Government to keep NHS on tight leash
The NHS will be expected to cut the mortality rate for cancer, reduce infection rates and improve the employment rate of people suffering from mental illness, under a tough new framework of national outcome measures published by the Government today.
The NHS Outcomes Framework sets out five "domains" in which the NHS is expected to deliver improved outcomes for patients: preventing people from dying prematurely, enhancing quality of life for people with long-term conditions, helping people to recover from episodes of ill-health or following injury, ensuring that people have a positive experience of care and treating and caring for people in a safe environment and protecting them from avoidable harm.
Within each domain is a number of indicators against which the Secretary of State for Health will track progress, as well as "improvement areas" where NHS managers will be expected to focus attention.
The Government has consistently emphasised that it wants to move away from "targets which get in the way of patient care", with a focus on outcomes for patients rather than process-driven targets such as maximum waiting times. However, the document suggests the Government intends to keep a tight leash on the NHS, expecting it to deliver better outcomes without significant increases in funding and during a period of structural upheaval.
In addition to meeting the outcomes staff will be required to pay attention to 150 "Quality Standards" drafted by the National Institute for Health and Clinical Excellence.
Overseeing the delivery of the outcomes will be an NHS Commissioning Board. It will be established in "shadow form" in April 2011 before its formal creation in April 2012, depending on whether Parliament approves it.
Acting NHS Confederation chief executive Nigel Edwards said: "While, overall, targets have helped improve our health services, there is little doubt that the next step forward has to be a focus on outcomes. They have genuine potential to deliver better care for patients.
"At the same time, it is worth pointing out that targets are not dead. Measuring outcomes is extremely difficult and in especially complex cases a process target might be the only way of ensuring a treatment is being performed properly.
"It can take some time for improvements in care to show up through improved outcomes. There will therefore need to be some flexibility over how and when those delivering health services are paid for the outcomes they achieve."
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