Dissecting Darzi's review

So was Ara Darzi’s 'Next Stage Review' (published on 30 June) ‘the most important published since the Beveridge report’ or ‘a missed opportunity’ to improve NHS services? Both views were being reported yesterday.If you set aside for one moment the razzmatazz of the launch (at times this has felt like NHS the roadshow, although they mercifully let us off the rousing final anthem yesterday), there was actually quite a lot in the report for people with asthma and a real sense that the review has galvanized people who work in the NHS.

First, several NHS Regions have made specific commitments to improve services. Yorkshire and Humber, for example, promised to halve the number of emergency hospital admissions for asthma. Other regions have pledged to improve the transition from child to adult services.

There was also some good news in the national ‘enabling’ report.

A renewed focus on care plans for people with long-term conditions, but based on a better model. These will be piloted and hopefully rolled out. We know that people with an asthma action plan are less likely to be hospitalised for their asthma, so this could be good news.

This should also underscore the commitment being made to working in partnership with patients.

The pilot to extend individual budgets for health will also be one to watch. We believe that some ‘expert’ asthma patients could benefit from having greater control over how NHS money is spent, as they already do over social care (if they get any support from that source of course!).

The focus on quality is welcome as is the commitment to measure patient experience and patient-related outcomes. This data will be published and will hopefully allow us better insight into the quality of local services. We want to inspect the proposed quality measures to make sure they take into account quality of life. The Quality Board also needs a degree of independence. But the focus on quality is right.

We are promised no new national targets but there will be national standards. As I hope you know, we have been lobbying hard for national standards on asthma. Without them a postcode lottery of the kind we now see appears inevitable.

And I personally think an NHS constitution is a positive step. With all the rhetoric about reform in recent years we have forgotten what the NHS stands for. Of course at heart it must be about compassion, dignity, quality and respect. And it gives patients rights too. Everyone who might benefit from new drugs like Xolair should get them regardless of their postcode and the constitution enshrines this as a right.

A quick judgement based on what I have seen so far? Probably the best chance we have seen to improve NHS services since extra money was put into the system in 2000. Let’s hope it pays off on the ground in better – and more consistently better – services.

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