Lansley: My 60-step plan for the NHS will save 20,000 lives a year by improving quality of care

Benchmarks: Andrew Lansley, the Health Secretary, wants NHS doctors and hospitals to be graded

Benchmarks: Andrew Lansley, the Health Secretary, wants NHS doctors and hospitals to be graded

Health Secretary Andrew Lansley will today unveil plans to grade NHS doctors and hospitals to improve the quality of service for patients.

They will be judged against 60 tough new “benchmarks” designed to save more than 20,000 lives a year.

In a speech at a Central London hospital, he will call on the NHS to focus on not only the speed at which patients are treated, but the quality of care that patients receive.

Figures on hospital death rates, the performances of GPs and surgeons and patients’ experiences will be published as part of the NHS Outcomes Framework.

Fifty-seven indicators will replace the former target-led system and will include a focus on improving cancer survival and a zero-tolerance approach to hospital-acquired infections such as MRSA.

The plans are designed to ensure patients are treated with dignity by measuring the ‘responsiveness’ of staff to patient needs.

They aim to improve women’s and families’ experiences of maternity services, increase the number of people who can access an NHS dentist and help older people recover independence after illness.

Under the plans, fewer people with long-term conditions like asthma and diabetes will be treated in hospitals, and patients undergoing hip and knee operations will receive better care.

An indicator on carers who look after sick and elderly relatives is also included.

Mr Lansley will say: ‘We have to clear the decks and be clear this is what we are focusing on.

“We have to clear the decks and be clear this is what we are focusing on”

Andrew Lansley, Health Secretary

‘People say in three and a half years’time, in 2015, at the next election, how will we know whether you’ve succeeded or not The answer is, “Have the outcomes improved”

‘It will be my failure if we haven’t improved them and the NHS should feel that it has not succeeded, that iswhat we are setting out to do.’

The Government will publish details ofthe current performance for each of the sixty benchmarks next week. National targets from improvement will then be set out by the time of the next election.

Today, the Government will publish forthe first time data comparing patients” experiences at individual GPs” surgeries, including recovery times.

It is hoped that revealing the information will force up standards by allowing patients to choose to avoid poorly performing doctors or institutions.

Where performance falls below minimum requirements the NHS Commissioning Board and Care Quality Commission will intervene to drive up quality, although how this will work in practice is unclear.

Held to account: Nurses and other NHS staff will be judged against nearly 60 tough new goals designed to save more than 20,000 lives a year

Held to account: Nurses and other NHS staff will be judged against nearly 60 tough new goals designed to save more than 20,000 lives a year

The aim of the plan is also to move away from a focus on targets, such as those for waiting times introduced under Labour.

However, patients will still have the right to prompt treatment within 18 weeks of referral by their GP as setout in the NHS Constitution.

Mr Lansley hopes the framework will also provide reassurance to parliamentarians about the accountability ofthe Health Secretary for the NHS.

There have been concerns that the Health and Social Care Bill, currently going through the Lords, dramatically weakens accountability of the secretary of state.

THE 60 INDICATORS FOR PATIENT OUTCOMES

PREMATURE DEATH

1. Numbers of extra years that, on average, a person could have lived if given access to timely and effective health care.

2-3. Life expectancy at 75, for men and women.

4-7. Mortality rates in under-75s from cardiovascular disease, respiratory disease, liver disease and cancer.

8-13. One and five-year survival rates for colorectal (bowel), breast and lung cancer.

14. Mortality rate in under-75s, above the normal, in adults with serious mental illness.

15-17. Rates of infant mortality, neonatal mortality and stillbirths.

18. Mortality rate in under-75s, above the normal, in adults with learning disabilities.

QUALITY OF LIFE FOR PEOPLE WITH LONG-TERM CONDITIONS

19. Health-related quality of life for people with long-term conditions.

20. Proportion of people feeling supported to manage their condition.

21. Employment of people with long-term conditions.

22-26. Unplanned hospital admissionsin adults with conditions like asthma, diabetes, epilepsy, congestive heart failure and chronic obstructive pulmonary disease.

27-29. Unplanned hospitalisation for asthma, diabetes and epilepsy in under-19s.

30. The health-related quality of life for carers.

31. Employment of people with mental illness.

32. Quality of life for people with dementia.

HELPING PEOPLE RECOVER AFTER ILL HEALTH OR INJURY

33. Emergency hospital admissions for acute conditions (ie, injury or sudden onset of ill health) that should not usually require hospital admission.

34. Emergency readmissions to hospital within 30 days of discharge.

35-37. Health improvements following pre-planned operations for hip and knee replacements, groin hernia, and varicose veins.

38. Numbers of children who have to be admitted to hospital due to very bad chest (lower respiratory tract) infections.

39. Degree of recovery from injuries and trauma.

40 Degree of recovery six months after a stroke.

41. Degree of recovery after brittle-bone fractures, namely the proportion recovering previous levels of mobility after 30 days and 120 days.

42. Proportion of over-65s still at home 91 days after being discharged.

43. Proportion of over-65s offered rehabilitation after discharge from general or community hospital.

PATIENT EXPERIENCE

44. Patient experience of GP services; GP out-of-hours services; NHS dental services; hospital care (overarching indicators).

45. Patient experience of outpatient services.

46. How well hospitals respond to in-patients” personal needs (ie, basic care such as help with eating and going to the toilet).

47. Patient experience of A&E.

48. Ease of access to GP services and NHS dental services.

49. Women”s experience of maternity services.

50. A measure of the experience of end-of-life care (by asking bereaved carers).

51. Patient experience of community mental health services.

52. Children”s/young people”s experience of health care.

TREATING PEOPLE SAFELY

53. Reported patient safety incidents.

54. Safety incidents involving severe harm or death.

55. Incidence of hospital-related venous thromboembolism (VTE), a type of serious blood clot.

56. Incidence of health care-associated MRSA and Clostridium difficile infection.

57. Incidence of serious pressure ulcers, often acquired due to staying in hospital beds and not being moved often enough.

58. Incidence of medication errors causing serious harm.

59. Admission of full-term babies to neonatal care.

60. Incidence of harm to children due to “failure to monitor” their condition.

Mr Lansley also hopes the plan will provide a much greater level of NHS accountability by allowing better comparison with other health systems around the world.

The NHS has been criticised for lagging behind other countries in areas such as cancer survival.

Ministers will be expected hold the health service to account on delivering increasing improvements across all areas in the new framework.

Where performance falls below minimum requirements they will intervene to drive up quality, although how this will work in practice is as yet unclear.

The framework will also draw on existing information collected about the NHS to reduce the potential for”administrative burden”.