Public sector targets to be scrapped

Public sector targets to be scrapped (GU 18/7/07)

Reduction in PSAs from over 100 to 30. Change to most depending on local decisions by councils and NHS bodies, rather than top-down targets. Evidence of shift to more relational model?

Paying for quality

Paying for quality (Healthcare July 2007) <In example pack>

PbR is example of extremely transactional performance management. Quality only addressed indirectly. Compare to GPs QOF framework which relates payments not only to activity by to various quality outcomes. Pilot scheme in NW SHA based on US model. Define quality measures for high volume conditions and score to create a composite quality score for each. Bonuses are payable to high quality hospitals.

Defining outcome measures is difficult because of the effect of factors outside the hospitals’ control.

Comment – Caring and sharing, by Peter Coates

Comment – Caring and sharing, by Peter Coates (PF 23/11/07)

In support of SBS. Not just savings; financial control improved, centralised e-procurement, automated FIMS reports.

Nine NHS trusts under scrutiny after continued failures

Nine NHS trusts under scrutiny after continued failures (PF 26/10/07)

Failure is an inevitable consequence of disaggregation. Much re-aggregation seeks to take failing organisations in hand.

University to join NHS trusts in joint healthcare venture

University to join NHS trusts in joint healthcare venture (GU 4/5/07)

Potential merger and FT application from Hammersmith and St Mary’s trusts and IC. First non-NHS FT sponsor. Combined management structure for treatment, teaching and research. FTs give more independence from Whitehall, but seem to be triggering some re-aggregation.

Sleepwalking into an unhealthy alliance

Sleepwalking into an unhealthy alliance (GU 14/11/07)

Creation of Care Quality Commission from the various health inspectorates. Concerns that the upheaval will impact negatively on care standards. May be particularly damaging to social care, as ministers clearly prioritise infection control at present. Also change in rationale: was to reduce burden of inspection, now is to increase effectiveness.

Majority of operations could be done locally

Majority of operations could be done locally (PF 20/4/07)

BMA and Ara Darzi (then advisor on surgery) emphasize the importance of district general hospitals. In contrast to aggregation into large trusts.

Where do we go from here? By Peter Hetherington

Where do we go from here? By Peter Hetherington (PF 20/4/07)

Herefordshire Council and PCT form one public service trust for all health and social care services. Save by having one management structure. Plans to bring in public safety, environment & transport by bringing in more partners.

Sheffield also has a joint Director of Public Health with the PCT and has many collaborative partnerships: an economy board, a city development company, a work and skills board. Place-shaping.

Lyons: need to remove departmental financial silos to deliver joined up local services.

Point of law – The weakest Links, by Stephen Cirell and John Bennett

Point of law – The weakest Links, by Stephen Cirell and John Bennett (PF 5/10/07)

400 NHS-run Patient Forums to be replaced by 150 Local Involvement Networks (Links). New powers to recommend improvements to service-providers and to require responses to them.

Made to measure, by Tash Shifrin

Made to measure, by Tash Shifrin (PF 26/10/07)

Brown emphasises personalised services over choice. Choice demands diversity, but personalisation does not necessarily, opening the door to increased re-aggregation.