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Read the full consultation document on GOV.UK

About you

In what capacity are you responding to this survey?
On behalf of an organisation
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Organisations and individuals sharing their views as professionals

What sector do you work in?
Association of doctors and other healthcare professionals
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What is the main area of focus of your work?
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Where does your organisation operate services?
Nationally
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What is the name of your organisation?
Christian Medical Fellowship
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Responding to deterioration

To what extent do you agree or disagree with this proposal?
Agree
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If you have any further views on the proposal, please provide these in up to 250 words, if possible.
A 'pledge' can amount to little more than a good intention. We urge the NHS to see this as a statutory requirement, to be applied within a stated timeframe.
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Health disparities

To what extent do you agree or disagree with this proposal?
Agree
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If you have any further views on the proposal, please provide these in up to 250 words, if possible.
One area of application we would like to bring to your attention concerns the access to good quality palliative care services. Assisting people to die is obviously much cheaper than providing palliative care. A cash-strapped NHS is looking for ways to save money. In countries where assisted dying has been legalised, it has proved impossible to limit its scope to those thought likely to die imminently of an incurable condition and who have capacity to decide. It has proved impossible to build effective safeguards into legislation. It is clear that one of the factors behind the demand for assisted dying is the lack of easily-accessed, high quality palliative care. An estimated 100,000 people in the UK that could benefit from palliative care die without receiving it each year (1) The Worldwide Hospice Palliative Care Alliance has recently called out palliative care as "one of the most inequitable areas of healthcare" and emphasized the need to improve equitable access to palliative care (2). 'Good palliative care available to all who need it is mandated by the UK Heath and Care Act (2020). Good palliative care is put at great risk by introduction of assisted suicide/euthanasia. The quality of end of life care has fallen in countries which introduce assisted dying, and the countries with the best provision do not permit it' (3). We urge the government to improve funding for palliative care services, to work with local authorities and other community services, including hospices, towards the provision of high quality palliative care for all, so that lack of it does not lead to an increase in demand for assisted suicide/euthanasia. 1. https://post.parliament.uk/research-briefings/post-pn-0675/ Accessed 08.05.2024 2. Worldwide Hospice Palliative Care Alliance 2021. Equity in Access to Palliative Care Report 2021. https://www.thewhpca.org/resources-2021/item/equity-in-access-to-palliative-care-report-2021. 3. Aria-Casais, N. (2020) ‘Trends analysis of specialized palliative care services in 51 countries of the WHO European region in the last 14 years’. Palliat Med, 34(8), pp1044-1056, cited in 'Written evidence submitted by Dr Dominic Whitehouse (ADY0350)' https://committees.parliament.uk/writtenevidence/116922/pdf/
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Environmental responsibilities

To what extent do you agree or disagree with this proposal?
Disagree
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If you have any further views on the proposal, please provide these in up to 250 words, if possible.
The question is: 'what will this stated value look like in practice?' Noble aspirations are good, of course, but without some specific commitments, plans, priorities and actions, they remain empty, albeit good, intentions. Vague generalisations such as 'improving resilience and efficiency' only mean something if they are tied to measurable outcomes over a set time period.
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Patient responsibilities

To what extent do you agree or disagree with this proposal?
Agree
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If you have any further views on the proposal, please provide these in up to 250 words, if possible.
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Research

To what extent do you agree or disagree with this proposal?
Agree
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If you have any further views on the proposal, please provide these in up to 250 words, if possible.
We thoroughly agree with the pledge in the additional sentence. It is not immediately clear if the this sentence is 'in addition to' or 'in place of' the previous wording.
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Leadership

To what extent do you agree or disagree with this proposal?
Disagree
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If you have any further views on the proposal, please provide these in up to 250 words, if possible.
Strong and effective leadership, management and governance of NHS organisations certainly plays a part in the delivery of high-quality care, but we are not convinced that they are central.  There is a risk that the current focus on staff rights and NHS pledges to staff could tend towards an increasing sense of staff entitlement and self-interest. The NHS Constitution has rightly had patient-centred care at its heart since its inception.  Kindness, compassion and a desire for 'your-good-at-my-cost' are central to the delivery of high-quality care.  Management that models, encourages, and, where necessary seeks to recover that culture is the way to go. 
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Sex and gender reassignment (page 1 of 3)

To what extent do you agree or disagree with this proposal?
Agree
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If you have any further views on the proposal, please provide these in up to 250 words, if possible.
We welcome the clarity, defining sex as biological sex.
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Sex and gender reassignment (page 2 of 3)

To what extent do you agree or disagree with this proposal?
Disagree
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If you have any further views on the proposal, please provide these in up to 250 words, if possible.
We welcome the attempt to provide sleeping accommodation acceptable to transgender patients. But there is a contradiction built into the language. The characteristic of gender reassignment, protected by the 2010 Equality Act, is defined as 'proposing to undergo, undergoing or having undergone' a process to reassign sex. The NHS Constitution uses 'sex' to refer to biological sex which by definition is immutable - it cannot be 'reassigned.' Gender identity, a comparatively recent term, is used in common parlance to describe something different from biological sex, and not necessarily congruent with it. Whether the notion of gender identity is 'real' and will stand the test of time remains to be seen. Meanwhile, the suggested extension to the pledge serves both to accommodate and perpetuate the confusion..
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Sex and gender reassignment (page 3 of 3)

To what extent do you agree or disagree with this proposal?
Neither agree nor disagree
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If you have any further views on the proposal, please provide these in up to 250 words, if possible.
Again, a worthy aim. We suggest a small change to the wording such that it reads: "You have the right to expect that NHS services will reflect your preferences and meet your needs, including the differing needs of the biological sexes, providing single and separate-sex services where it is a proportionate means of achieving a legitimate aim" i.e. re-siting the word 'biological.'
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Technical changes to reflect the Equality Act 2010

To what extent do you agree or disagree with this proposal?
Agree
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If you have any further views on the proposal, please provide these in up to 250 words, if possible.
We welcome the change from 'gender' to 'sex' (biological) as it will helpfully reduce confusion. Within the Equality Act, we would prefer a change from 'religion or belief' to 'religion or other belief' as beliefs may be inspired by religious convictions but may also be based on other, non-religious, convictions. The suggested wording appears to equate religion with belief.'
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Unpaid carers

To what extent do you agree or disagree with this proposal?
Agree
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If you have any further views on the proposal, please provide these in up to 250 words, if possible.
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To what extent do you agree or disagree with this proposal?
Agree
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If you have any further views on the proposal, please provide these in up to 250 words, if possible.
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To what extent do you agree or disagree with this proposal?
Agree
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If you have any further views on the proposal, please provide these in up to 250 words, if possible.
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Volunteers

To what extent do you agree or disagree with this proposal?
Agree
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If you have any further views on the proposal, please provide these in up to 250 words, if possible.
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Health and work

To what extent do you agree or disagree with this proposal?
Agree
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If you have any further views on the proposal, please provide these in up to 250 words, if possible.
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Person-centred care

To what extent do you agree or disagree with this proposal?
Agree
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If you have any further views on the proposal, please provide these in up to 250 words, if possible.
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Other areas

If you have any other comments about the NHS Constitution, please provide these.
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