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Practices will be forced to offer e-consultations by 2015

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By 2015, patients must have the option to book general practice appointments online and to communicate with health staff via 'e-consultations' under plans detailed in the NHS Mandate.

Unveiling his strategic direction to the NHS Commissioning Board (NHSCB) last week, health secretary Jeremy Hunt set out what patients in the UK can expect from GPs, hospitals and community services.The NHSCB will be tasked with delivering the outcomes by 2015 and will be given £95 million to do so.

While pledging to allow health professionals to be more 'operationally independent', Mr Hunt said: 'We need to embrace a technological revolution to address the lack of consistency in the quality of care. Technology will free up time at GP surgeries.'

The mandate is structured around five key areas in which the government expects the NHSCB to make improvements: preventing people from dying prematurely; enhancing quality of life for those with long-term conditions; speeding up recovery for those with ill health or injury; ensuring people have a positive experience of care; and treating people in safe environments, protecting them from avoidable harm

Core objectives include improving standards of care and not just treatment, especially for the elderly and vulnerable and better diagnosis, treatment and care for people with dementia. Pregnant women will have a named midwife responsible for their care.

Success will be measured by outcomes and patient feedback rather than process-driven targets. By 2015, 'everyone should be able to find out how well their local NHS is providing the care they need,' due to greater transparency.

Sir David Nicholson, chief executive of the NHS Commissioning Board said: 'The NHS Mandate is the most radical document in the history of the NHS. It has an obsession with improvement for patients - and this is more radical than the structural changes. It is an ambitious document, but is easy to do.'

RCN chief executive and general secretary Dr Peter Carter welcomed the mandate, but warned: 'It is important that it does not add to the burden of paperwork and administration which takes nurses, doctors, and other clinical staff away from direct patient care.'

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