No decision about me, without me - Department of Health

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2.28 Where possible, information should be available in a variety of formats so that all groups can access it, including those with learning disabilities, those with hearing or sight impairments and non-English speaking people. This may include the provision of interpreters so that patients with specific language or communication difficulties can communicate freely with healthcare professionals. 2.29 Part of the Right Care Shared Decision Making programme has focused on delivering 36 patient decision aids in a variety of formats, to help patients understand and consider the pros and cons of possible treatment options. The decision aids are a valuable tool in providing information in a format that helps patients to make an informed decision and encourages communication between patients and healthcare professionals. 2.30 Some respondents raised concerns about the capacity and compatibility of the IT systems to be able to support the proposals. Having chosen a hospital, and perhaps a named consultant-led team, a patient would expect that team to have received their health and care record and any test results, to best inform their clinical advice. “The proposals are challenging and caution must be taken to ensure uncoordinated care pathways are not inadvertently introduced: IT systems and interrelationships with different providers must be strong and resilient for these proposals to be successful.” [The Royal College of Physicians of Edinburgh] 2.31 We recognise that the systems currently in place are not always as joined-up as they need to be, and a key ambition of the Information Strategy is: “Information recorded once, at first contact, and shared securely between those providing our care – supported by consistent use of information standards that enable data to flow whilst keeping our confidential information safe and secure.” 19 2.32 The strategy proposes an approach, based on nationally set information standards, which will enable information to be captured once and shared right across the health and care system. It will be for the Department of Health and the NHS Commissioning Board to agree, by April 2013, how to take this forward. 2.33 The strategy also sets out the steps to enable electronic access to people’s own GP records. This will support individuals to take more control of their own health and care and to work with professionals to ensure that there really is “no decision about me without me”. 19 http://www.dh.gov.uk/health/2012/05/information-strategy/; Chapter 3 13
Quality and continuity of care 2.34 Some respondents were concerned about the risk of fragmentation of care as a result of providing a choice of provider, and the risk of a variation in the quality of care if it was provided by non-NHS service providers: “The consultation document does not make clear how governance will work across the full patient pathway. With fragmentation of care amongst providers there are dangers that no one organisation will have responsibility for ensuring that the quality of care meets required standards.” [North East Yorkshire and Humber Clinical Alliance] 2.35 It is precisely by giving people more choice over their care that the Government aims to enable all patients to access the highest quality providers of healthcare services. Encouraging people to ‘vote with their feet’ by making choices about their care will strengthen the incentives of the NHS to meet patient requirements and improve the quality of services. 2.36 We are not advocating a ‘one size fits all’ approach to patient choice: it is for commissioners to decide how best to commission services. Where integration is particularly important, commissioners might decide that one provider is responsible for care planning and delivery, whilst still offering choice of treatment, setting and lead clinician. 2.37 Where patients are offered choice of provider, the providers will be contractually obliged to co-operate so that patient care is safe, transfers are coordinated properly, and patient experience is good. As is the case now, GPs will be there to help patients navigate the system, advising patients to make sure they have continuity. If continuity of care or integration issues arise, clinical commissioning groups will be able to address these with providers directly. 2.38 The Health and Social Care Act 2012 places a clear duty on both the NHS Commissioning Board, and the clinical commissioning groups 20 , to ensure health services are provided in an integrated way so as to improve the quality of those services (including the outcomes that are achieved from their provision), and to reduce inequalities. 20 http://www.legislation.gov.uk/ukpga/2012/7/pdfs/ukpga_20120007_en.pdf; 13N and 14Z1 14
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No decision about me, without me - Department of Health

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