Following the NHS improvement plan in 2004, Creating the patient-led NHS: delivering the NHS improvement plan was published in order to provide further detail regarding the plan’s implementation.
Primary care trusts would need to ensure that from 2006 choice was offered to patients for acute and elective services. PCTs would be required to offer a selection of four or five local providers. Funding for providers would be determined by patient choice and tariff payments.
The document discussed practice-based commissioning and its potential to incentivise GP practices to invest in the health of their patients. PBC would enable practices to offer more in-house services and would allow commissioning decisions to be based on local and individual needs.
The government made it clear that the relationship between PCTs and local authorities was integral to ensuring effective commissioning and service delivery. PCTs would be expected to be involved in local strategic partnerships and the development of local area agreements in order to develop joint planning and commissioning.
PBR was highlighted in the paper as an important tool for incentivising organisations. The government committed to implement PBR for emergency and urgent care, long-term conditions and mental health services.
The document outlined that the government still aimed to offer all NHS trusts the opportunity to bid for foundation trust status by 2008 alongside a renewed development programme sponsored by Monitor and the strategic health authorities. NHS trusts would be helped to achieve foundation trust status by progressively incorporating elements of the foundation trust regime.