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CCGs to be compared using ‘traffic-light’ metrics

Health secretary reveals plan for new way of holding commissioners accountable for care

Louise Prime

Friday, 05 June 2015

Jeremy Hunt has told delegates at the NHS Confederation’s annual conference that he wants to bring the same transparency, efficiency and accountability to the commissioning of health care, as to the provision of health care. The health secretary proposed a ‘traffic light’ system of rating clinical commissioning groups (CCGs) that he said should help the NHS to become the ‘world’s largest learning organisation’.

He said that the Government could ‘help’ those working in the NHS by changing the way that NHS performance data are published, to reduce the current level of inconsistency between reporting of, for example, A&E figures and cancer waiting times, and for safety data to be included.

But he also revealed to delegates: “I have asked The King’s Fund’s Chris Ham to help myself and NHS England to develop some transparent metrics that look at the provision of health care in every part of the country, as the proper and correct way of holding CCGs accountable for the way they deliver health care.”

He said the intention was to look at global best practice, and models used in Sweden, the US and elsewhere, to move “one step closer to true outcomes-based assessment”, with a patient-focused approach to examining healthcare economies.

He proposed a ‘traffic-light’ system of looking at CCGs’ performance right across their commissioning of all health care, including co-commissioning of social and primary care and specialist commissioning, ‘through the lens of five key patient groups’ – older people, people with long-term conditions, people with mental health conditions, mums and children and the generally healthy. He said they would look at access; quality, including clinical outcomes and safety; and prevention.

These factors would then be weighted, and CCGs given ratings so that the quality of care that they commission could be compared with that in other CCGs nearby and across the country.

Mr Hunt argued that although the quality of care is determined by providers, nevertheless, “in the end the CCG holds the chequebook so they are responsible for making it work.”

He said that if this could be achieved it would “make this country one of the first in the world to try to understand the quality of whole-patient care of an entire patient pathway – primary, secondary and social care” and enable us to see where it is and isn’t working well.

He explained that CCGs awarded ‘lots of green ticks and lots of blue OKs’ would be able to be left alone, but said: “On behalf of patients we have a responsibility to step in if we have persistent failure that is not being addressed” – which, in his presentation, was denoted by a red exclamation mark symbol.

Assessment would also include a metric for resilience – for example, how well prepared CCGs were for seasonal variations in the demand for emergency and urgent care – and another for ‘transformation’, which referred to planning for changes over the next, say, 3-5 years.

Mr Hunt said: “I want to stress that this [proposal] is a way that we can move beyond targets as a way of driving change in the NHS, to transparency, to peer review and to becoming the world’s largest learning organisation as the real way that we drive up quality. And if we can do that, that will be transformational for the NHS.”

Picture credit: Helga Esteb / Shutterstock.com

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