Background
The NHS is largely funded from central taxation and therefore is accountable, through the relevant minister, to parliament for its use of public funds. The National Audit Office, parliament’s own watchdog, audits its accounts and checks for financial irregularities.
Since 2004 any existing NHS trust that can demonstrate financial stability and effective management arrangements has been able to apply to a regulator (Monitor) to become a foundation trust. This removes them from the direct control of the Secretary of State and gives them greater freedom to raise capital and develop new services. The coalition government wants all hospital trusts to become foundation trusts by 2013, when the NHS trust model will be abolished (Equity and Excellence: Liberating the NHS).
The Care Quality Commission (CQC) was established in 2009. It replaced the Healthcare Commission and incorporated the functions of the Mental Health Act Commission and the Commission for Social Care Inspection. It is responsible for ensuring that all publicly and privately funded providers of hospital and adult social care to the NHS meet essential standards of quality and safety.
Under the coalition government’s proposals the CQC and Monitor will be responsible for a joint licensing regime of providers: CQC will remain the quality inspectorate for all providers of NHS care and the role of Monitor will expand so that it becomes the economic regulator for all providers of NHS care from April 2013. An independent NHS Commissioning Board will take over responsibility for assessing the performance of commissioners from the CQC (Equity and Excellence: Liberating the NHS).
The coalition government is proposing the creation of an independent NHS commissioning board which will allocate NHS revenue resources to GP consortia and be accountable to the Department of Health for an overall NHS commissioner revenue limit (Equity and Excellence: Liberating the NHS).
The previous government had strengthened the accountability of NHS trusts to the government through the use of targets and through direct performance management. The coalition government is committed to replacing targets with outcome measures. The National Institute for Clinical Excellence will develop a new NHS Outcomes Framework which will be translated by the NHS commissioning board into a commissioning outcomes framework to be used by GP consortia. The NHS board will be held accountable for the attainment of a set of national outcome goals determined by the Secretary of State (Equity and Excellence: Liberating the NHS)
The coalition government is planning to establish HealthWatch England, a national ‘consumer champion’ which will sit inside the Care Quality Commission. Local Improvement Networks (LINKs), which were established by the previous government to facilitate local involvement in health and social care will become local HealthWatch bodies (Equity and Excellence: Liberating the NHS).
