NHS England’s refreshed mandate, published on 12 November, said its role 'will require it to consider how best to balance different ways of enabling local and national delivery'.
This could include changes to its ‘control over incentives such as improving the basis of payment by results, introducing the quality premium for CCGs, and the quality and outcomes framework in the GP contract', the document said.
GPC deputy chairman Dr Richard Vautrey said: ‘We have always been clear that patients expect consistency wherever they are treated in the country which is why we have a national QOF. There has always been the possibility for local areas to use additional funding to support local enhanced schemes.’
A mandate from the government to NHS England: April 2014 to March 2015 committed to the friends and family test being rolled out in general practice by the end of December 2014 but does not detail how it will work.
A GP investigation this month revealed delays and lack of interest from patients had undermined progress on rolling out telehealth, and left some CCGs withdrawing investment.
But the NHS England mandate claimed that by 2017 ‘significant progress will be made towards the 3m people with long-term conditions being able to benefit from telehealth and telecare by supporting them to manage and monitor their condition at home, and reducing the need for avoidable visits to their GP practice and hospital’.
GPs need to treat mental health with the ‘same importance as physical health’, it said. GPs need to involve mental health patients and their carers in ‘any decision about their treatment and care plans’, it added.
By 2015, two thirds of the estimated number of people with dementia in England should have a diagnosis, ‘with appropriate post-diagnosis support’, it said.
NHS England should ‘shine a light on variation and unacceptable practice’ to ‘inspire and help people to learn from the best’. It warned that ‘because standards are high overall, most people assume all NHS services are equally good’.
‘There are huge and unwarranted differences in quality and results between services across the country – even between different teams in the same hospital, or GP practices in the same vicinity,’ it said.
The mandate’s objectives can only be ‘realised through local empowerment’, it said.