To receive information on proposed organisational changes to the local Health Service as a result of a DoH paper on “Commissioning a Patient-Led NHS” and to respond to the Strategic Health Authority (SHA) Consultation.

THAT  (a)            Cabinet agrees to state the case strongly for the retention of a Herefordshire sovereign NHS body commissioning service for the Herefordshire public; and

            (b)            Cabinet comments on a draft response to consultation by the Strategic health Authority on the implications for local services.

On 27th July, 2005, the Department of Health published “Commissioning a Patient Led NHS” setting out a framework for improving commissioning of services alongside improvements in health and service delivery.  The main factors in the guidance are:

• PCTs of the future will concentrate on commissioning and improving public health
• PCTs will not directly provide services (this may be allowed only in the most exceptional circumstances)
• GP practice-based commissioning will be fully developed
• A reduction in the number of SHAs, Ambulance Trusts and PCTs
• Most NHS Trusts will become Foundation Trusts
• An expectation that PCT boundaries will match those of Local Authorities
• Delivery of at least 15% reduction in management and administrative costs.

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