Issue 8: pay linked to quality; e-records; Darzi’s 5 principles; NHS performance regime
Fewer deaths could mean more pay for consultants
Source: HSJ, 5th June 2008
Hospital consultants’ pay could be linked to outcomes such as the number of patients who die in their care, the NHS medical director has signalled.
This is a good sign. Measuring the outputs of care, such as re-admission and 30 day survival rates for secondary care and Patient-Reported Outcome Measures (PROMs) for elective and chronic procedures, is a step towards improving quality. It’s heartening that this comes from the medical side of the NHS, and not its managerial side, as it indicates that doctors want it.
The first set of outcome data is due to be published on NHS Choices in September. By April next year, acute trusts will begin collecting PROMs for certain elective procedures. Slowly but surely, we believe such data will shape service delivery – people will vote with their feet and the best centres for care will flourish. In this respect, the UK stands to be way ahead of many other nations in the transparency of their health service.
Fujitsu IT deal for e-records abandoned
Source: HSJ; 5th June 2008
The NHS’ troubled IT programme has been dealt a further blow after negotiations with a key supplier broke down. An £896m, 10-year contract with Fujitsu Services to install new electronic records systems across south and south west England will be terminated.
The NHS’ £13bn IT programme is 4 years behind schedule and is limping in its attempts to install an electronic records system.
Meanwhile, in the US Microsoft’s Healthvault and a healthcare insurer have an alternative solution – a user application for controlling your own health records…
Kaiser and Microsoft to offer consumer controlled health records
Source: medicalnewstoday.com; 12th June 2008
America’s largest managed care organization, Kaiser Permanente, is teaming up with computer technology giant Microsoft to pilot a consumer controlled personal health record service to 156,000 Kaiser employees, which if successful, will then roll out to 8.7 million members in nine states and the District of Columbia.
Darzi review: fine words. Now let’s see the action
Source: NHS Alliance, 9th June 2008
A welcome breath of fresh air seems to be wafting through the NHS. Health Minister Lord Darzi’s latest announcement from the Next Stage Review: Leading Local Change, talks about five principles that everyone should be able to support.
Darzi’s five principles relate to changes, namely, that they should:
- always benefits the patient;
- be based on good clinical evidence;
- be led locally instead of imposing national solutions;
- depend on the involvement of patients, the public and other key partners;
- and that existing services should not be withdrawn until the new service has proved itself
If this turns into action, it will redress the lack of influence that clinicians and patients currently have. But that last point is tricky - it implies that a provider would be running the old and new service in parallel, potentially with duplicate costs. If you have a comfy budget, it shouldn’t be a problem but if you don’t, you’re less likely to innovate. That is a shame because it’s exactly those surplus-strapped providers that need to change the most.
Credo comment
The DoH’s report published in early June aims to set out a “systematic and transparent approach to managing performance across the NHS”. It has three goals: identifying underperformance; supporting recovery; and managing failure. The tone is tough: we’ll bring in external reinforcements if you’re struggling; but if you’re failing you’ll be outsourced, taken over or shut down. There is also opportunity here for the best PCTs and trusts to takeover underperforming peers. We hope the regime has teeth. Here are our take-aways.
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