NHS Financial Flows

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2003 Health Care Service Group Conference
1 December 2002

This Conference notes with serious concern the Government’s plans for a new financial framework within the NHS, as outlined in the DOH consultation document, NHS Financial Flows – Introducing Payments By Results. These proposals set out plans to fundamentally change the way that funds flow through the NHS. They will have profound and potentially serious implications for service delivery and quality issues from a user perspective, and for staff working within the NHS. The document specifically states:

“The NHS will move, over the next few years, from a monopoly provider of health services, run from Whitehall, to offer a greater diversity and plurality of services for NHS patients, inspected and regulated against transparent, common standards by an independent body. The Government’s commitment to a national health service requires a diversity of locally appropriate, patient responsive services delivered within the context of national standards.”

Conference notes that the range of other allied policy initiatives that will influence the future direction of the NHS. These include:

·Patient Choice (Between 2002 and 2004, patients will be offered a choice of hospital after a 6/12 month wait on the waiting list. From 2005, patients will have a full choice of hospital from the point of referral);

·Plurality of provision (A shift from public to private sector healthcare provision with the creation of Diagnostic Treatment Centres and greater involvement of the UK Independent Sector and overseas providers, as well as the establishment of Foundation Hospitals and an increased role for Primary Care Organisations);

··Three year planning/ allocations as outlined in Improvement, Expansion & Reform: the next three years, Priority and Planning Framework 2003-2006;

·GMS/ Consultant contracts and PMS/ PMS Plus schemes;

·New regulatory standards commissions;


Conference notes UNISON’s response to the Government’s plans which outlines our concerns about the following:

i)The reintroduction of damaging competition into the NHS, repeating mistakes of the previous discredited internal market;

ii)That payment by results will endanger quality;

iii)That independent providers will be exempt from the national tariff system, and thus on a more advantageous footing to NHS organisations;

iv)Fundamental problems in the proposed commissioning process including lack of clarity about how it will work, inadequate consideration of workforce issues and lack of transparency about process;

v)That withdrawal of funds on a quarterly basis, where providers are failing to meet targets, will cause serious financial instability.

Conference confirms its opposition to these plans, and instructs the Service Group Executive to undertake the following:

1)Campaign against these plans working with other appropriate organisations and trades unions;

2)Commission research;

3)Seek to lobby through the APF;

4)Develop a comprehensive strategic plan to address the organisational implications for UNISON (including briefings and training for stewards to deal with these proposals locally, organising and recruitment implications).