In the White Paper, 'Equity and Excellence: Liberating the NHS', the Government made a commitment to extend the choices people have over their healthcare, as part of its vision of ensuring patients and the public are at the heart of the NHS.

The goal is to enable patients who are referred for a particular service to choose, where appropriate, from a range of qualified providers and select the one that best meets their needs. Extending the choice of provider is expected to enhance quality, where patients have identified this as variable in the past and provides an opportunity to improve access and address gaps in inequalities.

NHS Halton & St Helens are carrying out a short consultation to find out which of a small number services might benefit from extended choice of provider from April 2012

For example, most forms of hearing loss do not involve illness or disease and therefore people do not need to be treated in hospital. Given a wider choice, many people with hearing problems may prefer instead to visit a service located in the high street or a mobile clinic because it is more convenient and doesn't make them feel like they are 'ill'. Increasingly we expect that patients will seek information about the quality of care when choosing which provider to select. Extending choice of provider will enable patients to access better quality services provided by a wider range of health providers.

The roll out will start with selected community and mental health services from April 2012, with these in place by September 2012. NHS Halton & St Helens are now supporting a piece of work happening across the country which asks people their views on which of these service areas they think might benefit from having an extended choice of health providers to meet the needs of patients and deliver quality improvements. This needs to be completed by the end of October this year.

How will this affect patients?

In the future, patients will be offered a wider choice of healthcare providers when they are referred for some treatments by a health professional. The NHS has been asked to help test a small number of services that patients have said might benefit from extended choice of provider from April 2012. These services are:

• Services for back and neck pain
• Adult hearing services in the community
• Continence services (adults and children)
•  Direct Access Diagnostic tests
•  Wheelchair services (children)
•  Leg ulcer and wound healing
•  Primary Care Psychological Therapies (adults) ('talking therapies')

What this means for healthcare providers?

All healthcare providers – including NHS and independent organisations, charities and social enterprises, which meet the qualifying requirements will be able to deliver some NHS services.

From the end of this year and subject to the results of testing, local commissioners will start to work with patients, healthcare professionals and providers, making decisions about which services in their local community will benefit from extended choice of provider. For 2012 they will then invite new and existing providers to qualify and register to provide services to patients.

There will be clear referral protocols and thresholds. This means that providers will treat patients within a set of criteria in line with clinical best practice. The volume of patients any provider sees and is paid for will be entirely dependent on patient choice. Providers will need to focus on offering responsive, high quality services and ensure patients and GPs have accurate and comprehensive information about the services they offer.

All providers will need to be 'qualified' to provide services and will need to accept NHS prices. We expect that a national qualification process for 'Any Qualified Provider' would minimise bureaucracy and reduce transaction costs for providers and commissioners. Patient safety is paramount. Qualification would also ensure that a provider who is registered in one locality does not have to go through a full qualification process again for that service in another locality. NHS Halton & St Helens will continue to work with commissioners and providers to decide how best to do this.

Commissioners will set local care pathways, and will have the flexibility to ensure services are fully integrated and responsive to local needs. Providers will agree final contracts with PCT clusters or, in future, Clinical Commissioning Groups. After agreeing contracts and prices, providers will then be ready to receive patients, and the payment that follows. Commissioners cannot refuse to accept providers once they have qualified, unless they are unwilling or unable to meet any of the qualification requirements.

NHS Halton & St Helens would like to hear your views on which services you would like to see opened up to wider choice of clinicians.

Feedback from this engagement will help inform commissioners on which local community and / or mental health services would benefit from becoming an extended choice of provider.

To take part in the survey, please visit

http://www.surveymonkey.com/s/L3W8G9D

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