Plans to scrap some centrally driven targets and proposals for giving doctors and nurses control of their budgets were recently announced by Health Minister Lord Darzi.
The new proposals are part of Lord Darzi’s one year on report High Quality Care for All: Our Journey so Far which shows the progress the NHS has made on delivering high quality care to patients, since his review of the NHS was published in June last year. The report claims that major improvements have been delivered by the NHS over the last year, with millions of long-term conditions diagnosed and patients now having personalised care plans. Over 75% of GP surgeries now open for longer hours and there are 50 new GP led health centres and more GP surgeries opening in under-doctored areas. The NHS has met targets to dramatically reduce C. difficile and MRSA infections and has ensured that no one now waits more than 18 weeks from referral to treatment. The next steps will be to drive up quality even further and free up clinicians’ time to do this. Areas targeted will include:
• Clinician budget ownership: The DH will look at giving doctors and nurses in hospitals ownership of their budget to promote entrepreneurship and innovative delivery of services built around the needs of the patient.
• Refining of targets based on evidence: The DH intends to free up front line staff so they can focus on delivering high quality care and reducing costs. It will remove the obsolete 13-week outpatient and 26 week inpatient performance targets, as well as reviewing data collection across the board, in order to reduce the burden on front line staff.
• Peer review accreditation system: The DH will create a new voluntary peer review system in which clinicians will judge the standard of their peers in order to drive up quality and achieve a “gold standard” of care. The system will be developed through close collaboration and consultation with the relevant partners and stakeholders.
• Promoting the health and wellbeing of staff.
Health Secretary Andy Burnham said: “Ara Darzi set out a vision for an NHS with quality at its centre. We have made great progress on delivering this vision but it will be innovation, productivity and prevention that will drive the next stage in creating a people-centred NHS. “When I came into this job, I said we should ‘deep clean’ the target regime so that it achieves what we all want: better patient care and more staff satisfaction. So to show we mean business, we will remove the 13 and 26 week inpatient performance targets which will reduce the burden on front line staff, freeing them up to focus on delivering high quality care for all.” Responding to the publication of Lord Darzi’s report, Dr Peter Carter, chief executive and general secretary of the Royal College of Nursing (RCN), said: “Nurses have always strived to deliver quality care and welcomed Lord Darzi’s vision for how clinical staff could achieve this. It has been a significant achievement that since the publication of the NHS review a year ago, everybody is talking about how quality of patient care should take centre stage in the NHS. However, in the tough economic climate we must not take our eye off the ball and let the focus on quality slip. If we are to make quality a reality rather than an aspiration, it is vital that nurses are empowered and given the right level of support. “We have always said clinical leadership is key to driving up patient care and welcome the news that nurses are set to have greater control over budgets. Their front line perspective means nurses know where money should be spent to achieve the best care for patients. However, adequate support and training for these professionals is needed, particularly while the threat of public spending cuts looms.”
