The Healthcare Commission (HCC) will be replaced by the new Care Quality Commission (CQC) from 1 April 2009.
In the final State of Healthcare report for 2008, Professor Sir Ian Kennedy, Chair of the HCC, believes that the Commission has painted a ‘richer picture’ of NHS performance than has existed in this past. This, he says, “has led boards of trusts to concentrate ever more intensively on what matters.” Indeed, his parting words of wisdom for the NHS appears to be the old maxim “what gets measured gets done.”
According to the HCC, the NHS must now focus on enhancing the quality of care by doing more to measure outcomes for patients, the experience of patients, and the journey people make through the system of care.
Sir Ian Kennedy said: “It is crystal clear that there have been major improvements in the care provided by the NHS over the past five years.
“We have seen more money going in, more staff providing services and more patients being treated. People are getting care much more quickly than they used to, notably for cancer. NHS trusts have, for the first time, a clear understanding of the core standards of service that they should be providing. We are seeing signs of real progress in driving down rates of healthcare-associated infection. People are living longer and there have been some remarkable reductions in premature deaths from the major killer diseases.
“But there are a small number of trusts trapped at a level of performance that is unacceptably poor. It’s also clear that, while patients overall indicate high levels of satisfaction with care, the NHS is still playing catch up when it comes to consistently providing the patient-centred care that people rightly demand. This is particularly true for those least able to make themselves heard when it comes to getting the best care, such as older people, children and those with mental health needs or learning disabilities. There have been some real improvements in mental healthcare but significantly more remains to be done to support people, especially young people, in the community.”
He added: “We have made the safety of care our highest priority. Safe care is the first building block of good quality care. It’s clear that safety is higher on the agenda than ever, but we are also a long way from an NHS that hungrily and systematically examines its own performance, gathers in and learns from mistakes, reinforces good practice, and does things differently for the future.
“The Healthcare Commission is four years into what was planned as a long-term project. The improvements so far are clear but the pace of change has varied. It is very important that the momentum be maintained.”
Key points from the report include:
- The NHS has benefited from major increases in funding and now has more resources than at any time in its history
- Demand for care has also risen dramatically
- The health of the nation is improving
- There have been sustained improvements in meeting the government’s standards and targets, with dramatic improvement in waiting times
- There is a small number of trusts trapped at a level of performance that is unacceptably poor
- Services are still not always as patient-centred as they should be and there are groups of patients whose needs are still not sufficiently well served
- The safety of care is higher up the NHS agenda but trusts are still not doing enough to monitor and learn from incidents and ensure good practice is followed
- Commissioning must improve, as must measurement of patient outcomes, the experience of patients, and the journey people make through the system of care.
In relation to the safety of care, Sir Ian said Sir Ian said the issue of patient safety had risen up the Government’s and the NHS’s agendas. “But in my view the NHS is really only just out of the starting blocks,” he said. “There’s a great deal to do before we can be confident that the care patients receive is as safe as it reasonably can be.
“We are a long way from an NHS which systematically and hungrily examines its performance, reinforces safe practice, gets in and learns from things that go wrong and does things differently and more safely as a consequence.”
Download the HCC’s State of Healthcare 2008 report here.
