Commenting in response to the publication of the NHS Operating Framework for 2008/09, The King's Fund chief executive Niall Dickson said:
'It is right that the government should set national priorities and right too that they should maintain the assault on hospital infections and the drive to cut waiting times. These are areas that patients are justifiably concerned about and it is imperative the NHS makes progress in them.
'Crucially, this document is an important step forward in getting to grips with what has long been the Achilles heel of the service – commissioning. The Department of Health is right to emphasise that better care and services will not be achieved through central directives and targets, but through better local commissioning led by primary care trusts (PCTs).
'That will only be achieved if PCTs accept that this is what they are there for, rather than running services themselves. The encouragement to explore other ways of running community services is welcome and should allow them to concentrate on what really matters and to develop their skills in how best to assess local needs and commission services to meet them.'
Niall Dickson added: 'One area of concern is that while the Department appears to have reduced the number of national targets, many of them appear in the guise of 'national priorities for local delivery'. It's unclear how much autonomy PCTs will have to deliver local priorities given all the national requirements and priorities.
'The Department undoubtedly faces a difficult balancing act between local freedoms and national responsibilities. And too many PCTs continue to look upwards towards government rather than out into their local communities. Now the strategic priorities for the NHS have been set for next year, PCTs must be left to get on with the task in hand with minimal central interference.'
Notes to editors:
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