The NHS Constitution (the Constitution) was one of a number of recommendations contained in Lord Darzi’s report High Quality Care for All. The Constitution was published on 21 January 2009 and aims to set out what staff, patients and public can expect from the NHS. It is divided into three sections:
- principles that guide the NHS;
- patients and the public: rights, NHS pledges and responsibilities; and
- staff: rights, NHS pledges and responsibilities.
The core purpose and values of the NHS will be reinforced by placing a duty on providers and commissioners of NHS services to have regard to the new NHS Constitution. This legal duty is contained within the Health Bill (the Bill), which was introduced into Parliament on 15 January 2009.
The class of bodies required to take the constitution into account extends beyond commissioners and providers. Other bodies who "must, in performing its NHS functions, have regard to the NHS Constitution" are the special health authorities like the National Patient Safety Agency and the NHS Institute for Innovation and Improvement as well as strategic health authorities. The law also extends to primary care, dental and pharmaceutical contractors.
One twist is that the duty also applies to Monitor and the Care Quality Commission. This is interesting because the functions of strategic health authorities, Monitor and the CQC are essentially regulatory/performance management of other bodies. We could foresee challenges to their decisions on the grounds that in exercising (or deciding not to exercise) their powers in relation to another NHS body they have failed to take account of the Constitution.
The Bill also sets out the procedure for reviewing and amending the NHS Constitution and handbook which will be renewed every ten years and three years respectively.
The Constitution can be found here.