NHS leaders pour scorn on star ratings
pharmafile | October 31, 2003 | News story | |Â Â Â
New star ratings for all NHS trusts have been attacked by leaders in primary and secondary care, who say they fail to reflect the overall standard of patient care.
England's 304 PCTs have been given star ratings for the first time ever, with 45 gaining the top three star rating, 139 earning two stars, 98 with one star and 22 judged as failing to meet most standards, earning no stars.
Meanwhile the proportion of three star acute hospital trusts increased by 45 from last year, but some hospitals, which had been eligible for foundation trust status such as Newcastle upon Tyne Hospitals Trust and Essex Rivers Healthcare NHS Trust are now out of the running after losing their top ranking.
BMA Chairman James Johnson said: "Nobody should judge how well a hospital is doing by looking at star ratings. They measure little more than hospitals' ability to meet political targets and take inadequate account of quality of clinical care, or factors such as social deprivation.
"It is grossly unfair on staff working on low-rated trusts that public confidence in them is being undermined".
The ratings have been carried out for the first time by the quasi-independent Commission for Health Improvement, which will shortly be succeeded by the fully independent Commission for Healthcare Audit and Inspection.
Michael Sobanja, NHS Alliance Chief Executive and member of CHI's advisory committee on improving the rating system said: "I am opposed to measuring spurious outputs and then foisting them on the public as true outcomes".
"These star ratings do not tell us whether any particular PCT is good or bad, whether they are delivering good quality healthcare to their local populations, nor whether the PCT is improving or deteriorating".
One key indicator for PCTs is the prescribing of benzodiazapenes, which the Government wants to see fall in line with NICE guidance, but Mr Sobanja says this is an inadequate indicator for wider performance.
"Benzodiazepenes are prescribed to only a small number of patients. The star rating does not even consider the majority of patients who are not, and never will be, prescribed this particular group of drugs. Nor does it look at how the PCT implements NICE guidance overall".
Despite these warning, the NHS Modernisation Agency and Strategic Health Authorities will be focussing on helping no star trusts improve their rating. CHI and the Modernisation Agency have been keen to stem any 'us and them' feeling in their relationships with PCTs, and have both hinted that the inadequacy of current star ratings is well understood.
Director of PCT Improvement for the MA's primary care team NatPaCT Ali Wilson recently told PCTs: "This time, neither zero or three star ratings reflect clinical performance or the skills present in primary care or community teams. They reflect delivery against targets".
In future years, CHAI will draw on its clinical governance reviews to give a more holistic overview of PCT performance to inform star ratings and make them more reflective of service quality.
