Government sets out how NHS standards will be measured

The Government has set out how NHS standards are likely to be measured in future, with a focus on how well treatments and care are working for patients.

Health Secretary Andrew Lansley wants the NHS to focus on "outcome goals", which he says will enable patients, the public and Parliament to hold him to account for the performance of the health service.

He has pledged to scrap NHS targets which have no "clinical justification", but the Government has denied the new proposals are just a new set of targets.

The British Medical Association (BMA) welcomed the move towards focusing on patient outcomes but said many difficult questions still needed to be answered, such as how the success of the NHS in achieving these goals would be measured.

Today, the Department of Health launched a consultation on how the new NHS Outcomes Framework could look.

It will focus on five key areas: preventing people from dying prematurely, enhancing the quality of life for people with long-term conditions, helping people to recover from episodes of ill health or following injury, ensuring people have a positive experience of care, and treating and caring for people in a safe environment and protecting them from avoidable harm.

Each of these five areas will have an "overarching" outcome indicator, or indicators, to measure the progress made in making improvements.

These indicators will also have five specific improvement areas.

For example, when it comes to preventing people from dying prematurely, the overarching indicator could be death rates which can be affected by good or poor healthcare.

Specific improvement areas might be premature death rates from heart disease or stroke, one and five-year cancer survival rates, and how many years of healthy living 65-year-olds can expect to have.

Each area will be supported by Quality Standards developed by the National Institute for Health and Clinical Excellence (Nice), which will highlight the type of care patients should expect.

Nice has been tasked with producing around 150 of these Quality Standards over the next five years.

Today's consultation document says the new NHS Outcomes Framework will initially focus on indicators where data can be collected.

However, it is unclear if extra data will need to be collected for hundreds more areas than at present.

A new NHS Commissioning Board will measure how well the health service performs against these areas.

The board will "determine how best to deliver improvements against the selected outcomes by working with GP consortia and making use of the various tools and levers it will have at its disposal".

This could include "designing payment mechanisms and incentive schemes".

Dr Hamish Meldrum, chairman of the BMA, said: "The Government's intention to move away from politically motivated targets to patient outcomes supported by clinical evidence is sound, in principle.

"However, this is a highly complex undertaking, and many difficult issues need to be addressed, such as how success against these goals is measured, the robustness of any data used, and how we avoid creating unwelcome perverse incentives.

"The BMA will contribute fully to this consultation to try to ensure that we achieve a set of measures that are fair to clinicians and really help to inform patients in the choices they wish to make.

Mr Lansley said: "The White Paper set out the Government's vision for the NHS - a quality service that achieves health outcomes that are among the best in the world.

"I want to free doctors and nurses to focus on what really matters - better results for their patients - instead of them being stifled by top down targets.

"Instead of politically motivated targets which lack clinical evidence, we will measure the outcomes that are most important to patients and that are relevant to healthcare professionals.

"These will be backed up by authoritative, evidence-based Quality Standards that will ensure everyone understands how those outcomes can be achieved."