NHS targets and management costs in the firing line
pharmafile | June 22, 2010 | News story | | NHS, NHS funding, NHS targets
Management costs and the use of targets are at the top of the government’s NHS hitlist, the health secretary Andrew Lansley has revealed.
Under coalition government plans the bill for employing managers will be £850m by 2013-14 – a 46% reduction on the figure for the financial year just gone.
It also plans to remove targets around access to primary care, while the four-hour A&E target threshold will be reduced from 98% to 95%.
Health Secretary Lansley will also abolish the top-down performance management of the target which says there should be 18 weeks from referral to treatment.
But he said this did not mean it would now be a free-for-all for hospitals. “While the NHS will no longer be accountable to ministers or the Department for its performance in these areas, it will be very much accountable to the patients and public it serves,” Lansley insisted.
Patients would still have rights under the NHS Constitution and providers will be expected to make improvements on things like referral to treatment times, and to provide this information to patients.
But Chris Ham, chief executive of think tank the King’s Fund, warned: “We will now have to see whether patients’ rights and publishing data are sufficient to prevent waiting times creeping back up.”
The government says management costs in Primary Care Trusts and Strategic Health Authorities have gone up by over £1 billion since 2002-03 to £1.85 billionn.
Lansley’s rationale for slashing these is that NHS spending will increase, but demand on NHS services will also rise.
“In order to meet this demand, the NHS needs to make substantial savings and that is why I want to see immediate action this year to reduce management costs so that the savings made can be reinvested in NHS care for patients,” the Health Secretary said.
Ham called the cuts “a bold move” but questioned whether eradicating the waste of managerial overheads would improve NHS efficiency.
“Given the NHS faces a shortfall of up to £21 billion a year, improving productivity at the frontline will have the most impact,” he said.
“It is therefore vital that the NHS continues to invest in its leaders to engage frontline clinical staff in improving care quality and efficiency.”
Modifying targets was necessary in order to free up doctors to focus on providing quality patient care, Lansley said. “I want to free the NHS from bureaucracy and targets that have no clinical justification and move to an NHS which measures its performance on patient outcomes,” he continued.
In a revision to the 2010-11 NHS Operating Framework, the NHS is now also being asked to give greater priority to military veterans’ health and dementia, as well as confirming trailed plans to withhold payment from hospitals where patients are readmitted within 30 days of discharge.
Adam Hill
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