In July 2010 the Government published a White Paper, Equity and Excellence: Liberating the NHS, setting out its long term vision for the NHS.
The key principles of the changes are:
Primary Care Trusts (PCT) and Strategic Health Authorities will be abolished.
Clinicians will have responsibility and budgets for commissioning, the planning, designing and paying for health services. They will work together in Clinical Commissioning Groups.
Greater emphasis on outcomes for patients, rather than simply meeting targets.
Putting patients at the heart of the NHS.
More independence for healthcare providers and reduced bureaucracy.
Health improvement will be the responsibility of Local Authorities.
The Government's original idea was to have groups of GPs taking on responsibility of commissioning health services. However, during May and June 2011 there was a legislative pause and the NHS Future Forum was established to review the Government's proposals.
Responsibility for commissioning healthcare has been extended so that a wider range of health professionals (which may include nurses and hospitals doctors) could share this responsibility.
Clinicians already have had responsibility for commissioning health services through an initiative called 'practice based commissioning'. In Milton Keynes this partnership was called health:mk. This saw GP practices take responsibility for a portion of the PCT budget in order to design health care locally for patients.
Clinical commissioning builds this and the key role that GP practices already play in coordinating patient care and acting as advocates for patients. Clinical commissioning will give groups of GP practices and other clinicians more financial accountability for the consequences of their decisions.
As well as establishing the clinical commissioning group and taking on the role of commissioners, local GPs and other members of the group will be responsible for ensuring about £50m of efficiencies are made to reinvest into the local health system.