Doctors will have to make sure their patients are happy or their hospitals could lose money.
This is the latest policy announcement from health secretary Andy Burnham who wants payments for acute care to be linked to levels of patient satisfaction.
In a speech to the King’s Fund on the future of the NHS, he said a “powerful, new financial framework” will reward people-centred service and care. “This is a big culture change for the NHS, which has traditionally been paid by volume,” he said.
Earlier this year a web tool that allows people to compare the standards of care at different hospitals was launched on the Government website NHS Choices.
But Burnham wants to go further by measuring patient satisfaction service-by-service in each hospital and publishing the results on a regular basis. Patients will be able to rate issues such as dignity, cleanliness, how they were spoken to and car parking.
“At the moment, quality is only faintly recognised in the tariff. In the future, we’ll progressively link a much bigger proportion of a trust’s income to quality and, importantly, levels of patient satisfaction,” he said.
He also warned that the new payment system would encourage commissioners to move services away from hospitals that patients were not happy with.
Next year the Department of Health will introduce a best practice tariff for stroke, hip fractures, gall bladder and cataract surgery. “This will link tariff payment to delivering the highest quality, not just the average cost,” explained Burnham.
Whitehall sources are reported as saying “significant” sums will be involved because the new policy is at the heart of Labour’s vision for service improvement.
Under a pilot scheme launching next spring in NHS Northwest, hospitals will be able to earn a premium of up to 4% of their budgets if patients are satisfied with their care.
Stephen Campion, chief executive of the HCSA described the idea as a “non starter”.
“How can patients judge what is the benchmark around which they are assessing the quality of service? What is the point of having a Care Quality Commission which is there to assess and monitor the quality a trust provides if that responsibility is going to be passed to patients, who with the greatest respect are probably not best placed to judge the quality of care they are given?”
Dr Hamish Meldrum, BMA Council chairman, added: “In the long run, the overall benefits of treatment on a patient’s health - which can take months to become clear - are more important than factors such as the distance of the car park from the ward.
“Rewarding quality is a laudable aim but we must avoid penalising hospitals or their staff on the basis of factors beyond their control.”
Mr John Black, president of Royal College of Surgeons, said discovering and rewarding high quality care would mean measuring health outcomes and this would require increased funding for clinical audits and systematic patient reported outcome measures.
“Mr Burnham’s recent speech dwelt heavily on patient and staff satisfaction surveys and, while these are useful, we won’t find out the true quality of NHS treatment by these alone,” he said.
Read coverage of NHS Choices.
Tags: NHS Choices, Patient satisfaction

Whilst the politicians’ view of ‘quality’ often seem to be focussed on such things as car parks, waiting, communication and speedy discharge (all of which are important to patients), this PROM does seem to be CLINICALLY orientated - and is really only what a lot of clinical audit is doing already!
We should be grateful that, at long last, they are beginning to realise that whether the treatment does any good is what realy matters!