Pledge to put quality at heart of care

Jul 1 2008 The Journal

THE Government pledged to put quality at the heart of patient care yesterday as Health Minister Lord Darzi set out his vision for the NHS.

His long-awaited report outlined measures to raise standards of care but also to increase choice over how and where patients are treated.

It includes plans to force all hospitals to publish quality accounts of the care they provide in the same way they publish financial accounts.

Patients’ assessments of the care they receive will also be linked to hospital funding, with hospitals offering poor care having their incomes reduced.

In his introduction, Lord Darzi said: “For the first time, patients’ own assessments of the success of their treatment and the quality of their experiences will have a direct impact on the way hospitals are funded.” Many of the details in yesterday’s report have already been announced, including the speeding up of drug appraisals by the National Institute for Health and Clinical Excellence (Nice).

Personal health budgets for people with conditions such as diabetes or multiple sclerosis will also be piloted to give patients greater control over their care.

There is a focus on preventing ill- health, with the creation of a Coalition for Better Health which will initially look at tackling obesity.

The 12-month review involved consultations with 60,000 patients and staff and has been hailed by the Prime Minister as a once-in-a-generation opportunity to make the NHS one of the world’s best systems.

The document, which is open to consultation, includes rights to local NHS services, to seek treatment in the rest of Europe if faced with an undue delay in England, and the right to drugs and treatments recommended by Nice. Other rights include the right to choose a GP practice and the right to express a preference for choosing a particular doctor.

But some areas of the constitution only lay down pledges, including striving to ensure services are provided in a clean and safe environment.

The report said: “We will make payments to hospitals conditional on the quality of care given to patients as well as the volume.”

Lord Darzi said the country was now moving into a decade where patients’ experience will have a significantly higher weighting than it ever has before.

“This is about giving more clout to patients, more say to patients.”

Health Secretary Alan Johnson said the NHS was in much better shape than 10 years ago and welcomed the report.

He added: “These locally-driven, clinically-led plans show how quality of care will be raised right across the country, with doctors and nurses supported to offer big improvements in treatment at the bedside. Quality of life will be improved and more lives saved.”

Dr Mike Knapton, director of prevention and care at the British Heart Foundation (BHF), said: “The BHF welcomes Darzi’s emphasis on improving patient experiences as well as clinical effectiveness throughout the NHS.

“We will watch and see if today’s announcements will make a difference.”

But Shadow Health Secretary Andrew Lansley said: “The complete lack of vision in these proposals means that, sadly, the Government has missed its ‘once-in-a-generation opportunity’ to enact the real reform that our NHS needs.

“Instead of scrapping the targets which distract doctors from delivering the best possible health care, Labour have opted for more of the same.”

Dr Hamish Meldrum, of the BMA, said: “There is much here that could bring about improvement – if it can be delivered.

“That will depend on the details.”

Tory reaction

CONSERVATIVE leader David Cameron yesterday called on ministers to "get out of the way" and allow health professionals to decide how to run the NHS.

Mr Cameron claimed that Lord Darzi’s flagship proposal of a constitution for the NHS was, in fact, a Conservative idea.

And he said that plans for polyclinics to provide GP surgeries and specialist treatment under one roof were no more than the latest fad.

Mr Cameron said: "The NHS has suffered from wave upon wave of top-down Government reorganisations.

"The latest idea, polyclinics – shutting a lot of GP surgeries and imposing polyclinics on communities – is just the latest fad that the NHS does not need.

"It needs the money, and it needs sensible reform which ensures the professionals are making judgments rather than the politicians."