Headlines: July 26th, 2002

Health Secretary Alan Milburn has praised the NHS for raising standards in the past year. The latest performance assessment shows that 68 of the 304 trusts received the highest three star rating. Within acute trusts, 46 were awarded three stars, 77 got two stars and 35 received one star. The tables show that standards improved in 47 trusts compared with last year but deteriorated in 36. 10 trusts received no stars at all. All trusts were assessed on a variety of targets, including patient waiting times, deaths after surgery, cleanliness and finances.Trusts with the highest rating will be given more freedom and those with no stars will have three months to show signs of improvement or face being franchised out to a new team of managers from elsewhere in the NHS, or the private or independent sectors. Trusts where managers have already been replaced or franchised out will be given 12 months to turn their services around.

The value of the assessments and the reliability of the figures have been questioned and there has also been criticism about the effect the results are having on people in the health service. The Institute of Healthcare Management expressed reservations about damning whole multi-million pound organisations from a snap shot of indicators. The NHS Confederation, which represents health service managers, believes that more robust and reliable data is needed if an accurate picture of the NHS is to be provided. The Royal College of Nursing warned that the ratings could do more damage than good with an adverse effect on morale. The British Medical Association shares the government’s desire to improve services for patients and speed up access, but it believes that the flood of new targets, initiatives and performance measures is destabilising the NHS and creating “a pressure cooker atmosphere” in hospitals.