The Healthcare Commission is the independent watchdog for England. Its function is to assess and report on the quality and safety of services provide by the NHS and independent sector. This is the fifth and final annual 'State of Healthcare Report', as the Commission is to be replaced by the Care Quality Commission on 1 April 2009. The report is mainly about the findings for the financial year 2007-08, but it also reflects on the progress that has been made in healthcare over the past five years. The report presents six pictures of the state of healthcare: for mothers; for children and young people; for people with mental health needs; for people with a learning disability; for people needing urgent and hospital care; and of the support offered to enhance people's health and wellbeing in the community. The Commission highlights improvements, with better use and management of resources in the NHS, falling death rates from cancer and heart disease, progress in public health matters such as smoking, a greater attention to safety. Concerns remain, however: a variable picture of quality in maternity services, mental health services and urgent care; commissioning of healthcare; meeting the needs of the more vulnerable in society; children's services; care for older people. Further improvement is needed to ensure that patients really are at the centre of care, are able to make meaningful choices, be fully involved in decisions and have the information they need.
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