‘Too many’ NHS targets
A report by the Audit Commission has claimed that many NHS Trusts are diverting money away from future projects in favour of quick fixes.
The independent report found that whilst the NHS is making progress in achieving progress in patient waiting times, other targets are likely to be missed.
The Audit Commission warned that there are too many ‘piecemeal’ targets which distort the clinical priorities of the NHS. The Commission expressed concern that the reallocation of money in the NHS away from investing in the future would mean that the improvements in the NHS would be unsustainable.
James Strachan, the chairman of the Commission, commented, ‘There are too many piecemeal targets and the pressure put on waiting-time targets has led to a tremendous amount of distortion of the system. Having too many targets risks obscuring where the real priorities lie.’
The Commission called for fewer targets which are based on the treatment patients receive rather than on waiting times. The report called for NHS managers and medical staff to be allowed to decide how best to achieve improvements in service to their patients.
Conservative Shadow Health Secretary, Dr Liam Fox argued that the Government should be ‘alarmed’ by the Commission’s findings.
Dr Liam Fox stated, ‘Ministers should be alarmed when an organisation as reputable as the Audit Commission says: ‘There is a lot to be done, both nationally and locally, to make the improvements sustainable and permanent.’
‘Ministers must now surely tackle such problems as care for the mentally ill and the elderly, the widespread damage caused by the obsession with targets and the financial crisis gripping organisations throughout the NHS.’
However, Sir Nigel Crisp, chief executive of the NHS disagreed with the report and argued that the NHS had moved on since.
Sir Nigel added, `This Audit Commission report provides another external commentary on achievements in the health service. I agree with its comments on the optimism and achievements of the NHS. However, it is a snap shot report and in most cases the NHS has moved on. The health service is turning the corner. The resources and reform are biting. The NHS Plan is well on track. It is becoming a reality across the country.’
Dr Gill Morgan, Chief Executive of the NHS Confederation, which represents NHS managers, stated, ‘We believe that many of the targets have helped to concentrate efforts and that genuine improvements have been delivered as a result. But we do need a new approach to setting and measuring targets to ensure we encourage real innovation and a focus on long term sustainable change.’
The Commission’s report also highlighted concerns with the Government’s star rating system for hospitals. The report pointed out that some hospitals that had been given a zero rating had strong management and good finances whilst many three-star rated hospitals had poor finances and weak management.
Mr Strachan added, ‘A more robust procedure for ranking hospitals is needed, focusing on management and financial capacity as well as patient care. Without this there is a real risk that the value of billions of pounds of new public money earmarked for nascent structures like foundation trusts will not be maximised.’
