NHS makes progress but difficulties remain says watchdog

The NHS is making "good progress", but some trusts are finding it difficult to balance the books and some government targets fail to accurately represent the quality of service, according an independent watchdog.

The Audit Commission's report on the NHS, 'Achieving the NHS Plan', published today, said that while the overall picture was one of good progress, the targets ethos was not working "universally well". The commission found that "a lot needs to be done" to make progress "sustainable and permanent".

More specifically, targets and the manner in which they are assessed can fluctuate – so while hospitals may reach their targets, it is not truly reflective of progress on a year-on-year basis.

The report recommends that assessment procedures should become "more robust", drawing evidence together from a number of sources to form a rounded judgment.

Some trusts, said the commission, which achieved ‘three stars’ and could apply for freedoms as NHS Foundation Trusts, were judged by auditors to have significant management weaknesses.

The commission added: "It is clear that setting national standards and developing action plans are powerful tools for improving services to patients, and holding organisations to account for their performance.

"Making more efficient use of resources is an important part of meeting targets and is the key to long-term progress. But for improvement to be sustainable, targets need to make sense locally to encourage strong local ownership of the need to change.

"Managers have found it difficult to foster a culture of partnership working, especially to deliver the mental health and older people’s National Service Frameworks.

On the bright side, the majority of trusts were found to be making progress and the effort into reducing waiting times for outpatient appointments and for hospital inpatient treatment was "paying off".

However, the majority of trusts were finding it difficult to balance the books – some had redirected money intended to boost specific services to offset underlying deficits, while auditors judged a third of recovery plans to be unrealistic.

Responding to the report, NHS Chief Executive Sir Nigel Crisp said: "I agree with its comments on the optimism and achievements of the NHS. However, it is a snapshot report and in most cases the NHS has moved on. The health service is turning the corner. The resources and reform are biting. The NHS Plan is well on track. It is becoming a reality across the country."

However, Shadow Health Secretary Dr Liam Fox MP said that the NHS must have radical reform "to give patients the care they deserve".

He added: “Ministers must now surely tackle such problems as care for the mentally ill and the elderly, the widespread damage caused by the obsession with targets and the financial crisis gripping organisations throughout the NHS.”

(GMcG)