The health secretary urged clinicians to lead quality improvements in the NHS, at the BMA’s annual representatives meeting.
Andrew Lansley said he would empower doctors and free up the service to deliver results in return for the profession’s support and leadership in delivering change.
He said key priorities for the government were to continuously improving outcomes for patients - “not inputs or processes, but results” - and to make the NHS sustainable through prioritising prevention.
He said: “I can’t count how many times doctors have told me, on a personal and professional level, how frustrated they are by the way the system works. How their judgements and activities are restricted by the rigidity of the system, and how their clinical priorities have been distorted by narrow process targets.
“If we are going to achieve the outcomes we all want to see, we need to break down that system and build one that is focused on improving results for patients.”
He outlined four steps to achieving this.
The first is measuring outcomes rather than inputs. He wants to construct a national outcomes framework for the NHS which will include targets for improving one and five year survival rates for cancer and reducing premature mortality from stroke, heart and lung disease.
The 18-week target for hospital waiting times, the four hour A&E target and the 48-hour target for GP access, will all be scrapped.
Secondly, control of commissioning with be given to GPs to enable the design of more tailored services for patients.
The government also wants to introduce “proper” measures of quality across the service.
He said: “Clinicians will be accountable in a different way - not to tick-box process targets, but to quality standards.
“Standards which do not distort clinical judgement, but which are based on clinical evidence. Standards which achieve better outcomes and are comprehensible to patients so that they can hold clinicians to account.”
And, finally, improving access to information. He pointed to the National Joint Registry and 2008 National Adult Cardiac Database Report and claimed they should provide a model for how feedback can be delivered to clinicians to improve quality and outcomes.
He supports the North West’s Advancing Quality programme, which has been collecting outcomes data on five high cost and high frequency interventions, including heart failure, pneumonia, and hip replacements.
He said: “They’ve been measuring their performance - not against national targets - but against their own standards, and working to improve the quality of the service they provide.
“It’s the first time in the UK that such data has been reported on behalf of a regional health system, assured by the Audit Commission, and made available online so that the public can see exactly what’s going on.”
Lansley concluded his speech by highlighting the deal he wants to strike with the profession: “The critical issue is this: what will you do with these freedoms and responsibilities? That is a question of leadership,” he said.
Tags: Health policy, Lansley
