Sorry to start the new year of on a cynical note but... Just before Christmas the NHS Commissioning Board (the central body which sets standards for the NHS) published a series of documents.
The news-making headlines were that hospitals and GP practices would be open seven days a week and that data was being published that will enable better patient choice.
Potentially this is not just good news for patients but also for PMI insurers and IFAs, as it would go some way to addressing, in the NHS, one of the issues raised by the OFT inquiry – the lack of data to make informed comparisons on quality of care. It would also put pressure on private hospitals to provide equivalent information. But, as always, things are not so clear cut.
And with one mighty bound the NHS is turned into a 7/7 organisation which is patient focused, efficient and has better clinical outcomes. Not quite. What is actually going to happen is that the national medical director will establish a forum that includes national and local commissioners, providers and regulators to identify how there might be better access to routine services seven days a week and report in the autumn of 2013.
So actually it equates to another review. And even that is restricted to diagnostics and A&E. As for GP practices “we will ensure primary and community-based services also deliver a high quality, responsive service both in and out of hours” – ie no change in theory from now.
Next to data. Here we have a bit of progress for people like me who do research. Finally in one place we have published data sets for each local commissioning group and local authority. The problem is that each file is around 6mb and there is no way of doing comparisons without turning your quest into a full time job with a team of supporting researchers.
They do seem to recognise the comparison problem as the Healthcare Quality Improvement Partnership (HQIP)5 (another quango with a catchy title) will develop methodologies for case-mix comparison, publish activity, clinical quality measures and survival rates from national clinical audits for most consultants.
The data will be published by “summer” 2013. And publication will be part of the NHS Standard Contract from 2014-15 to allow for comparisons across hospitals. A slow process.
The second area of data concerns patient satisfaction. They start with a bold ambition to capture real-time patient and carer feedback. But the timetable is for 2015. Trials in limited areas will start this year. It remains to be seen how the NHS will cope in reality.
Finally there is the issue of data from GP practices and for care pathways (where care takes place as a journey through different interventions often in different locations).
They have committed themselves to collecting a core set of clinical data from GP practices for 2013-14. I wish them well with obtaining this – we must assume it will be treated more seriously than the data some practices provide for insurers through the GPR system – which they get paid for of course.
As for care pathway data, this will only be possible if all providers use the NHS number provider identification code. Currently this does not happen and they aim to achieve it by 2014. Only at this point will this aim start to be achievable on a universal basis.
So overall we can expect to see little real change until the next election – by which time we will probably have another NHS reorganisation.
Richard Walsh is a director and fellow of SAMI Consulting, www.samiconsulting.co.uk
