Health secretary cuts number of targets in a move to local health plans
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《英国医生杂志》
The next stage of NHS reform will be driven by local planning rather than national targets, according to the secretary of state for health, John Reid, who last week launched the government抯 latest three year plan for the health service.
The document sets out the guidelines by which all organisations in the NHS will be expected to implement the June 2004 NHS Improvement Plan. The emphasis is on local autonomy and care of individual patients. National targets, previously a keystone of government healthcare policy, have been cut by more than half, from 62 to 20.
Mr Reid stressed that the aim of the strategy was to build on past success, and he insisted that previous target setting initiatives had delivered results. He described the next stage of NHS reform as "a managed transition from a centrally driven system which has achieved very significant improvements to a patient driven system where local providers will have more authority to determine how to meet the demands of patients." Most of the targets omitted from this year抯 list had been met, he claimed, with the only new addition being a commitment to reducing the incidence of methicillin resistant Staphylococcus aureus.
The chief medical officer, Liam Donaldson, tacitly acknowledged criticisms of the government抯 zeal for national planning when he said that he hoped the shift of emphasis would safeguard the quality of care of individual patients. He said, "We want a situation where, for every NHS staff member, at that moment when they抮e with the patient, that patient is the most important thing to them—their health and their welfare."
Until 2008 about ?50bn ($460bn; �380bn) of public money will go into the NHS, with primary care trusts disposing of around 80% of that total. In return these trusts will now have responsibility for identifying local healthcare priorities, with reference to the needs of the local population and gaps in local services; producing local delivery plans to direct the provision of health care; and monitoring performance against their own locally set targets by means of auditing and feedback from patients.
Accompanying these responsibilities will be a new funding structure, "payment by results," which will reward the services that a primary care trust provides according to a standard national tariff.
Performance will be inspected by the independent Healthcare Commission, which is in the process of drawing up the relevant assessment criteria. The commission will also have the authority, where it is felt that significant failings exist, to make recommendations to the health secretary or, in the case of foundation trusts, which have been granted some independence, the independent regulator of NHS foundation trusts.
Broad national targets will still define the areas on which primary care trusts are expected to concentrate, and the government will continue to be responsible for national standards and the overall direction of the NHS.(London Madeline Brettingh)
The document sets out the guidelines by which all organisations in the NHS will be expected to implement the June 2004 NHS Improvement Plan. The emphasis is on local autonomy and care of individual patients. National targets, previously a keystone of government healthcare policy, have been cut by more than half, from 62 to 20.
Mr Reid stressed that the aim of the strategy was to build on past success, and he insisted that previous target setting initiatives had delivered results. He described the next stage of NHS reform as "a managed transition from a centrally driven system which has achieved very significant improvements to a patient driven system where local providers will have more authority to determine how to meet the demands of patients." Most of the targets omitted from this year抯 list had been met, he claimed, with the only new addition being a commitment to reducing the incidence of methicillin resistant Staphylococcus aureus.
The chief medical officer, Liam Donaldson, tacitly acknowledged criticisms of the government抯 zeal for national planning when he said that he hoped the shift of emphasis would safeguard the quality of care of individual patients. He said, "We want a situation where, for every NHS staff member, at that moment when they抮e with the patient, that patient is the most important thing to them—their health and their welfare."
Until 2008 about ?50bn ($460bn; �380bn) of public money will go into the NHS, with primary care trusts disposing of around 80% of that total. In return these trusts will now have responsibility for identifying local healthcare priorities, with reference to the needs of the local population and gaps in local services; producing local delivery plans to direct the provision of health care; and monitoring performance against their own locally set targets by means of auditing and feedback from patients.
Accompanying these responsibilities will be a new funding structure, "payment by results," which will reward the services that a primary care trust provides according to a standard national tariff.
Performance will be inspected by the independent Healthcare Commission, which is in the process of drawing up the relevant assessment criteria. The commission will also have the authority, where it is felt that significant failings exist, to make recommendations to the health secretary or, in the case of foundation trusts, which have been granted some independence, the independent regulator of NHS foundation trusts.
Broad national targets will still define the areas on which primary care trusts are expected to concentrate, and the government will continue to be responsible for national standards and the overall direction of the NHS.(London Madeline Brettingh)