(2003), "UK. Audit Commission report on the NHS", International Journal of Health Care Quality Assurance, Vol. 16 No. 6. https://doi.org/10.1108/ijhcqa.2003.06216fab.003Download as .RIS
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UK. Audit Commission report on the NHS
Audit Commission report on the NHS
Keywords: Waiting times, NHS hospitals, NHS modernisation
An Audit Commission report, Achieving the NHS Plan assesses the work done so far by all trusts in England to meet the government's targets. It says that NHS targets and action plans are helping to improve services to patients, but the way these targets are being met means the progress may not continue for the long term.
In the short term the focus on waiting times is beginning to pay off, with patients being able to see a GP within 48 hours, a reduction of outpatient waiting times to 21 weeks and a reduction in waiting times for operations to a maximum of 12 months.
However, there are questions about whether these improvements will last in the long term, given the pressures on the NHS and the way in which some hospitals are achieving the targets. The report says that a number of trusts are finding short-term solutions to keep everyday services going by taking money away from the longer-term modernisation of the NHS, and more than half of trusts in England have been diverting money for specific improvements to keep services running in the short term. Examples include taking money away from IT and medical equipment, making it more difficult to improve areas like cancer care, allowing hospital buildings to deteriorate so maintenance money can be spent on patient care, incurring considerable extra costs by paying private hospitals to carry out NHS work, and making one-off payments to consultants for extra sessions
Accident and emergency waiting times are still a problem for many trusts and few acute trusts had been able to keep A&E waits to target levels.
The Commission welcomes the improvements made in patient care, but would like to see further developments. The next step is to take a more rounded approach to improvement, by looking at services through the eyes of patients. Waiting times, for example, are important to patients, but waiting is only part of the picture.
James Strachan, Audit Commission Chairman said: "The NHS is improving as measured by waiting list targets in the NHS Plan, but while important, waiting lists do not equal the health of the nation. Furthermore, in addition to inaccuracies in the data, the improvements that have been achieved are too often the result of short-term fixes. While setting national standards and developing action plans are powerful tools for improving services, having too many targets risks obscuring where the real priorities lie. It would be better to focus on a few major targets, such as reducing deaths from cancer, and then allow local health services to tailor plans to local needs. A more robust procedure for ranking hospitals is needed, focusing on management and financial capacity as well as patient care. Without this there is a real risk that the value of billions of pounds of new public money earmarked for nascent structures like Foundation trusts will not be maximised."
Commenting on the report, NHS chief executive Sir Nigel Crisp said: "I agree with the commission's comments on the optimism and achievements of the NHS. However, it is a snapshot report and, in most cases, the NHS has moved on.
"The health service is turning the corner, the resources and reform are biting, The NHS Plan is well on track – it is becoming a reality across the country."
Further information: The report, Achieving the NHS Plan, is available on the Audit Commission Web site at www.audit-commission.gov.uk/