Case study

Department of Health

Supporting the development and implementation of Patient Choice policy

The introduction of choice of hospital for elective care patients in the National Health Service (NHS) is arguably the largest cultural change programme faced by the NHS in the last 50 years. The initial phase was the introduction of ‘Choice at six months’ – giving patients who were due to wait more than six months for treatment a choice of an alternative hospital.

For the policy to be successfully implemented, and for key stakeholders to have confidence in the policy, substantial risks had to be addressed, such as:

• Forecasting risk – the NHS needed to develop new demand modelling skills to produce robust forecasts of the patients expected to take up choice
• Eligibility risk – new processes and systems were needed to identify all the patients eligible, clinically assess them, and contact them.

PA managed these risks by complementing the Department of Health’s (DH’s) internal policy expertise with strategic planning, modelling and programme delivery expertise. PA's contribution to the successful launch of the programme included producing a strategy, plan and guidance for delivery by the NHS. Implementation plans were then assessed to assure that delivery risks were being mitigated. PA's modelling and analysis expertise were also used to ensure that the changes were both affordable and deliverable.

The policy has been successfully launched and, to date, the risks have been effectively managed, enabling the policy to operate effectively. The policy has also been effective in driving the NHS to reduce waiting times as rapidly as possible – providing significant additional progress towards the key NHS target of reducing inpatient waits below six months by December 2005.