On 5 November 2012, the DH announced plans to strengthen the NHS Constitution.

Readers will recall that amendments were recently made to it in March 2012. The initial version was published in January 2009. From March 2012, the updated constitution and handbook placed an enhanced focus on whistle-blowing as a means of creating a culture of patient safety. Please see our April 2012 Health Legal Update for more information.

The reason for the review of the NHS Constitution is due to the NHS Future Forum making a “powerful case” for raising awareness of the Constitution and for giving it “teeth”.

For now however, the consultation focuses on amendments to ten key areas intended to strengthen the text of the Constitution. It also seeks thoughts about how awareness can be raised.  

In addition, it will be updated to take into account the changes made by the Health and Social Care Act 2012.  

The ten key areas are:  

  • Patient involvement
  • Duty of candour
  • End of life care
  • Integrated care
  • Complaints
  • Patient data
  • Staff rights, responsibilities and commitments
  • Dignity, respect and compassion  

There are 18 specific questions posed in connection with these areas.

A track changed version of the Constitution with the proposed changes can be found at Annex 4. Some of the proposed changes are as follows:  

  • The Constitution currently states that the NHS is open to all irrespective of gender, race, disability, age, sexual orientation and belief. The amendment proposed is to add “gender reassignment and marital or civil partnership”
  • A new duty of candour to apply to all providers of NHS-funded services through contracts with the NHS
  • The Secretary of State is bound to take account of the Constitution in his own decision-making  

Those who saw the press coverage will be alive to the fact that much of the focus ended up being on end of life care. It has been thought that this was inserted due to recent concerns about the Liverpool Care Pathway (see our nugget below). One comment in the Health Service Journal was “knee jerk reaction from a bunch of jerks!” We will leave readers to form their own views!  

This consultation seeks views by 28 January 2013.

An updated Constitution is to be published by 1 April 2013.

There will be further consultation on giving the Constitution greater traction following the publication of the Mid-Staffs Public Inquiry report in 2013. Norman Lamb will be chairing an expert group to develop proposals around this.