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'Liberating the NHS: greater choice and control' consultation

In Liberating the NHS: greater choice and control, the government provided further detail on its plans for increasing patient choice and control, as outlined in the Equity and Excellence white paper. The government also sought the views of patients, the wider public, healthcare professionals and the NHS on its proposals.

Plans outlined

The government outlined its plans to implement a policy of any willing provider to enable patients to choose from any organisation in England that offered a clinically appropriate service, met the quality standards expected of NHS providers and could deliver services within NHS prices.

The government reiterated its commitment to extend provider choice to all healthcare services. In particular, there was a focus on increasing choice of provider for mental health, diagnostic services, long-term conditions and end-of-life care.

The document outlined that a number of policy developments would be necessary before any willing provider could be implemented, including the development of national standard pricing and payment currencies for some services and the development of a joint-licensing regime.

Liberating the NHS outlined plans to allow referrals to named consultants. At the time, named-consultant referrals could only take place if clinically necessary. The government intended to change this so all referrals could be made to a named consultant by April 2011.

Response to findings of consultation

The government responded to the findings of the public consultation on 8 December in Liberating the NHS: legislative framework and next steps. The paper summarised the main themes arising from over 6,000 responses and the main changes the government would make to its plans for reform as a result.

The government acknowledged that competition and provider freedoms were the issues that had most divided respondents. The response noted that trade unions and existing NHS organisations had been most likely to object on principle to the idea of increased competition. In contrast, social enterprises, voluntary providers and the independent sector were supportive of the plans to remove barriers to market entry.

With regard to commissioning, the government decided to:

  • create a new responsibility for local authorities and NHS commissioners to develop joint health and wellbeing strategies, which would cover NHS, social care, public health and other local services
  • enable a phased approach to introducing GP commissioning, by first setting up GP consortia pathfinders who would operate under existing legislation but test new elements of GP commissioning
  • speed up the introduction of health and wellbeing boards, through enabling early implementers
  • improve transparency of commissioning by obliging all GP consortia to publish constitutions
  • provide GP consortia with a stronger role in helping the NHS Commissioning Board to drive up quality in primary care.

The government's commitment to 'level the playing field' between providers was clear. For example, the government decided to include a power in the health and social care bill for the secretary of state to issue regulations in relation to commissioners and procurement. These regulations were intended to protect choice and competition. However, in response to the consultation, the government revised some of its proposals relating to economic regulation to allow for a longer and more phased transition period.

Liberating the NHS: legislative framework also committed to extending the role of the Competition Commission. The government intended to require the Competition Commission to carry out a review of the development of competition and healthcare regulation every 7 years.


Department of Health.
Liberating the NHS; greater choice and control. A consultation on proposals.
Department of Health; 2011.

Department of Health.
Liberating the NHS: Legislative framework and next steps.
HMSO; 2010.