By Richard Johnstone | 5 November 2012
Public awareness of the three-year old NHS constitution is ‘unacceptably low’ and needs to be improved, the independent NHS Future Forum has found.
The constitution, which sets out individual’s rights in the health service, has been in place since 2009 but ‘few people know about it [and] fewer still use it to uphold their expectations of the NHS’, the forum said. It added that the document also needed to be updated following the government’s NHS reforms.
The expert group, which advised the government on the controversial reforms, was asked in March by then health secretary Andrew Lansley to look at how the constitution could be strengthened.
Today’s recommendations by the panel, submitted to Lansley’s successor Jeremy Hunt and accepted in full by the government, conclude there are ‘several areas’ where the document could be improved.
Although the panel does not recommend an expensive advertising campaign to boost awareness, it does call for ‘carefully targeted’ resources to be committed so the message gets through to patients and the wider public.
As well as increasing public awareness, other ‘essential steps’ include ensuring NHS staff ‘really understand what the constitution means for their everyday work’. The document should also be clearer about what happens when the NHS falls short of people’s rights or expectations.
Forum chair Professor Steve Field said the government should consider modifying the complaints procedure in the health service to ensure processes for feedback and redress are fit for purpose in the reformed system. One possible solution would be strengthening the Patient Advice and Liaison Service, which helps patients to make complaints. It could be put on a statutory footing, with the constitution at its heart.
The forum also called for the constitution to be updated in five specific areas. These include a commitment to involve patients fully in decisions about their care and changes to encourage a more open working culture within the NHS.
Field said that ‘despite the importance and potential’ of the constitution, its impact so far had been ‘patchy’.
He added: ‘The NHS is going through a period of great change and massive financial challenge. After the debates about structures and systems over the past two years, we believe that the focus should be on what matters most to patients, staff and the public – protecting and improving the quality of the service.
‘This opportunity to embed the constitution must not be lost. All organisations must play their part.’
Ministers today launched a consultation on possible changes to meet the forum’s recommendations. In addition, the Department of Health is working with the bodies created by the Health and Social Care Act – the NHS Commissioning Board, Health Education England and clinical commissioning groups – to consider how best to promote the constitution.
Responding to the report, health minister Norman Lamb said: ‘The NHS is one of this country’s greatest achievements. This government will always make sure it is free to all, no matter your age or the size of your bank balance. That’s why at the same time as we are protecting its budget, we are strengthening this constitution, which enshrines the right of everyone to have first class care, now and in the future.’
The NHS Confederation said the constitution needed to be more accessible to be effective.
Chief executive Mike Farrar added: ‘These proposed changes rightly acknowledge the importance of full transparency when people's care is not up to the highest standards.
‘Used in the right way, the constitution can help trigger a major cultural shift in the way the NHS thinks about dignity and person-centred care. It cannot do this on its own, but it can play a major part in making it happen.’