The NHS Constitution brings together the principles, values, rights and responsibilities that underpin the NHS. It is designed to secure our commitment to the enduring principles of the NHS, making sure that the NHS continues to be relevant to the needs of patients, the public and staff in the 21st century.
The Constitution contains:
- A short introduction, which outlines the purpose of the NHS and of the Constitution.
- The principles of the NHS, which are the enduring high-level ‘rules’ that govern the way that the NHS operates, and define how it seeks to achieve its purpose.
- NHS values - that inspire passion in the NHS and should guide it in the 21st century. Individual organisations will develop and refresh their own values, tailored to their local needs.
- Rights and pledges for patients, the public and staff, as well as their responsibilities.
The Constitution is a short declaratory document. All the rights and pledges are underpinned by existing law or policy, except the new rights to choices and information to support those choices, and access to vaccines. These new rights were created through new regulations and legal directions, and came into force from 1 April 2009.
From 19 January 2010, following the successful passage of the Health Act through Parliament, all providers and commissioners of NHS care fell under a new legal obligation to have regard to the NHS Constitution in all their decisions and actions.
The Department of Health subsequently published a consultation on new patient rights on 10 November 2009. Following the consultation, a revised NHS Constitution was published, including a new right to start non-urgent treatment within 18 weeks, and to see a specialist where cancer is suspected within 2 weeks of referral, or for the NHS to take all reasonable steps to offer a range of alternative providers where this is not possible. This new right came into effect on 1 April 2010.
In 2012 further amendments were made as part of a series of measures intended to highlight the importance of whistleblowing in the NHS. The updated Constitution includes:
- an expectation that staff should raise concerns at the earliest opportunity
- a pledge that NHS organisations should support staff when raising concerns by ensuring their concerns are fully investigated and that there is someone independent, outside of their team, to speak to
- clarity around the existing legal right for staff to raise concerns about safety, malpractice or other wrong doing without suffering any detriment.
The NHS Constitution for England is available online at http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_132961
A consultation has been launched asking the public and the NHS how they think the NHS Constitution can be strengthened. The proposed changes to the NHS Constitution would be the first major set of changes since it was introduced three years ago, including:
- Openness: a new right for patients to receive acknowledgement, an explanation and apology where mistakes have been made;
- End of life care: a new right that patients, their families and carers should be involved in all discussions and decisions;
- Complaints: a new right for complaints to be acknowledged within three days, as well as stronger rights on how complaints are then handled;
- Single sex accommodation: a new pledge making it explicit that this is what patients can expect; and
- A pledge on abusive and violent patients, making it clear that they could be denied access to NHS services, if it is safe to do so.
The rights set out in the Constitution are all based on existing law. The Government wants patients to be aware of their rights so they can get what they are entitled to first time, every time. The consultation can be found at: http://www.dh.gov.uk/health/2012/11/constitution-consultation.