A paper discussed the way the output of the National Health Service was measured. It made proposals for changes designed to capture quality change. Two broad aspects of quality were examined: health gain (including safety and effectiveness); and patient experience (including aspects of responsiveness, user focus, acceptability, access and timeliness).
Source: Healthcare Output and Productivity: Accounting for quality change, Department of Health (08701 555455)
Links: Report | Technical papers (links)
Date: 2005-Dec
The healthcare inspectorate announced plans to strengthen measures to penalize National Health Service trusts for poor financial performance. Financial performance would be given a stronger weighting under the new annual health check, which had replaced star ratings.
Source: Press release 7 December 2005, Commission for Healthcare Audit and Inspection (020 7448 9200)
Links: CHAI press release
Date: 2005-Dec
The Department of Health published its autumn performance report for 2005, showing progress towards achieving its public service agreement targets.
Source: Autumn Performance Report 2005, Cm 6704, Department of Health, TSO (0870 600 5522)
Links: Report
Date: 2005-Dec
A report proposed improved ways of measuring National Health Service outputs and inputs to improve estimates of productivity growth. It estimated that NHS productivity had declined by about 1.59 per cent a year since 1998-99.
Source: Diane Dawson et al., Developing New Approaches to Measuring NHS Outputs and Productivity, Centre for Health Economics/University of York (01904 433648)
Links: Report | NPCRDC press release
Date: 2005-Dec
The healthcare inspectorate published its annual report for 2004-05.
Source: Our Progress - One Year On: Annual report 2004/2005, Commission for Healthcare Audit and Inspection (020 7448 9200)
Links: Report
Date: 2005-Dec
An audit report said that the performance of the National Health Service in Scotland had improved in key areas such as availability of treatment, and also in death rates from cancer, stroke, and heart disease.
Source: Overview of the Performance of the NHS in Scotland, Audit Scotland for Accounts Commission and Auditor General (0131 477 1234)
Links: Report | Audit Scotland press release | SE press release
Date: 2005-Dec
A report by the Chief Executive of the National Health Service said that, for the fifth year running, the NHS was treating more patients, reducing waiting times, and making good progress in tackling cancer and coronary heart disease.
Source: Chief Executive s Report to the NHS: December 2005, Department of Health (08701 555455)
Links: Report | DH press release | King's Fund press release
Date: 2005-Dec
The foundation trusts regulator said that the new trusts had led to strengthening finances, improving governance, and increasing local engagement.
Source: Review and Consolidated Accounts of NHS Foundation Trusts 2004-05, HC 622, Monitor, TSO (0870 600 5522)
Links: Report | Monitor press release | FT Network press release
Date: 2005-Nov
Foundation trusts said that they were delivering real improvements to patient care, and involving patients and the public in the way hospitals were run.
Source: NHS Foundation Trusts: Making A Difference, Foundation Trust Network (020 7074 3200)
Links: Report (pdf) | Foundation Trust press release | Healthcare Commission press release | NHS Confederation press release
Date: 2005-Oct
A report said that arrangements for overseeing and scrutinizing healthcare bodies was working - despite challenges around resources, joint working, and service changes.
Source: Process, Progress and Making it Work: Health overview and scrutiny in England, 2005, Centre for Public Scrutiny (020 7296 6595)
Links: Report (pdf) | Summary (pdf)
Date: 2005-Oct
A report (by the independent regulator of National Health Service foundation trusts) said that the best approach to healthcare regulation in England was the model of a separate economic regulator and quality inspector.
Source: Developing an Effective Market Regulatory Framework in Healthcare, Monitor (020 7340 2400)
Links: Report (pdf) | Monitor press release
Date: 2005-Oct
A report said that the government's promise that foundation hospitals would be more accountable to local communities had yet to be delivered. Elected governors remained unclear about their role and how best to represent patients, staff and the public.
Source: Richard Lewis and Lisa Hinton, Putting Health in Local Hands: Early experiences of Homerton University Hospital NHS Foundation Trust, King s Fund (020 7307 2591)
Links: Report (pdf) | King's Fund press release
Date: 2005-Oct
An audit report reviewed early experiences of the payment by results financial regime in the National Health Service. It assessed its impact nationally and locally, and drew out practical recommendations for NHS bodies and policy-makers.
Source: Early Lessons From Payment by Results, Audit Commission (0800 502030)
Links: Report | Audit Commission press release | Monitor press release | NHS Confederation press release
Date: 2005-Oct
The healthcare inspectorate said that differences in people's perceptions of the National Health Service could be partly explained by consistent factors such as age, where they lived, and how well they were. Self-reported health status, or how well people said they were, was the biggest factor explaining differences in experience across individual surveys.
Source: Variations in the Experiences of Patients in England: Analysis of the Healthcare Commission s 2003/2004 national surveys of patients, Commission for Healthcare Audit and Inspection (020 7448 9200)
Links: Report (pdf) | CHAI press release
Date: 2005-Oct
The government published the NHS Redress Bill. The Bill provided for the establishment of a scheme to enable the settlement, without the need to commence court proceedings, of negligence claims arising in connexion with hospital services provided to National Health Service patients in England.
Source: NHS Redress Bill [HL], Department of Health, TSO (0870 600 5522)
Links: Text of Bill | Explanatory notes | Guardian report
Date: 2005-Oct
An audit report said that more widespread implementation of central guidance on best clinical practice would only be achieved if financial management in the National Health Service improved.
Source: Managing the Financial Implications of NICE Guidance, Audit Commission (0800 502030 and National Health Service in England
Links: Report | Audit Commission press release | NHS Confederation press release | Guardian report
Date: 2005-Sep
A survey by the healthcare inspectorate found that National Health Service care (excluding hospitals) was improving. Patients gave broadly positive impressions of their experience of primary care services, including care given by doctors and dentists.
Source: Primary Care Trust: Survey of patients 2005, Commission for Healthcare Audit and Inspection (020 7448 9200)
Links: Report (pdf and Excel links) | CHAI press release | DH press release | King's Fund press release | NHS Confederation press release
Date: 2005-Sep
An annual statistical report examined how increased government spending was affecting the National Health Service and the health of the nation. Three main areas were examined: where the extra NHS money was going, with a particular look at family doctor productivity; changes in the amount being spent on medicines relative to the rest of the NHS; and changes in the life expectancy of men and women.
Source: Peter Yuen, OHE Compendium of Health Statistics: 17th edition 2005-2006, Radcliffe Publishing (01235 528820)
Links: Summary
Date: 2005-Sep
A regulatory report praised the performance of the first National Health Service foundation trusts in establishing themselves as well-run autonomous organizations, delivering high standards of patient care.
Source: Annual Plan Review: Summary findings, Monitor (020 7340 2400)
Links: Report (pdf) | Monitor press release
Date: 2005-Sep
An independent report said that Northern Ireland's health and social care services would benefit both from large increases in spending and tougher incentives to improve efficiency.
Source: John Appleby, Independent Review of Health and Social Services Care in Northern Ireland, Department of Health, Social Services and Public Safety/Northern Ireland Executive (028 9052 0500)
Links: Report (pdf) | BMA press release | King's Fund press release
Date: 2005-Aug
The healthcare inspectorate said that most patients were happy with the standard of care they received in accident and emergency departments: but performance varied widely between hospitals.
Source: Acute Hospital Portfolio Review - Accident and Emergency, Commission for Healthcare Audit and Inspection (020 7448 9200)
Links: Report (pdf) | CHAI press release | DH press release | NHS Confederation press release
Date: 2005-Aug
The healthcare inspectorate published the 2004-05 star ratings of performance for National Health Service trusts in England. Overall the ratings showed an improvement in performance against tougher waiting time targets for outpatient appointments and operations, as well as lower death rates for cancer and heart disease. But almost a quarter of all trusts, including a third of acute trusts, failed to achieve financial balance for the year.
Source: Press release 27 July 2005, Commission for Healthcare Audit and Inspection (020 7448 9200)
Links: CHAI press release | BMA press release | King's Fund press release | NHS Confederation press release | RCGP press release | Mental Health Foundation press release
Date: 2005-Jul
A new book provided an independent, expert assessment of the quality of healthcare in the United Kingdom. It said that patients had benefited from the sustained and substantial increase in per capita spending across the UK, with for example more nurses and doctors, more critical care beds, additional stroke units, and more community mental health teams. However, it questioned whether there had been a sufficiently rigorous evaluation of value for money and the relationship between cost and quality.
Source: Sheila Leatherman and Kim Sutherland, Quest for Quality in the NHS: A chartbook on quality of care in the UK, Radcliffe Medical Press (01235 528820)
Links: Summary | Nuffield Trust press release (pdf)
Date: 2005-Jul
The healthcare inspectorate published its annual report for 2004-05. It praised improvements in some services, such as cancer and heart services. But it said that other services had been left behind, such as sexual health, mental health, maternity and dental services. The National Health Service also still had a long way to go to achieve a patient-led service.
Source: State of Healthcare 2005, Commission for Healthcare Audit and Inspection (020 7448 9200)
Links: Report (pdf) | CHAI press release | King's Fund press release | NHS Confederation press release | Mind press release | Guardian report
Date: 2005-Jul
The 2004-05 annual report was published for the parliamentary and health service ombudsman.
Source: Annual Report 2004-05: A year of progress, HC 348 (Session 2005-06), Parliamentary and Health Service Ombudsman, TSO (0870 600 5522)
Links: Report (pdf) | Summary (pdf) | Ombudsman press release
Date: 2005-Jul
A book chapter examined the difficulties of measuring government output in the healthcare sector.
Source: Adriana Castelli, Diane Dawson, Hugh Gravelle and Andrew Street, 'The challenges of measuring government output in the healthcare sector', Social Policy Review 17: Analysis and debate in social policy, 2005, Policy Press, available from Marston Book Services (01235 465500)
Links: Table of contents
Date: 2005-Jun
An inspectorate report said that most patients in Wales were satisfied with the care they received from the National Health Service and local authority social services, and that services were starting to work well together to avoid unnecessary hospital admissions.
Source: Thematic Inspection of Health and Social Services for Adults who Require Hospital Inpatient Treatment for Physical Ill-health in Wales, Social Services Inspectorate for Wales (029 2082 5655)
Links: Report (pdf) | WAG press release
>Date: 2005-Jun
A concordat was signed between 15 different bodies responsible for inspecting, regulating and auditing health and social care in Wales. The concordat was designed to support the improvement of heath and social care services, and to eliminate unnecessary burdens of inspection programmes on front-line staff.
Source: Concordat Between Bodies Inspecting, Regulating and Auditing Health and Social Care in Wales, Welsh Assembly Government (029 2082 5111)
Links: Concordat (pdf) | Covering letter (pdf)
Date: 2005-May
The government announced plans (in the Queen's speech) for an NHS Redress Bill. The Bill would overhaul the compensation regime for cases where National Health Service treatment had gone wrong.
Source: House of Commons Hansard, Debate 17 May 2005, columns 29-31, TSO (0870 600 5522)
Links: Hansard
Date: 2005-May
A report described activity in the National Health Service over the previous year, and since publication of the NHS Plan. It said that there had been five years of continuous improvement, and that innovations and reforms were beginning to take effect.
Source: Chief Executive s Report to the NHS: May 2005, Department of Health (08701 555455)
Links: Report (pdf) | Summary
Date: 2005-May
A report said that many National Health Service trusts were failing to deliver the government s vision of a patient-centred complaints handling system that was accessible, prompt and responsive.
Source: Liz Phelps and Ann Williams, The Pain of Complaining, Citizens Advice (020 7833 2181)
Links: Report (pdf) | Summary | Citizens Advice press release
Date: 2005-May
The health services regulator published a strategic plan for 2005-2008. It said that a key cornerstone of the plan was a focus on reducing inequalities in access to healthcare and in the health of the population - whether as a result of age, gender, ethnicity, social class, disability or geographical area.
Source: Strategic Plan 2005/2008, Healthcare Commission (020 7448 9200)
Links: Strategy (pdf) | Healthcare Commission press release
Date: 2005-May
The Office for National Statistics published two articles describing improvements to the methodology used to measure output of public services (stemming from work resulting from the Atkinson Review). The changes affected health, education, personal social services, administration of social security, and public order and safety. There were particularly significant changes to the measurement of output of adult personal social services (the subject of the second article).
Source: Improvements in the Methodology for Measuring Government Output, Office for National Statistics (0845 601 3034) | Improvements to the National Accounts Measure of Output of Adult Social Services, Office for National Statistics
Links: Article (pdf) | Adult Social Services article (pdf) | ONS press release (pdf) | Guardian report
Date: 2005-May
A new book examined why it often proved difficult for organizations to be improved by research findings about best practice, based on nearly 50 case studies of attempts to introduce evidence-based practice in the National Health Service.
Source: Sue Dopson and Louise Fitzgerald, Knowledge to Action? Evidence-based health care in context, Oxford University Press (01536 741727)
Links: Summary
Date: 2005-May
A new book compared the experiences of the United Kingdom and the United States in the publication of key outcomes data on hospital performance.
Source: Anne Mason and Andrew Street, To Publish or Not? Experience and evidence about publishing hospital outcomes data, Office of Health Economics (020 7930 9203)
Links: Summary
Date: 2005-Apr
A report assessed patients experiences of the National Health Service, based on the views of nearly a million people who had participated in the National Patient Survey Programme. The report said that priority areas which had been the focus of co-ordinated action and investment - such as waiting times, cancer care, and coronary heart disease - had seen major improvements: but patient-centred care was not the norm for many other areas.
Source: Is the NHS Getting Better or Worse? An in-depth look at the views of nearly a million patients between 1998 and 2004, Picker Institute Europe (01865 208100)
Links: Report (pdf) | Picker Institute press release (pdf) | Guardian report
Date: 2005-Apr
A think-tank report said that the government had made 'huge strides' in reforming the health service since coming to power in 1997. But it warned that there were still important problems to be solved, and that there was no firm evidence to show the reforms had produced a marked improvement in the nation s health.
Source: Lyn Whitfield, Mary Jean Pritchard and Lucy Latchmore (eds.), An Independent Audit of the NHS under Labour (1997 2005), King s Fund (020 7307 2591)
Links: Report (pdf) | Summary (pdf) | King's Fund press release
Date: 2005-Mar
The healthcare regulator published details of a new system for assessing public and private health services in England. The system aimed to reduce regulatory burdens, while giving the public a more accurate picture of performance. Instead of routinely subjecting all National Health Service trusts to week-long visits every three years, it would target inspections on those where there was evidence of a problem. Patient and public representatives would for the first time have a formal role in judging the quality of services.
Source: Assessment for Improvement: The annual health check, Healthcare Commission (020 7448 9200)
Links: Report (pdf) | Healthcare Commission press release | BMA press release | NHS Confed press release
Date: 2005-Mar
An ombudsman report called for reform of the National Health Service complaints procedure. It described the problems caused by the fragmentation of complaints systems within the NHS, between the NHS and private healthcare, and between health and social care. This was combined with a failure to focus on patient needs, poor leadership, and lack of capacity and competence in complaint handling.
Source: Making Things Better? A report on reform of the NHS complaints procedure in England, HC 413, Health Service Ombudsman for England (020 7217 4051)
Links: Report (pdf) | Ombudsman press release | Guardian report
Date: 2005-Mar
The regulator for National Health Service foundation trusts published a 'compliance framework', making the board of directors of each trust principally responsible for ensuring that it complied with its terms of authorization. The regulator adopted a risk-based approach to regulation, designed to ensure that the regulatory burden was proportionate, with the most successful trusts having less regulatory oversight.
Source: Compliance Framework, Monitor (020 7340 2400)
Links: Framework (pdf) | Monitor press release
Date: 2005-Mar
A survey found that 8 out of 10 accident and emergency departments in England said that clinical concerns had arisen because of pressure placed on them to see patients within the 4-hour target.
Source: BMA Survey of A&E Waiting Times, British Medical Association (020 7387 4499)
Links: Report (pdf) | BMA press release
Date: 2005-Mar
A report said that National Health Service finance procedures did not adequately safeguard against errors. The payments-by-results system allowed payments to be made regardless of whether a patient s family doctor had received clinical discharge information: family doctors who directly commissioned services for their own patients could therefore find they had no way of checking costs, nor of correcting any errors.
Source: Caveat Emptor: Payment by results and practice led commissioning, NHS Alliance (01777 869080)
Links: NHS Alliance press release
Date: 2005-Feb
The healthcare inspectorate published two surveys of patient opinion, covering emergency care and outpatient departments. Patients said they were waiting less time for both emergency treatment and outpatient appointments. But many thought that doctors did not give them enough information to make sensible choices about their treatment.
Source: Emergency Department Survey 2004/2005, Healthcare Commission (020 7448 9200) | Outpatient Department Survey 2004/2005, Healthcare Commission
Links: Emergency report | Outpatient report | Healthcare Commission press release | Guardian report
Date: 2005-Feb
The total number of patients waiting to be admitted to National Health Service hospitals in England at the end of December 2004 was 858,000 - a fall of 115,000 (11.8 per cent) since December 2003.
Source: NHS Inpatient Waiting List Figures: 31 December 2004, Statistical press notice 2005/0054, Department of Health (020 7210 4850) Links: Statistical press release | Guardian report
Date: 2005-Feb
An article explored the impact of star performance ratings in acute hospital trusts in England. It concluded that there were important gaps in knowledge, and failings in existing policy and practice. It was imperative for the impact of the data to be monitored, not only in terms of the degree to which they resulted in beneficial change, but also in terms of any unintended and dysfunctional side-effects they generated for patients and staff.
Source: Russell Mannion, Huw Davies and Martin Marshall, 'Impact of star performance ratings in English acute hospital trusts', Journal of Health Services Research and Policy, Volume 10 Number 1
Links: Article (pdf)
Date: 2005-Jan
An audit report said that most patients in Wales were treated within the targets set for the National Health Service: but some people could face long waiting times for non-emergency health treatment. The report pointed to inefficiencies in the system of health and social care which contributed to long waiting times.
Source: NHS Waiting Times in Wales, Auditor General for Wales (029 2067 8500)
Links: Report part 1 (pdf) | Report part 2 (pdf) | AGW press release (Word file) | BMA press release | Guardian report
Date: 2005-Jan
A think-tank report highlighted failures of healthcare in the United Kingdom compared to other European Union countries. 85 people died each day because health standards were lower than the EU average.
Source: Chris Philp and Aaron Smith, The Quality of UK Healthcare: Comparison to Europe, Bow Group (020 7431 6400)
Links: Report (pdf)
Date: 2005-Jan
A report examined the feasibility of measuring health service performance in terms of patients' health-related quality of life.
Source: John Appleby and Nancy Devlin, Measuring Success in the NHS: Using patient-assessed health outcomes to manage the performance of healthcare providers, Dr Foster Ethics Committee Limited (020 7256 4900)
Links: Report (pdf)
Date: 2005-Jan