Headlines: November 18th, 1998

Health Secretary Frank Dobson has given fresh details on the arrangements for tightening up on clinical standards.He told a clinical audit conference in Harrogate the aim was to prevent tragedies like the one at Bristol, rather than apportion blame afterwards.

He said for far too long the NHS had been concerned with finance and management machinery, and neglected any proper way of setting clinical standards, monitoring them and spreading best practice.

The two major benchmarking mechanisms being created are National Service Frameworks, which will set out ‘service blueprints’ for the major conditions, and NICE, the National Institute for Clinical Excellence, which will draw up clinical guidelines on a far wider range of treatments and conditions.

In future, all hospital doctors will be measured against these in a national external audit programme.

Mr Dobson said: “In many specialties these national audits are already up and running. The key now is to ensure that all doctors – not just the enthusiastic innovators – are participating in them. Without that it will be impossible for other doctors to compare their results nationally, and it will be impossible to assure patients that all parts of the NHS are up to scratch.

A new Commission for Health Improvement will visit every NHS Trust at least every three to four years. It will have access to the data from national audits and have statutory powers to investigate concerns about clinical quality and to report on trusts’ and PCGs’ clinical governance processes.