Darzi NHS review calls for innovation, quality and ‘intelligent regulation’

1 July 2008

Health minister Lord Darzi has released his report on and strategy for the NHS in England, the NHS Next Stage Review, which is based around delivering quality of care; quality is defined as “clinically effective, personal and safe” (see report summary). It is suggested that that NHS funding for hospitals, GP practices and other bodies will depend on how well they are deemed to have provided accessible, high quality care by patients, although how this will be measured is not decided. This includes increased emphasis on improving health and preventing disease, including implementation of all recommendations from national expert committees for screening programmes.

The report calls for what it terms ‘intelligent regulation’ as a means to safeguard quality, saying that NHS commissioners will benefit from “clearer standards from an expanded NICE” (National Institute for health and Clinical Excellence) to ensure that “clinically and cost effective innovation in medicines and medical technologies is adopted” This echoes the PHG Foundation’s emphasis on the public health genomics principle of the prompt and effective (ie. evidence-based) translation of genome-based knowledge for the benefit of population health.  The report also notes that innovation should not be confined to research but rather is “a broader concept, encompassing clinical practice and service design”, which supports the PHG Foundation’s service development work considering how novel genomic technologies should best be incorporated into NHS services. Strategic health authorities are to have a new legal duty to promote innovation, with access to funds and prizes.

The report promises that the pathway from development to clinical application will be streamlined, NICE’s process for assessing and (if suitable) approving new drugs and treatments speeded up, and that ways to benchmark and monitor uptake of new interventions will be defined. It also proposes the establishment of selected Health Innovation and Education Clusters, bringing together partners from the NHS, academia and industry to pioneer and develop new treatments and models of care, and of Academic Health Science Centres (AHSCs) “to take new discoveries and promote their application in the NHS and across the world”.

The report also sets out a new ‘NHS constitution’ to clarify patient rights and provide measures of increased transparency and clarity with respect to decision-making and accountability.

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