Theoverallresult ofthesefactors isamajorimpetusforchange;thischange is
already proceeding at a fast rate and is gaining momentum.
5.1 The Government`s health policy agenda
Conceptsunderpinningpracticeinnursingandhealthcarecomeandgoastimes,
and governments, changeand as new opportunities and challenges arise. Nurses
andothersintheNHSnowhaveanewhealthpolicyconcepttounderstand,work
with and to apply ± patient empowerment. This concept sits alongside those
mentioned above and, as we will see, it has important legal implications.
5.1.1 Patient empowerment
The concept of patient empowerment is built into the central government's new
healthservicepolicyagenda,theNHSNationalPlan[1]andtheHealthandSocial
Care Act 2001. It can be regarded as the key NHS buzz phrase and has quickly
becomethemaindriverofchangeintoday'sNHS.Theconceptisessentiallylinked
to health litigation and nursing law and ethics, and the agenda ± of patient cent-
redness ± that it embodies is explored in other chapters of the book but can be
summarised here: the NHS, according to the NHS National Plan, exists for the
benefitofpatients,andtheirinterestsaretoberegardedasparamount.Thepatient
istherecognisedweakerpartyinthecareequationbutnowmovestotakecentre
stage.
Wherehealthpolicyisbeingdeveloped,forexampleinrelationtoclinicalriskor
litigationmanagement,itcannowbearguedthatinkeepingwiththespiritofthe
plan, patients' interests should weigh more heavily in the policy making process
and in the balancing of competing interests. Also patients have under the Plan
more formal mechanisms to make their voices heard in the NHS.
InitiativeshavecomeintoeffectundertheNHSPlanandtheNHSActtoputthe
patientempowermentconceptfullyintoplace.Forexample,consenttotreatment
practices have been reviewed with a newReference Guide to Consent for Examina-
tion orTreatmentproducedbytheDepartmentofHealthinJune2001.NewPatient
Forums are to be established in every NHS Trust and Primary Care Trust, to
provide direct input from patients into how local NHS services are run. Further
changes to the clinical negligence system are also mooted as a possibility in the
NHSPlan.Asthequalityofhealthcarerises,sodopatientexpectations.TheNHS
National Plan should help ensure that patients are alert to their rights and to the
dutiesofnursesandothers.Thisbookhopefullyshedslightonwheretheserights
and duties lie in the context of the forever developing NHS and the law.
5.1.2 New organisations for new needs
Anumber of new organisations have been set up to achieve the Government's
goals of NHS care quality improvement and litigation management; these are
introducedinthischapterandsomeofthemarefurtherdiscussedinsubsequent
chapters. They are: NICE .National Institute of Clinical Excellence), CHI
The Policy Dimension: the Legal Environment of the New NHS 61