Supplementary memorandum by the Association
of Community Health Councils for England and Wales (PS 2A)
EVIDENCE ON THE NHS CONCORDAT WITH THE PRIVATE
AND VOLUNTARY SECTORS
1. Under current conditions, the Concordat
is necessary because the NHS in England (especially in London
and the South East) does not have the capacity to meet the ambitious
targets for waiting lists and times in the NHS Plan in the short
term. The use of private sector hospitals in England can help
to fill the gap. However, it may not be sufficient on its own
to do this safely—or even at all.
2. One acute trust (St. Georges's Healthcare
NHS Trust) managed to have 350 elective in-patients treated successfully
under the Concordat, enabling twice as many admissions through
its hardpressed Accident and Emergency Department that winter
(2000-01). To achieve this, a rigorous procedure was applied:
— The case mix of those selected took
into account clinical appropriateness as well as waiting list
factors.
— There was a clear procedure for dealing
with clinical complications.
— Responsibility for the scheme lay
with the Director of Operations of St. George's.
It was a successful scheme; there have been
no complaints thus far—rather compliments and letters of
appreciation from patients.
3. Last winter (2000-01) commissioning under
the Concordat was restricted to NHS Trusts. This summer the Department
of Health announced that Primary Care Trusts (PCTs) would be allowed
to commission under it in future. There are issues about the ability
of PCTs to commission acute services knowledgeably. There is also
a probity issue given the government regime as it has developed
in PCTs.
4. Monitoring under the Concordat could
be improved by extending the visiting rights of Community Health
Councils (CHCs) in England by secondary legislation to all relevant
independent and voluntary providers of health care. This could
be done in the current session of Parliament. This would be without
prejudice to the eventual creation of Patients' Forums relating
to NHS Trusts and PCTs with similar powers by statute. It could
be improved also by increasing, or at least maintaining, the minimum
frequency of visits to independent and voluntary hospitals by
the inspectors, who will be reporting to the Care Standards Commission
from 1 April 2002. There may be a particular problem this winter
(2001-2) as existing registration and inspection staff prepare
to transfer from Health Authorities. In these circumstances, early
action to extend CHC visiting rights (and support the increase
in activity and responsibility appropriately) would be particularly
important.
November 2001
| 
