Current Issues in the Health and Social Care Field - National Service Frameworks

The NSFs launched so far include:

• Cancer NSF (1998)
• Paediatric Intensive Care NSF (1998)
• Mental Health NSF (1999)
• Coronary Heart Disease NSF (2000)
• Older People NSF (2001)

There are currently NSFs in preparation for:

• Diabetes
• Renal Services
• Children’s Services
• Long Term Conditions, focusing on Neurological Conditions.

Before the NSFs were introduced there was huge geographical variation in the standard of health care; this was often known as the “postcode lottery”.  The standard of care a person received depended on where they lived; while some areas provided a high standard of service, others provided minimal, and poor quality, care.  The NSFs were designed to bring health care in all areas to an acceptable National Standard.  They aimed to root-out and put a stop to discrimination, provide person-centred care, offer fair and prompt access to services and be appropriate to people’s needs.  They also intend to respond to the experience and concerns of service users, use resources efficiently to achieve the greatest possible benefits and promote peoples’ health and independence

Under the NSFs, services are assessed against a benchmark.  A department that is performing highly sets a milestone, and all others are cross-referenced and marked against it.  Through this, a set of minimum standards is established.

The NSFs are monitored through a new Commission for Health Improvement, an NHS Performance Assessment Framework and a new national survey of patient and user experience.

For many people the NSFs have changed the way they use health care services.  Like all things, NSFs have pros and cons.  Almost all people agree that they were a necessity, and that they