A report said that homeless people experienced discrimination by family doctors and other health services, and should be involved in monitoring how such services performed.
Source: Sarah Gorton, Elizabeth Manero and Clare Cochrane, Listening to Homeless People: Involving homeless people in evaluating health services, Groundswell UK (020 7737 5500) and Health Link
Links: Report (pdf)
Date: 2004-Dec
The National Health Service Chief Executive published an end-of-year report on NHS performance. The report said that sustained improvement was being delivered across the NHS, with waiting lists falling at record rates, continued falls in the number of premature deaths from the big killer diseases, and increasing patient satisfaction rates for health services.
Source: Chief Executive s Report to the NHS: December 2004, Department of Health (08701 555455)
Links: Report (pdf) | Summary (pdf) | Statistical supplement (pdf) | DH press release | NHS Confed press release | Guardian report
Date: 2004-Dec
The Scottish Executive published a plan for tackling National Health Service waiting times.
Source: Fair to All, Personal to Each: The next steps for NHS Scotland, Scottish Executive, available from Blackwell's Bookshop (0131 622 8283)
Links: Report
Date: 2004-Dec
The Department of Health published its 2004 autumn performance report, showing progress against public service targets.
Source: Autumn Performance Report 2004, Cm 6417, Department of Health, TSO (0870 600 5522)
Links: Report (pdf)
Date: 2004-Dec
A report said that many Muslim women received inappropriate maternity care, putting them and their babies at risk. The most common complaints were about lack of privacy, and being treated by male doctors. Many problems were caused by a lack of understanding about the Muslim faith: but some were due to discrimination.
Source: Nasreen Ali with Helen Burchett, Experiences of Maternity Services: Muslim Women s Perspectives, Maternity Alliance (020 7490 7639)
Links: Report (pdf) | BBC report
Date: 2004-Dec
A think-tank report said that, by 2010, the National Health Service would cost up to 20 billion more than it should for its level of performance. The NHS would deliver a better service, and waiting times targets would be met - but a failure to introduce reform meant that improvements would be bought at a huge and unnecessary cost.
Source: Nick Bosanquet, The NHS in 2010, Reform (020 7799 6699)
Links: Report (pdf)
Date: 2004-Dec
The healthcare regulator began consultation on a new system of performance assessment in the National Health Service in England, with 'health checks' replacing star ratings from 2006. Key proposals were: health checks would be broader than star ratings, covering standards such as safety and the care environment; they would give greater weight to the priorities of patients, the public, and those providing care; inspections would be targeted, focusing on areas of concern; a reduced burden of regulation, by using information gathered by healthcare organizations and other regulators; spot checks, unannounced visits, patient forums and information from local authorities would be used to check the data given.
Source: Assessment for Improvement, Healthcare Commission (020 7448 9200)
Links: Consultation document (pdf) | Healthcare Commission press release | Guardian report
Date: 2004-Nov
The Welsh Assembly government began consultation on a common framework of healthcare standards to support the National Health Service and partner organizations in providing effective, timely and quality services across all healthcare settings.
Source: A Statement of Healthcare Standards: Standards for NHS care and treatment in Wales, Welsh Assembly Government (029 2082 5111)
Links: Consultation document (pdf) | WAG press release
Date: 2004-Nov
A report examined good 'corporate citizenship' in the areas of National Health Service procurement, employment, capital build, travel, and waste management.
Source: Karen Jochelson with Clare Delap and Sally Norwood, Good Corporate Citizenship and the NHS: A regional mapping, Health Development Agency (020 7430 0850)
Links: Report (pdf) | Summary (pdf)
Date: 2004-Nov
The government said that National Health Service efficiency increased by around 0.4 per cent in 2002-03, according to a new experimental measure. Under the new measure, improvements in value for money were calculated as the inverse of unit cost growth, after adjustment for changes in the mix of NHS services provided; input cost inflation; and expenditure on improving NHS quality.
Source: The Experimental NHS Cost Efficiency Growth Measure, Department of Health (08701 555455)
Links: Report (pdf) | Guardian report
Date: 2004-Oct
A new book sought to identify the specific characteristics of organizational cultures that helped or hindered performance in healthcare services.
Source: Russell Mannion, Cultures for Performance in Health Care, Open University Press (01280 823388)
Links: Summary
Date: 2004-Oct
A non-journal article estimated the change in productivity of public expenditure on health using national accounts data from 1995 to 2003, in the context of wider information about health spending, outputs, outcomes and measurement issues. A second article dealt with methodological issues. It was concluded that productivity in the National Health Service had fallen since Labour took power in 1997. The Health Minister reportedly described the approach adopted in the article as 'absurd'.
Source: 'Public service productivity: health', Office for National Statistics (0845 601 3034) | 'Measuring government health services output in the UK national accounts: the new methodology and further analysis', Office for National Statistics | The Guardian, 19 October 2004
Links: Article 1 (pdf) | Article 2 (pdf) | ONS press release (pdf) | Guardian report
Date: 2004-Oct
A report by the statistics watchdog examined proposals for enhancing the capacity of health statistics to support decision-making and the wider user community.
Source: York Health Economics Consortium, Enhancing the Value of Health Statistics: User perspectives, Statistics Commission (020 7273 8008)
Links: Report (pdf) | StatComm press release (pdf)
Date: 2004-Oct
An annual compendium of health statistics showed that health expenditure in the United Kingdom was heading towards average European spending levels, providing more capacity in the National Health Service, and more medicines for the UK public - particularly for the government s key target diseases such as coronary heart disease and diabetes. But it said that it remained unclear whether the government was achieving value for money from its increased expenditure programme: healthcare activity rose only half as much as NHS spending in the period 1999-2003.
Source: Peter Yuen, Compendium of Health Statistics (16th edition), Office of Health Economics (020 7930 9203)
Links: OHE press release | Guardian report
Date: 2004-Sep
An article proposed a way of calculating healthcare output growth in real terms, in the presence of innovation and treatment substitution.
Source: Nicola Mai, 'Measuring health care output in the UK: a diagnosis based approach', Economic Trends, September 2004, Office for National Statistics, TSO (0870 600 5522)
Links: Article (pdf)
Date: 2004-Sep
An audit report criticized the Scottish Executive for failing to demonstrate how increased funding for the National Health Service in Scotland, and changes in service delivery, were benefiting patients.
Source: An Overview of the Performance of the NHS in Scotland, Audit Scotland for Accounts Commission and Auditor General (0131 477 1234)
Links: Report (pdf) | Audit Scotland press release (pdf) | SE press release | BMA press release | Guardian report
Date: 2004-Aug
The government's Delivery Unit for public services was said to have produced a progress report on how individual departments were doing against their performance targets and indicators. The Unit was said to be convinced that the target of ensuring no one waited more than six months for an operation would be met: but it was more anxious about a four-year failure to make progress on test results for children at age 11.
Source: The Guardian, 20 August 2004
Links: Guardian report
Date: 2004-Aug
An article argued that structural problems in health and social care services, such as racism and discrimination, were a form of institutional abuse of carers and those who received care.
Source: Liz Forbat, 'The care and abuse of minoritized ethnic groups: the role of statutory services', Critical Social Policy, Volume 24 Issue 3
Links: Abstract
Date: 2004-Aug
A think-tank report said there was a risk that billions of pounds would be wasted on information technology projects for the National Health Service, including those covering online appointments with family doctors, and electronic patient records. It said that the way the schemes were planned and evaluated should be improved in order to gain public confidence that money was being well spent.
Source: Jamie Bend, Public Value in e-Health, Institute for Public Policy Research, available from Central Books (0845 458 9911)
Links: Report (pdf) | Guardian report
Date: 2004-Jul
An article said that hospital inspection scores might be a better measure of performance than star ratings. Researchers analysed whether there was a relation between (on the one hand) star ratings and inspection scores and (on the other) hospital death rates (hospital standardised mortality ratios - HSMRs). They found no significant relation between HSMRs and star ratings: an increase in one star was associated with a 0.4 per cent fall in HSMRs. However, they did find a significant relationship with inspection scores: each point increase in the inspection score was associated with a 1.35 per cent decrease in HSMRs.
Source: Brian Jarman, Paul Aylin and Alex Bottle, 'CHI ratings and HSMRs: is there a relation?', British Medical Journal, 10 July 2004
Links: Article | BMJ press release
Date: 2004-Jul
The health service inspectorate published annual performance ratings for National Health Service trusts in England. It said the ratings showed an overall improvement, with better performance on targets that were tougher than the previous year. More trusts had been rated as '3 star' and '2 star'. Over 93 per cent of acute trusts had no one waiting for more than nine months for inpatient treatment. NHS organisations described star ratings as a 'crude measure' of performance. A consumer group said that fewer than half of NHS users were aware of star ratings, and almost half of them were unlikely to use the ratings to help them choose a health service.
Source: Press release 21 July 2004, Healthcare Commission (020 7448 9200) | Press release 20 July 2004, NHS Confederation (020 7959 7272) | Press release 19 July 2004, Consumers' Association (020 7770 7000)
Links: Healthcare Commission press release | Performance ratings webpage | NHS Confederation press release | Consumers' Association press release | Guardian report
Date: 2004-Jul
The National Health Service Ombudsman in England reported numerous examples of poor complaint handling by NHS bodies. It expressed disappointment that a new NHS complaints procedure had not yet been implemented. It also highlighted the failure by strategic health authorities to investigate and reassess all cases where patients with long-term care needs had been wrongly denied funding.
Source: Annual Report 2003-04: 3rd Report Session 2003-04, HC 703, Health Service Ombudsman for England (020 7217 4051)
Links: Report (pdf) | Help the Aged press release | Guardian report | Community Care report
Date: 2004-Jul
Following consultation, the government set out new targets and healthcare standards for National Health Service providers. The number of mandatory national targets would be cut from 62 to 20. Existing national targets which had been met by April 2005 such as waiting times for accident and emergency treatment would become core standards which providers of care would have to maintain. There would be more scope for targets to be set at local level.
Source: National Standards, Local Action: Health and social care standards and planning framework 2005/06-2007/08, Department of Health (08701 555455) | Standards for Better Health, Department of Health | House of Commons Hansard, Written Ministerial Statement 21 July 2004, columns 48-50WS, TSO (0870 600 5522)
Links: Framework (pdf) | Standards (pdf) | Hansard | DH press release | Consultation document (pdf) | NHS Confederation press release | National Aids Trust press release
Date: 2004-Jul
The new health service inspectorate published its first report on the state of healthcare in England and Wales,. It said there were many positive signs that healthcare provided by the National Health Service was improving. But it also said the pace of the improvement was not fast enough for the people who needed help most, for example in deprived communities.
Source: State of Healthcare Report 2004, Healthcare Commission (020 7448 9200)
Links: Report (pdf) | Summary (pdf) | Healthcare Commission press release | BMA press release | King's Fund press release | Rethink press release | Guardian report
Date: 2004-Jul
The government announced a package of measures to streamline the process of performance measurement in the National Health Service. They included: fewer, more consistent, and better-prioritised recommendations from inspectorates; joint inspections by regulatory bodies, reducing the number of visits hospitals faced; consideration of inspection holidays for high-performing trusts; and schedules of visits to be published in advance, enabling staff to plan ahead to meet inspection requirements. The Healthcare Commission published a related concordat between the main healthcare inspection, review and audit bodies in England, aimed at helping to reduce the regulatory burden on frontline healthcare staff.
Source: Press release 23 June 2004, Department of Health (020 7210 4850) | Concordat between Bodies Inspecting, Regulating and Auditing Healthcare, Healthcare Commission (020 7448 9200) and other inspectorates
Links: DH press release | Concordat (pdf) | Healthcare Commission press release | Guardian report
Date: 2004-Jun
The total number of patients waiting to be admitted to National Health Service hospitals in England at the end of March 2004 was 905,600; a fall of 35,600 (3.8 per cent) since the end of February 2004, and a fall of 86,500 (8.7 per cent) since March 2003.
Source: Statistical press release, 7 May 2004, Department of Health (020 7210 4850)
Links: DH press release
Date: 2004-May
A report said that the National Health Service was experiencing genuine improvement, as a result of changes in attitude and culture since the introduction of the NHS Plan. But it faced a 'tough challenge' to build on this momentum by putting patients at the centre of care, and providing more convenient, responsive and local services: this would mean a shift in emphasis towards treating patients in the community rather than in hospital, helping people manage chronic diseases and long-term conditions at home, and encouraging everyone to embrace a healthy lifestyle.
Source: Caring in Many Ways: The NHS Modernisation Board's Annual Report 2004, Department of Health (08701 555455)
Links: Report (pdf links) | DH press release | Guardian report
Date: 2004-May
The government said that special measures to tackle delayed discharges from hospitals had led to a reduction in them, from 7,065 in September 2001 to 2,895 in March 2004.
Source: Press release, 17 May 2004, Department of Health (020 7210 4850)
Links: DH press release | Guardian report
Date: 2004-May
An Audit Commission report called for radical reform of health services in Wales, in spite of a recent improvement in waiting list figures. It identified various weaknesses in National Health Service management, including failures to implement action plans, remedial actions that did not address causes, and lack of 'pro-activity'.
Source: Transforming Health and Social Care in Wales: Aligning the levers of change, Audit Commission for Wales (029 2026 2550)
Links: Report (pdf) | Summary (pdf) | ACW press release (pdf) | WAG press release
Date: 2004-May
The Chief Executive of the National Health Service reported that sustained improvements to services for patients were being accelerated, with measurable improvements in productivity throughout the NHS.
Source: Chief Executive s Report to the NHS, Department of Health (08701 555455)
Links: Report (pdf) | Statistical supplement (pdf) | NHS Confederation press release | Guardian report
Date: 2004-May
A new independent 'Healthcare Commission' (full name: Commission for Healthcare Audit and Inspection) was launched on 1 April 2004 with responsibility for inspecting healthcare standards in the National Health Service and the private and voluntary sectors. It replaced the Commission for Health Improvement, part of the National Care Standards Commission (both of which ceased to exist) and the work on national value for money in health previously carried out by the Audit Commission. Another body, the Office of the Independent Regulator, was established to authorise, monitor and regulate National Health Service foundation trusts.
Source: House of Commons Hansard, Written Ministerial Statement 30 March 2004, columns 83-84WS, TSO (0870 600 5522)
Links: Hansard | Healthcare Commission press release
Date: 2004-Apr
A report criticised the National Health Service for the 'ignorance and insensitivity' of its staff in dealing with people who were hearing impaired. It said the NHS could face legal action unless significant improvements were made.
Source: A Simple Cure: A national report into deaf and hard of hearing people s experiences of the National Health Service, RNID (0808 808 0123)
Links: Report (pdf) | Guardian report
Date: 2004-Mar
A healthcare inspectorate report analysed 11 investigations carried out by it in National Health Service organisations in the period 2000-2003, including investigations into allegations of abuse, clinical failure and administrative failure. Severe and sustained staffing shortages, poor working relationships, and inadequate risk management were some of the factors that regularly occurred in NHS services that failed.
Source: Lessons from CHI Investigations, 2000-2003, Commission for Health Improvement (020 7448 9200)
Links: Report (pdf) | CHI press release | Guardian report
Date: 2004-Mar
An audit report said that efforts to improve the accuracy of National Health Service information and data were beginning to pay off. National figures on waiting lists and times were now 'reliable'.
Source: Information and Data Quality in the NHS, Audit Commission (0800 502030)
Links: Report | Audit Commission press release
Date: 2004-Mar
An audit report said that cancer patients were increasingly surviving the disease as a result of the new initiatives launched by the Department of Health and the National Health Service over the previous decade. But the NHS needed to continue to do more to ensure all patients were treated swiftly and appropriately.
Source: Tackling Cancer in England: Saving more lives, National Audit Office (020 7798 7000) HC 364 (Session 2003-04)
Links: Report (pdf) | Summary (pdf) | NAO press release | Guardian report
Date: 2004-Mar
The number of English residents waiting over one year for National Health Service treatment at the end of December 2003 was 25, 99.8 per cent lower than a year earlier. A total of 8 English residents had been waiting over 15 months. The total number of patients waiting to be admitted to NHS hospitals in England at the end of December 2003 was 973,100, 7.9 per cent lower than a year earlier.
Source: Statistical press notice 13 February 2004, Department of Health (020 7210 4850)
Links: DH press release (1) | DH press release (2)
Date: 2004-Feb
The independent watchdog for the National Health Service published a technical commentary on the 2003 performance indicators and composite ratings for English NHS trusts. It said that star ratings were 'a long way from perfect'.
Source: A Commentary on Star Ratings 2002/2003, Commission for Health Improvement (020 7448 9200)
Links: Report (pdf) | CHI press release
Date: 2004-Feb
The government began consultation on new performance targets for the National Health Service. It said that targets were achieving the objectives of delivering speedier treatment for patients and in expanding the NHS through more beds, hospital wards and NHS staff: but most would be delivered before the dates specified for them, and so new ones were needed from April 2005. The consultation document set out 24 'core' standards and 10 'developmental' standards, covering seven key areas: safety, clinical cost effectiveness, governance, patient focus, accessible and responsive care, healthcare environment and amenities, and public health. Core standards would set the level of quality of care which every patient should expect, wherever they were treated in the NHS. Developmental standards would set out what the NHS should aspire to deliver for patients as extra investment in the NHS continued to make a difference.
Source: Standards for Better Health: Health care standards for services under the NHS - A consultation, Department of Health (08701 555455)
Links: Consultation document (pdf) | DH press release | BMA press release | King's Fund press release | NHS Alliance press release | NHS Confederation press release | Guardian report (1) | Guardian report (2)
Date: 2004-Feb