Clinical budget ownership is to be extended to hospital doctors and nurses, health minister Lord Darzi announced this week.
It’s one of a new set of proposals in High Quality Care For All: Our Journey So Far, which charts the progress of the Darzi Review one year on.
The report says that through giving consultants and nurses ownership of their clinical budgets - like with GPs and practice-based commissioning - entrepreneurship and innovative delivery of services will be promoted. They’ll also be more patient focused.
Lord Darzi said: “Quality is what we aspire to and innovation is how we achieve it. High quality care is better for patients and often better value for tax payers.
“The progress made since last year in the quality provided to patients and the safety of their care was not driven through top-down targets but by giving responsibility to the staff at local level.”
But Stephen Campion, chief executive of HCSA, doubted whether trust finance directors would give clinicians the level of ownership and protected funding required for them to make a real difference to how their services are delivered.
He said: “The principle of budget ownership by clinicians has been around for some time. It has largely failed because the responsibility to manage these budgets is not matched by giving effective authority to clinicians.”
Two “obsolete” clinical targets are also to be removed: the 13-week outpatient and 26-week inpatient performance targets. A review into other targets was also launched.
A voluntary peer review accreditation system will also be introduced to assess the standards of clinical teams and create competition among clinicians to improve. The royal colleges are currently developing a consistent approach, and it will be overseen by the National Quality Board.
Professor Ian Gilmore, president of the Royal College of Physicians, welcomed the report.
He said: “The challenge for the NHS is to ensure that the components of the quality agenda are practical and deliverable ensuring that the laudable aspirations can be transferred from paper into practice, especially in an increasingly cash-strapped environment.
“The College is delighted to be leading the national pilot project on the accreditation of stroke services. Service accreditation is a highly complex area but we believe it is a logical extension of our existing programme of guidelines and audit. We believe that service accreditation will complement the regulatory work of the Care Quality Commission and provide the organisational context for individual medical revalidation.”
The Department of Health report also highlights a number of successes over the past year such as a significant reduction in hospital-acquired infections and longer opening hours at many GP surgeries.
