Lansley calls for “cultural shift in the NHS”
pharmafile | June 9, 2010 | News story | | NHS, government, king's fund
In his first speech as health secretary Andrew Lansley has called for a “cultural shift in the NHS”, moving away from what he says is “a culture responsive mainly to orders from the top-down”.
This must change to a culture that is responsive to patients, in which patient safety is put first, he insisted.
The Lansley vision of public health sees hospitals made responsible for reducing the number of emergency readmissions, with more treatment at home, in return for a single payment.
“This will create more joined-up working between hospitals and community services,” he said. “This will improve quality and performance and shift the focus to the outcome for the patient, rather than the volume of activity paid to the hospital.”
Dr Anna Dixon, director of policy at health think tank the King’s Fund, welcomed the proposals, but warned: “The key to the success of this policy will be to ensure sufficient care can be provided in the community following a patient’s discharge.”
Lansley’s key line is that the previous government’s “bureaucratic approach of perpetual interference, coupled with the imposition of top-down process targets”, has failed patients.
Yet despite Lansley’s sideswipe at target-setting, much of his tone and language – for instance on providing comparative data about standards and putting patients “in the driving seat” – could have come from his Labour predecessors.
Patient focus has been a recurring theme over the last decade, and particularly since the 2008 Darzi Review emphasised quality of care.
Labour talked earlier this year about the need to move some treatment away from clinical settings and into patients’ homes, was trialling personal health budgets and had encouraged patients to post their experiences on hospital websites.
But Lansley insisted that Labour’s approach “has left us lagging behind our European counterparts on outcomes that matter to patients, such as how long they will survive after a cancer diagnosis”.
The King’s Fund’s Dixon said: “The government is right to place greater emphasis on improving quality, cleanliness, safety and giving patients more choice and control over their health care.”
But she added: “The real challenge is how to secure these gains while facing increasing financial constraints.”
Patients Association director Katherine Murphy said: “We welcome a much greater emphasis on the patient experience and a focus on patient needs and helping patients play a bigger role in shaping their health service.”
Adam Hill
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