The BMA has warned that refreshing the NHS mandate with new policy initiatives every year could make it unachievable. The association said it supports the principles behind the recent update, which include improvements for older people’s care and mental health but is concerned about the “ever-changing goalposts”.

Created as part of the Health and Social Care Act 2012, the mandate sets out the government’s ambitions for the NHS and the funding available for the work, and must be refreshed annually. The updated mandate for 2014/15 includes a plan to develop care for vulnerable older people and those with complex needs.

BMA council chair Mark Porter (pictured) said the NHS mandate provided an “encouraging vision”, but success would depend upon having fewer and more strategic objectives and how that was implemented.

Dr Porter said: “We believe the consistency shown through the mandate is broadly positive and allows NHS England to settle into its role.

“We support the principles behind the vulnerable older people’s plan and improvements in the treatment of mental health, although much work is needed if we are to deliver on those objectives. We are concerned, however, that refreshing the mandate so quickly and adding a new set of priorities could make it difficult to achieve against the original objectives and creates ever-changing goalposts for staff.

“Adding a raft of recent policy initiatives to it each year means it will quickly become unachievable.”

Health secretary Jeremy Hunt has said that the changes had been kept to an “essential minimum” to ensure the refreshed mandate remained strategic, outcomes-focused and affordable.

Parity for mental health

Chair of NHS England Sir Malcolm Grant welcomed the mandate and said his organisation shared the ambition of putting mental health on a par with physical health.

“Our vision is for a real change in attitude towards mental health and the way services are delivered, so people experience a holistic approach to their care,” he said.

“We also fully support and continue to work with the Department of Health in finalising proposals for the vulnerable older people’s plan.”

Chief executive of the Mental Health Foundation Jenny Edwards welcomed a commitment to develop waiting times for talking therapies.

“For too long, people have been waiting months to access psychological therapies on the NHS,” said Ms Edwards. “We also welcome the government’s renewed focus on parity of esteem and look forward to seeing how this parity will translate into practice.”

The Alzheimer’s Society said it was good that diagnosing dementia was now ‘hard-wired’ into the NHS and that there was an aim to provide appropriate post-diagnosis support.