The Healthcare Commission’s 2007/8 annual health check of all 391 NHS trusts in England finds a third have improved their ratings.
Overall, trusts have done well on cancer treatment waiting times targets with 83,000 (97%) of patients receiving their treatment in two months of a GP referral. In 2005/6, only 28,000 patients received this. The majority are also on course to meet the 18-week target - 108 (64%) of acute and specialist trusts likely to meet it by year end.
But over a third are still not meeting the core standards set by the Commission and face continued close scrutiny until improvements are seen.
Acute and specialist trusts have made the biggest strides with 29 rated ‘excellent-excellent’ on quality of services and use of resources compared to only two in 2005/06. 77% were ‘excellent’ or ‘good’ for quality of services and 64% scored the same on use of resources.
Only a third of primary care trusts were rated ‘excellent’ or ‘good’ on service quality but over half scored ‘excellent’ or ‘good’ on use of resources. In 2007/8, only 31% of PCTs met the 48-hour access target whilst 80% did the year before. Patient surveys and information from GPs’ surgeries are now included in the assessment, point out the Commission, which has lead to the significant change in results.
Geographically, the capitol is lagging behind many areas with a fall in quality of services. A&E waiting times, access to GPs, the waiting time from referral to treatment and screening for breast cancer are the main problem areas.
On infection control, 114 trusts (29%) didn’t meet one or more of the three core standards relating to infection control. Last year the figure was 111 trusts. Only 52% of acute trusts met the target to reduce rates of MRSA by at least 60% over three years (or a maximum of 12 cases of infection).
Sir Ian Kennedy, chairman of the Commission said: ‘Three years into this assessment, the public are entitled to expect urgent action at trusts which are still performing poorly. The primary care sector has improved, but more is needed as this sector delivers 88% of healthcare. Primary care trusts must redouble their efforts in areas such as access to GPs and the provision of choice.’
The BMA chairman, Dr Hamish Meldrum, said the report’s finding that there had been a fall in PCTs meeting the 48-hour access target was misleading. The NHS Information Centre patient survey on GP access carried out earlier this year demonstrated a more positive result – that almost 9 out of 10 patients said they were able to get an appointment within 48 hours.
Next year, the quality of commissioning by PCTs will be included in the annual health check.