The government is about to abolish most of National Health Service goals for the next year so that the health service works in a similar way to the schools.
Patricia Hewitt, former Secretary of Occupational Health, is currently working on a review of how NHS care in England is administered and managed You should report in March.
Ministers hope Ms Hewitt will recommend that most of the targets for heads of health services and GPs be dropped, giving local leaders more autonomy.
the perspective of significantly fewer targets it has been welcomed by the Royal College of GPs, which said many were “checkbox exercises that take clinicians and our teams away from providing frontline patient care.”
The Chancellor and Secretary for Health tasked Ms Hewitt last month to review how newly created integrated care systems should work, and in particular “how to empower local leaders to focus on improving outcomes for their populations, giving them greater control and making them more responsible. for performance and expense.
Ministers believe the NHS has become too centralised, with individual hospital trusts and GP practices forced to adapt their work to meet dozens of different objectives – 72 in all, in the case of GPs.
They would prefer to delegate responsibility to local managers, allowing them to decide how best to achieve fewer broad goals. “We need to run the NHS more like we run the school system,” said a senior government source.
Professor Kamila Hawthorne, President of the Royal College of GPs, said: “GPs and our teams are working under intense workloads and job pressures and the bureaucratic burden we face on a daily basis adds to this.
“There may be some value in some of the frameworks and performance indicators we are currently working on, but many feel like box exercises that steer clinicians and our teams away from providing frontline patient care, so at least a radical review of these in general practice is needed to ensure they are proportionate and broadly reduced, that they allow GPs to focus on patient needs in their local areas and that they are in the best interest of patients.”
He added that “a robust recruitment and retention plan to build the GP workforce” would be needed to increase the number of GPs and take pressure off the primary care network.
Integrated systems of care bring together health providers with municipalities, which are responsible for social care, in an attempt to improve the transition between hospital treatment and social care. NHS leaders have pointed out that councils currently have significantly more autonomy than they do.
Rishi Sunak is working on ways of increase the efficiency of the health service after becoming frustrated that standards have fallen even as funding has steadily increased, according to allies. It will drive faster GP appointments and a reduction in the backlog of elective surgeries in the New Year, as well as speeding up the process of discharging patients from social care so their hospital beds can be reallocated, which in turn should reduce waiting times for ambulances.
How the goals have grown and grown
Published targets were first introduced for the NHS in the 1990s and became a key part of Tony Blair’s plan to improve public services by making them more accountable.
But the growing number of targets has raised fears that managers are focusing more on achieving them than on improving overall service quality.
GP practices face 72 separate targets under the ‘quality and outcomes framework’, scoring on each to produce an overall score of 635 points. These are mainly very specific objectives such as ensuring that patients with depression have a check-up between 10 and 56 days after their diagnosis; administer statins to up to 90 percent of diabetics; and produce a “personalized written action plan” for as many asthmatics as possible.
While the metrics are theoretically voluntary, 97.5 percent of practices participate and results are published in leaderboard format.
For hospitals, the goals tend to be broader: patients should wait no more than four hours in emergency departments and no more than 12 hours to be admitted to a ward if necessary.
A&E targets and ambulance wait times have been repeatedly missed since the pandemic in great embarrassment to the Government; for example, only one in six regional ambulance trusts has reached the target of responding to all the most serious calls within seven minutes.
There are specific goals for cancer treatment, such as treating all patients within 62 days of an urgent referral and making an appointment with a specialist for anyone with breast symptoms within two weeks.
Targets for mental health include signing up a minimum of 1.6 million patients for talk therapy in a year, which, like many other NHS targets, was missed last year.