Headlines: December 12th, 2006



Staff working in the National Health Service at local level are to play a bigger role in deciding health and healthcare improvement targets under proposals in the operating framework for 2007-08. Local councils will also be involved in part of this process according to the Framework, which has been announced by the NHS Chief Executive David Nicholson and which sets out priorities for service over the next year and his expectations for progress on reform and improvement.

The main priorities in the document are that there should be more progress towards the 18-week maximum wait after patients are referred for treatment by their GPs with new milestones being set to achieve this. These will be set for Primary Care Trusts and other providers so that by March 2008, 85 per cent of patients who are admitted to hospital and 90 per cent of those who do not need to be admitted will be treated within the 18-week limit. Contracts mean that where NHS providers underachieve on this, PCTs will make smaller payments.

David Nicholson also sets out the need for the continued reduction of hospital acquired infections, including a new drive on Clostridium difficile. Targets in this area will be agreed and delivered locally. The framework makes clear that faster progress has to be made to reduce cases of MRSA infection and to step up the fight against other hospital acquired infections and it also says local targets should be agreed between PCTs and providers.

Targets will also be agreed locally on reducing health inequalities and promoting health and well-being with PCTs being required to set priorities with local authorities to address the issues that need the most urgent attention. The other main priority is to achieve financial strength and to deliver a net surplus of 250 million pounds across the NHS by the end of 2007-08. Mr. Nicholson and Health Ministers say they are confident the service is turning the corner and will return to overall balance by the end of the present financial year.

David Nicholson said the framework did not include any new national priorities for the service but there would be no let up in the pace of implementation. “Ultimately my ambition is to create an environment whereby the health care reforms, local organisations and patients create an inbuilt dynamic for continual service improvement, no longer requiring traditional top down performance management as we know it,” he said.

With the new local target on Clostridium difficile, the Health Secretary, Patricia Hewitt, announced that 300,000 pounds would be made available to all acute trusts to tackle healthcare associated infections this year. The money can be used for ward level improvements to tackle infection such as toilet refurbishment or work in older wards to provide more single rooms. Trusts who want to access the money will have to submit applications by January 12th.