ct negotiations between purchasing and providing bodies should increasingly take on the form of a dialogue between primary and secondary care clinicians rather than between managers.A major part of the white paper is given to quality inititiatives. A number of new national bodies came into existence from April 1999:Commission for health improvements: aka CHIMP. Government appointed, charged with ensuring that local systems are implemented to 'monitor, assure and improve clinical quality'.National Institute for Clinical Excellence: aka NICE. Body of patient representatives, managers, economists, academics and health professionals giving 'new coherence and prominence to information about clinical and cost-effectiveness'. The aims of NICE are:To speed up the pace at which good-value treatments are used across the NHS To address variations in treatment access based on different interpretations of evidence of benefit To reduce the use of treatments 'outside the range of circumstances in which they are clinically cost-effective' The current vision for NICE is that it will issue 10-15 evidence-based guidelines each year covering all aspects of existing medical and prescribing practice. In addition, NICE will make judgements on 30-50 healthcare interventions each year in order to illustrate their clinical and cost effectiveness. The judgement will grade each intervention as either (A) for clinically cost-effective use in the NHS, (B) for clinical trials only and (C) not for routine use.Health Improvement Programmes: locally produced strategies for improving health and healthcare, drawn up in consultation with hospital and community trusts, patients, primary care groups etc. Must be updated annually, and GPs must ensure that the care they provide - as well as the care they purchase - fits within the overall local plan.NHS Information Authority out of a restructuring of the old NHS Information Management Executive. The Authority will be responsib...
