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NHS Alliance warns of Health Check

Published on 09/03/05 at 12:21pm

The NHS Alliance has warned that the planned replacement to the controversial star ratings performance indicators may lead to 'perverse incentives'.

The proposed new NHS Health Check will be introduced in 2006, replacing a system that was deeply unpopular with NHS professionals and managers.

It aims to reduce the number of targets and move away from the tick box mentality, elemental features of the NHS star ratings systems that have been heavily criticised.

This month will see the NHS watchdog, the Healthcare Commission, announce its findings following a three month consultation, which assessed what information will be published under the new performance indicators.

Patient groups, healthcare workers and clinicians amongst others have contributed to the consultation and the new proposals have already been welcomed by a cross-section of stakeholders.

But the NHS Alliance, itself consulted by the watchdog, has warned that some of its proposals need more clarification.

Michael Sobanja, NHS Alliance chief executive, said: "While the commission's new Health Check looks better than star ratings, implementation needs to be handled very carefully if perverse incentives are to be avoided."

The alliance is concerned that the new Health Check has a one-size-fits-all approach, which needs to assess the differing roles of managing primary care and hospitals if it is to be successful and embraced by healthcare professionals.

It has also voiced concerns that the proposals are preoccupied with secondary care and raised questions as to how it will monitor the National Service Framework and the role of Strategic Health Authorities.

The Healthcare Commission has remained tight-lipped on the findings of its consultation but believes the new Health Check will allow frontline staff to focus more on patient care and making local services more representative of local population needs.

But Commission chairman Professor Sir Ian Kennedy has said the new annual health check will build a "richer picture of healthcare organisations".

"We will measure what matters to everyone following the patients' journey from prevention to treatment. We want to promote improvement through our system of assessment while allowing professionals to get on with the job of looking after patients," he said.

The replacement system for star ratings is intended to be broader in scope than its predecessor and cover standards that really matter to patients.

Set by the Department of Health, the new performance indicators will be based on safety, clinical and cost effectiveness, governance, patient focus, accessible and responsive care, care environment and amenities and public health.

The NHS star ratings have been in existence since 2001 and aim to show how well hospital, ambulance and primary care services are doing. The Healthcare Commission will publish star ratings for the last time in April of this year.

From April 2005 NHS trusts will be measured against core standards in seven areas set by the Department of Health.

It will also build on its work on public health, such as its reports on tobacco control and sexual health, by working with local authorities on health promotion.

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