Headlines: June 12th, 2008

Reforms of the National Health Service have led to improvements in its management but significant benefits for patients will take longer to deliver, according to the Audit Commission and the Healthcare Commission. They have today jointly published “Is the treatment working? progress with the NHS system reform programme”.

It looks at the market-style reforms of the NHS, set out first in 2000 and designed to improve efficiency. The key elements covered in the report are giving patients more choice, greater use of the independent sector, the creation of foundation trusts, practice-based commissioning and payment by results. The Commissions have also considered the impact of contract changes for NHS staff.

Some of the reforms, the report says, are beginning to work, particularly those for encouraging improved financial management and a more business-like approach to providing care, through payment by results and setting up foundation trusts. It also finds that competition, or the possibility of competition, in care provision has led to improved services in some areas. It concludes that general standards are improving across the service.

Today’s report shows, however, that changes most noticeable to patients, such as choice, need more time to deliver significant results. There has been limited progress moving care out of hospitals and closer to patients’ homes. It found evidence that patient choice can work but, to drive improvement, the choices offered need to be realistic and supported by more timely and accurate information than what is provided
at the moment.

Michael O’Higgins, the Chairman of the Audit Commission, said, “We don’t under-estimate the scale of the challenge of reforming the NHS. It employs four times more people than Tesco and is a much more complex organisation, so it will take time to deliver such major changes. But given the massive investment in the NHS in recent years, taxpayers and patients rightly expect that their money is spent as efficiently as possible and that services are improving. The NHS must keep the pressure on to make these reforms work for patients.”