13 February 2004
The government has cleared the way for the abandonment of controversial NHS targets and the reform of the star ratings system.
The current targets, such as those for waiting times (which are used in part to calculate star ratings), have been criticised for placing too much emphasis on the number of patients being treated rather than how well they are treated. Some trusts have been awarded zero or one star when they have an excellent treatment record.
Health Secretary John Reid said this week that from 2005 performance assessments would pay more attention to the quality of care. Over the next 12 weeks, the Department of Health will consult over a new system of 24 core standards and ten developmental or aspirational standards.
For now, many of the current targets will be retained – including waiting times to fall to three months by 2008, as well as better outcomes in diseases such as cancer by 2010. However, Reid hopes these will become irrelevant before then.
He believes the government's 'patient power' reforms, such as Patient Choice, will make NHS organisations improve their access times and outcomes. If they do not, they will lose income as patients will opt for those that have.
'In four years' time, the natural and beneficial consequence of a reformed NHS – driven by patient preference, where money follows the patient and power is devolved to frontline staff – will be the need for fewer targets,' he said.
The consultation document promises that the Commission for Healthcare Audit and Inspection, which will begin work in April, will use a redesigned performance ratings system incorporating the new standards.
Chai's chair, Sir Ian Kennedy, is reported to be unhappy with the current star ratings system, although the government would be reluctant to scrap an easily understood assessment of trusts' performance.
British Medical Association chair James Johnson welcomed the consultation. 'We hope the standards will not lead to yet another set of hoops for managers to jump through. Any new performance measures must be robust, transparent and meaningful,' he said.
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