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NHS England should scrap a number of national targets, review says NHS England should scrap many of its national targets, review says
(about 1 hour later)
Government-commissioned study by Patricia Hewitt also calls for a shift in focus towards preventing ill healthGovernment-commissioned study by Patricia Hewitt also calls for a shift in focus towards preventing ill health
The NHS in England should abolish a number of national targets while shifting its focus towards preventing ill health, according to a review by a former Labour health secretary. The NHS should abolish many of its national targets while shifting its focus towards preventive healthcare, according to a review by a former Labour health secretary.
The study by Patricia Hewitt, commissioned by the government and officially published on Tuesday, says a few targets help concentrate minds, but having too many makes them less effective. The study by Patricia Hewitt, commissioned by the government and due to be published on Tuesday, will say that, while targets can help concentrate the minds of those responsible for a service, having too many makes them less effective.
It comes as the NHS continues to miss targets on A&E waits, ambulance response times and cancer waits and treatment times. It comes at a time when record numbers of people are on NHS waiting lists and as the health service in England continues to miss targets on A&E waits, the speed of ambulance responses, and cancer treatment times.
The review will say that adding new targets and initiatives and not being consistent with funding makes it impossible to plan new services and recruit staff, and wastes money and time. Hewitt will also say that some targets, such as those on A&E waits, leave less room for medics to use their clinical judgment. The review, extracts of which have been seen by the PA news agency, will say that setting new targets and failing to provide adequate funding for new initiatives makes it far harder to plan new services and recruit staff.
An excessive focus on hitting targets by managers or NHS boards can lead to “gaming” of the targets and “disastrous neglect of patients themselves”, the review will say. It will add that an excessive focus on hitting targets by managers can lead to “gaming” of the targets and a “disastrous neglect of patients themselves”.
In her study, extracts of which have been seen by the PA news agency, Hewitt will say ministers should consider significantly reducing the number of national targets, with no more than 10 national priorities. There should also be more focus on outcomes to improve patient care. Figures show that, in February, only 71.5% of patients in all A&E departments were seen within four hours. The last time the 95% target was met was in July 2015.
Cutting waiting times for key surgery such as hip replacements and cataract operations should be matched by a focus on reducing waits for mental health treatment, Hewitt will say. An investigation by the Guardian found that more than 500 seriously ill patients died last year after ambulances took up to 15 hours to reach them.
Local leaders running new integrated care systems (ICSs) – which are partnerships of organisations that come together to plan and deliver joined-up health and care services – should be given more space and time to lead. Reports in December suggested the government was planning to scrap most national targets in favour of a greater emphasis on local management after the initial findings of Hewitt’s study.
On preventing ill health, the review will call for the share of total NHS budgets at ICS level going towards prevention to be increased by at least 1% over the next five years. The public health grant to local authorities should be increased after eight years of a real-terms squeeze on their funding. The study will recommend the current targets be replaced by no more than 10 national priorities and that local leaders be given more space and time to deliver improvements in services.
This “shift upstream” towards preventive services is vital to prevent more older and increasingly unhealthy people entering hospitals that will never be large or efficient enough to cope, the review will say. Hewitt will also say that hospitals will never be large or efficient enough to cope with the demands placed on them by an ageing and increasingly unhealthy population.
Hewitt will say the NHS is, in practice, more of a national illness service than a national health service and will call for rapid change. She will call for a “shift upstream” intended to avoid people going into hospital in the first place and for the share of total NHS budgets going towards preventive care to be increased by at least 1% over the next five years.
The government should also consider creating citizen health accounts carrying people’s health information and data, to help people manage their own health and care. She will say the government should consider creating citizen health accounts to hold people’s health data and help them manage their own health and care.
Further details will be set out on Tuesday. Hewitt served as health secretary from 2005 to 2007 and was thought of as a modernising member of the New Labour government.