Hospitals and family doctors are to be fined or financially rewarded based on what patients think of the quality of their care, according to a fundamental review of the NHS in England.

For the first time, patients’ opinions of the results of their treatment, and whether they were cared for with dignity and compassion, will have a direct impact on the income of NHS organisations, Lord Darzi of Denham, the Health Minister, said.

Publishing the findings of a 12-month review of NHS services yesterday, Lord Darzi said that doctors and patients would have a greater say over the performance of the health service.

The report was released alongside a landmark NHS constitution, which is set to grant patients a legal right to choose where they are treated and to receive approved medicines “where clinically appropriate”.

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The report envisages an NHS aspiring ever upwards to unimagined levels of quality. Life isn’t like that

Nigel Hawkes

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Ministers hope to avoid a flood of legal challenges with £100 million to fund extra prescriptions.

Information on service quality would be displayed on “dashboard” monitor screens in hospitals, GP surgeries and on the internet. The ten-year plan also proposes changing the way GPs are funded to make it easier for patients to switch practices.

After years of record investment in the health service and a number of targets designed to reduce waiting times, Lord Darzi said, the infra-structure of the NHS was now in place to make quality the benchmark of patient care.

He promised an end to centralised targets and more focus on improving quality through financial incentives and collecting data on outcomes, for example, on how patients fared after orthopaedic and cataract operations.

Lord Darzi, an eminent surgeon, was made a minister by Gordon Brown last year, with a brief to reform the health service in its 60th year. The 84-page review, he says, is the culmination of a process that has considered the opinions of 60,000 people and 2,000 medical experts.

It avoids making specific claims about expected changes to local health services, such as the introduction of 150 new “GP-led health centres” or the consolidation of hospital units, which some critics fear will lead to the loss of vital local services.

Instead, Lord Darzi said that his report, High Quality Care for All, was designed to “enable” the local changes already proposed by the ten regional NHS strategic health authorities in documents published in the past two months.

His final proposals include “making funding for hospitals that treat NHS patients reflect the quality of care that patients receive”.

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