Reform of the NHS in England at critical point and further progress needed

Commenting in response to today’s report from the Healthcare Commission and Audit Commission on NHS reforms, King’s Fund Director of Policy Anna Dixon said:

'Reform of the NHS in England has reached a critical point – today's report is right that there is potential for patients to benefit from many of the reforms introduced to the NHS but there remains a great deal to be done to realise these benefits fully.

'The report shows, for example, that some patients are being offered greater choice but this is yet to have an impact on the quality of care. Similarly, there has been a modest increase in the use of the private sector, but little evidence of this having had a significant impact yet on overall quality of care or waiting times.

'We agree with the report's recommendations that greater effort is needed to improve the quality of commissioning, particularly by engaging GPs better. We also agree that much more work is needed to ensure the availability and quality of information about health care services. Better information will help patients make better choices, assist GPs in understanding where the best quality care can be had for their patients and, above all, help local PCTs have a better understanding of what health benefits they are getting for taxpayers' money. Without such information about both public and private sector providers it will be impossible to judge whether the NHS reforms as a whole have been a success.

'The costs of the reform programme must be measured against the benefits that have been delivered. As the report highlights, there are still big gaps in our understanding and we agree with today’s report that a mandatory system of national data collection needs to be defined and implemented.

'Finally, today's report is right that handing hospitals more independence through foundation status has strengthened the financial acumen of those trusts. One area of concern is the large investment in the new contracts for NHS staff, which do not appear to have resulted in increased productivity or delivered commensurate benefits for patients.'

She added: 'Lord Darzi's imminent review provides an opportunity to set out a vision for the health service over the next decade. The next stage in the NHS reform journey should see much greater responsibility and control of day-to-day operational issues handed over to the health service, while Ministers and the Department of Health must focus on setting standards, goals and priorities for the NHS and holding local organisations to account for what they deliver. In addition to the current reforms, which have primarily aimed to improve the quality of hospital care, the vision needs to include the needs of those with enduring, chronic conditions and mental health problems.'

Notes to editors: 

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