHS, and helps ensure the NHS is accountable to Parliament and the public. Every year, the Secretary of State must publish a mandate to ensure that NHS England’s objectives remain up to date.

1.2. A new mandate to NHS England is due to be published later this year, to take effect from April 2016. The Government is currently carrying out a Spending Review (SR), which will determine the budget for the NHS. It is due to conclude on 25 November 2015. The new mandate will be published after the completion of the SR and will inform planning guidance for the NHS.

1.3. This year, every government department is producing a plan setting out its objectives to 2020 and how it will achieve them. The Department of Health’s plan will inform the objectives for its arm's length bodies, including the mandate to NHS England.

1.4. This consultation document sets out, at a high level, how the Government proposes to set the mandate to NHS England for this Parliament. The mandate itself will be finalised in light of consultation responses and subject to the outcome of the SR. Further detail underpinning each objective comprising the long-term aspiration to 2020, in-year deliverables and metrics to measure progress, will be agreed once the SR is complete and the funding settlement for the NHS is known.

Challenges facing the health and care system

1.5. The challenges for the NHS today are those facing healthcare across the world: how the NHS evolves to support people living longer and with more complex health conditions, and how we adapt to the opportunities presented by the advance of science and technology.

1.6. It’s not enough just to have the right values in the NHS. We need the right plan for the future. The coalition government gave the NHS important freedoms to develop its own plan. NHS England and its partners in other arm's length bodies have done just that, with the NHS Five Year Forward View.

1.7. Because of our long-term plan for a strong economy, this Government backs this long-term plan for a strong NHS. We will continue to increase spending in real terms every year in this Parliament, rising to at least an extra £10 billion a year by 2020.

1.8. In return, people need to have the confidence that the highest quality NHS services will be there when they need them. In the new mandate to NHS England for 2016/17, the Government will be entrusting NHS England with the NHS budget to help deliver the Five Year Forward View, and meet the evolving needs of the population in a way that is sustainable now and into the future.

1.9. At the same time, we want to develop a new relationship between the NHS and the public. People should be given more power and control over the care that is provided to them so that services are arranged around their needs and they are supported to manage their own health.

The Government’s priorities

1.10. The new mandate will be based on the priorities this Government believes are central to delivering the changes needed to ensure that free healthcare is always there whenever people need it most. Our priorities for the health and care system as a whole are:

  • Preventing ill health and supporting people to live healthier lives. The escalating demands of ill health driven by our lifestyles also threaten the long-term sustainability of the NHS. It’s a priority to help people to live healthier lives by tackling obesity and preventable illness, and to improve quality of life for people with long-term conditions such as diabetes and those with dementia.
  • Creating the safest, highest quality health and care service, by securing high quality health and care services and 7-day hospital care to improve clinical outcomes.
  • Maintaining and improving performance against core standards while achieving financial balance, by ensuring the NHS meets the needs of patients and operates within its budget.
  • Transforming out-of-hospital care, ensuring services outside hospital settings are more integrated and accessible. As part of a new patient guarantee, this means by 2020, we will ensure every patient has routine access to a GP in the evenings and at weekends, as well as effective 24/7 access to urgent care. We will also strive to reduce the health gap between people with mental health problems and the population as a whole.
  • Driving improvements in efficiency and productivity by reducing waste and inefficiency to ensure every penny delivers the maximum possible benefit to patient care.
  • Supporting research, innovation and growth, and influencing global health priorities.

1.11. Delivering these priorities will require contributions from all parts of the health and care system. As leader of the commissioning system, NHS England has a central role to play. This consultation document sets out how the Government proposes to set objectives for NHS England that reflect its contribution to these ambitions in the new mandate to NHS England for 2016/17 and beyond.