Make the policy fit

Abstract

The National Service Framework (NSF) for Long Term Neurological Conditions (LTNC) (Department of Health, 2005) was developed as a key tool for delivering the government’s strategy to support those living with a LTNC. The eleven quality requirements (QRs) central to the NSF would, if implemented, have helped to provide efficient, supportive and appropriate care to individuals throughout the continuum of a neurological condition—from diagnosis to the endof-life. Regretfully, the NSF is no longer current policy but the content remains sound which is why we should not lose sight of the NSF and try, where possible, to use the QRs to drive up standards of care for people with LTNC within other policy streams. One area of policy we need to focus on is the NHS Outcomes Framework and from within this, National Institute of Health and Clinical Excellence (NICE) quality standards. The Outcomes Framework has been designed to demonstrate how well the NHS is doing overall in improving the health outcomes of patients including those with neurological problems. It will allow the Secretary of State for Health to hold the new NHS Commissioning Board to account for the outcomes it is trying to secure for patients. It is felt that through greater transparency, the Outcomes Framework will help drive improvements to patients’ health by focusing on the results of the treatment and care individuals receive—patient health outcomes. This Framework is structured around five high-level outcome goals or domains (Table 1), which are designed to cover all treatment activity for which the NHS is responsible: Each of these five areas would have: ■An overarching outcome indicator (or set of indicators) to measure the overall progress of the NHS across the breadth of activity covered by the domain ■A small number of specific improvement areas where the evidence suggests better outcomes are possible or areas that are identified as being particularly important to patients ■Supporting quality standards developed by NICE to help patients, clinicians and commissioners understand how to deliver better care.