Health Policy

28.11.12

King’s Fund assesses Coalition NHS policy

The NHS is improving in a number of areas, but recent reforms are only resulting in gradual change from the old system, a new report suggests.

The King’s Fund has published an assessment of Coalition health policy, highlighting financial pressure, rising waiting times at A&E, the loss of experienced managers and major organisational changes as areas for improvement.

The report suggests the shift from targets and performance management under the last government has been gradual, with much of the previous system still in place.

Consistent improvements from 2010 include a fall in healthcare acquired infection rates, with MRSA down by 42% and C Difficile down by 55%. The number of breaches on mixed sex wards also fell by over 96% and over £10bn planned efficiency savings have been delivered through QIPP.

However, A&E waiting times have risen since the end of 2009 and 12 acute of ambulance trusts are performing below par in terms of finance. 15 FTs finished 2011/12 in deficit and there has been a rise in emergency admissions for patients with long-term conditions and emergency bed days for the over 65s.

Anna Dixon, director of policy at The King’s Fund, said: “The NHS is continuing to perform well but there are treacherous waters ahead. There are huge risks, particularly in ensuring that quality of care does not suffer with the further financial squeeze. The stakes for patients could not be higher, and frontline leaders will have a crucial role to play in meeting the challenges ahead.

“Neither competition nor commissioning reform alone can be relied on to make the improvements needed. Fundamental change will be required to address the challenges of the future as the population ages and health needs change.”

Mike Farrar, NHS Confederation chief executive, called the assessment a “fair and reasonable report card on the NHS’s performance.”

He said: “We need to do much more to make sure that every patient receives dignified care every time, and maintain a strong focus on reducing emergency admissions and avoidable mortality. We cannot afford to let standards slip in these important areas.

“A growing number of organisations are finding themselves being pushed towards a cliff edge and tough decisions need to be taken if they are to recover their financial footing and deliver better care.”

RCN chief executive & general secretary, Dr Peter Carter, said: “This report makes a lot of important points about the dangers facing the NHS in the coming years, and supports many of our own warnings. We agree that there is a real risk of financial control being maintained at the expense of quality patient care. There is already evidence that patient care is deteriorating as a result of cuts to staffing levels, and this trend needs to be stopped before it is too late. 

“To achieve this, we need bold leadership to reshape how services are organised and clear reinvestment of the efficiency savings currently being made in England.”

The report is at: www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/health-policy-under-the-coalition-government-kingsfund-nov2012.pdf

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