Headlines: April 20th, 2000

The concern about the difference in performance between the best and the worst hospitals has been heightened by a new survey. 112,000 patients who had suffered coronary heart disease and were discharged from hospital in 1998 were asked to complete a 20 page questionnaire. The survey results are based on the 84,300 questionnaires returned by ex patients.The survey found that the better hospitals achieve performance results that are about twice as high as those that perform badly. In the better hospitals, 16% of patients waited for more than 3 months before admission, compared to 53% in others. On arrival at hospital 25% of patients had to wait more than 10 minutes for attention, but this rose to 57% in others. 12% of patients felt they had not been sufficiently involved in decisions about their treatment in the best performing hospitals, but this rose to 27% in those performing badly.

The six Modernisation Action Teams launched last month to develop a National Plan for the NHS will have to come up with a strategy to ensure that the best practice which is evident in the high performing hospitals is transferred to those performing less well. The Commission for Health Improvement which began work on April 1, has a more direct responsibility for raising standards. It is expected to carry out about 100 Ofsted type reviews in the first year. It has sweeping powers and can even recommend that senior managers be sacked.