New NHS Operating Framework released

Published: 24 August 2010

The Coalition Government has released an amended 2010/11 NHS Operating Framework that will drive the provision of all health care services in England. Of particular note are the plans to amend the emergency care 4-hour access target and also to review hospital reconfigurations (although trauma and paediatric services will continue).

Targets

While some process targets will be discarded, the Government emphasises that this move cannot be used as an excuse to allow longer waiting times to develop. The four-hour A&E target will remain through 2010/11, with the threshold revised down from 98 to 95 per cent and removed altogether in 2011. Performance management may still be used to monitor median time spent in A&E.

Reconfiguration

While the Government has announced a moratorium on ‘future and ongoing’ reconfiguration schemes, the document confirms that plans for trauma care and paediatric cardiac surgery will proceed.

Reconfiguration proposals are expected to pass four tests in order to continue:
• endorsement from GP commissioners
• robust patient and public engagement
• clear clinical evidence
• remaining in tune with both current and prospective patient choice frameworks.

The Secretary of State may refer cases to the Independent Reconfiguration Panel if he feels that the four tests have been insufficiently applied.

The RCN is working with the College of Emergency Medicine (CEM) and various nursing groups across England on a number of Care Standards in Emergency Care. It is hoped that these standards (and more) will be used to compliment the amendments to the 4-hour access target and improve patient safety.