Falling stars blight NHS performance ratings
pharmafile | July 21, 2004 | News story | |Â Â Â
Four of the government's flagship foundation trusts have lost their three star ratings in the latest review, prompting further criticism of the controversial system.
Addenbrookes Hospital, Moorfield Eye Hospital, Papworth Hospital and Peterborough Hospital all lost their top ranking status, three of them for financial management reasons. The hospitals will not automatically lose their foundation status, but the regulator of the special trusts will demand action plans to remedy the problems.
Now in their fourth year, the star rating system and the multitude of targets on which it is based has been bitterly opposed by many in the NHS. The government has tried to deflect attention from the mixed findings of the review by confirming in a separate announcement today that the number of national targets for the NHS will be cut from 62 to 20.
In all, the new watchdog the Healthcare Commission reviewed 569 trusts in England and said its ratings showed the NHS was improving overall, with more trusts awarded two or three stars, and 93% of acute trusts having no one waiting more than nine months for inpatient treatment, even though the ratings system was tougher than last year.
Despite this, the fall from grace of a number of acute trusts and three star PCTs often because of financial problems or missed targets will be a major embarrassment for the government, and has attracted renewed criticism of the system.
Niall Dickson, chief executive of think tank The King's Fund told the BBC: "Stars are a good way of rating hotels but don't work so well for complex organisations like hospitals."
The overall improvement in the primary care trust ratings masks a huge change around in the rankings, with 31 of the 44 PCTs awarded three stars last year dropping out of the top ranking – most dropping to two star status, but Hertsmere PCT losing all of its stars in just one year. Their places have largely been taken by former two star trusts, but the factors which separate a three star trust and a two star neighbour are often very small.
Ambulance trusts showed an improvement, with over a third now having two stars, compared to under 25% a year ago.
Meanwhile, Sir Ian Kennedy, head of the independent regulator, expressed his concern about continuing underperformance in mental health trusts, over a third having just one star or less. Sir Ian said the "complex area" needed more focus and an improvement in the information available.
"The information which the NHS collects about the care of people who use mental health services is simply not good enough. It must be improved to ensure the better care of patients," he said.
Sir Ian defended the usefulness of NHS ratings, saying the Healthcare Commission's statutory role was a "valuable way of holding NHS organisations to account" and that the more detailed information behind the ratings could help managers improve their services.
The Commission will nevertheless introduce a new system in a year's time which Sir Ian says will allow a "broader, richer picture" to be presented each year, almost certainly built around the reduced 20 core targets announced this week.
A consultation on the new system will be launched in the autumn – anyone with an interest, including NHS professionals, patients and the public are invited to contribute.
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