'Our health, our care, our say' white paper

The government published its white paper Our health, our care, our say, which set out four aims:

• providing better prevention services with early interventions
• giving people more choice and a greater voice
• tackling inequalities and improving access to community care services
• providing more support for people with long-term conditions.

The white paper proposed to fulfil these four aims by:

• giving GPs more responsibility for local health budgets (practice-based commissioning)
• exploring changes to the payment by results tariff to incentivise changes
• offering more community care services and care at home
• developing a joint commissioning framework for health and wellbeing
• encouraging innovation and quality through the use of direct payments and individual budgets
• allowing different providers to compete for service delivery.

The government committed to:

• introducing 'life checks' to support people to assess their lifestyle risks (such as risks from obesity or smoking). These checks would first be piloted for the over-50s in areas of the worst health and deprivation
• improving local leadership, joint commissioning and joint working by strengthening the roles of directors of public health (DPH) and directors of adult social services, with an emphasis on the DPH role sitting jointly between local government and the NHS
• rolling out local area agreements (LAAs) to all local authorities by 2006/07. LAAs measured local performance against indicators and outcomes
• conducting pilots over 18–24 months for individual budgets for older and disabled adults, beginning in 2006. If successful, the government would roll out implementation by 2009/10
• amending the Quality Outcomes Framework (QOF) to reward GP practices that provided preventative and public health services
• establishing a Third Sector Commissioning Task Force and a Social Enterprise Unit within the Department of Health, which would provide funding (from April 2007) to support the development of new models of care provided by the voluntary sector
• offering patients the choice of GP practice (although choice was limited by catchment area). This sat alongside existing reforms to empower GPs to commission services for their registered patients (practice-based commissioning), which had been introduced from 2005.