NHS hospitals to be given bonuses for treating patients well

NHS hospitals will receive financial bonuses for how well they treat patients, under new schemes linked to feedback from those they treat.

Simon Stevens, the new NHS chief executive, announced the plans yesterday as he set out a five-year vision for the health service, to improve the quality of care delivered in local communities, and give patients “more clout”.

Mr Stevens, a former advisor to Tony Blair, promised changes in the way NHS services are funded, so that those which deliver the best outcomes receive extra funds.
 
He told the NHS Confederation annual conference in Liverpool: “Across all NHS-funded services, we’ll be pushing for a steadily increasing proportion of payments tied to performance, quality and outcomes.”

A spokesman for NHS England said the future schemes would include patients’ feedback on the quality of care they received, with details yet to be drawn up.

Currently around £2.3bn a year is allocated to NHS organisations via “performance incentives” but Mr Stevens is keen to ensure that clinical outcomes, and the views of patients about how they are treated get sufficient focus.

In his first major speech as NHS England chief executive, Mr Stevens also called on the health service to be at the “forefront” of advances in personalised medicine, so patients can receive treatment tailored to their genetic make-up.

Simon Stevens said the health service should be at the “forefront” of advances in treating patients based on their genetic make-up.

The NHS must “actively exploit the fundamental transformations in modern western medicine”, he said.

It has to “grab these opportunities with both hands”, he added.

“As we’re discovering with cancer, what we once thought of as a single condition may be dozens of distinct conditions. So common diseases may in fact be extended families of quite rare diseases.

“That will require much greater stratification in individualised diagnosis and treatment. From carpet-bombing to precision targeting. From one-size-fits many, to one-size-fits-one.

“The NHS should be at the forefront of this global medical revolution.”

Mr Stevens also detailed new models of care for the NHS, following an interview with The Daily Telegraph last week in which he signalled plans to boost local hospitals, in a shift away from “mass centralisation”.

The NHS chief executive said different areas should respond flexibly to the needs of their populations, but called for more care to be delivered in the community.

He said groups of GPs and social workers could form new teams, working with either community hospitals or district hospitals, to bring about improvements in health and social care, especially for the elderly.

However, the NHS chief executive said changes in the way care is delivered, with shorter stays, and more day treatment and use of techology, mean the overall number of hospital beds is likely to keep reducing, as in other countries.

He said: “Our vital interest – as patients and as staff – is in care and health, not bricks and mortar. Yes we do need healing facilities and modern equipment, but the where, and the how, is bound to keep changing. For good reason, some beds and buildings will doubtless continue to close over the coming decade, just as they will in France, Germany, the US, Canada, Australia, Sweden and any other country you care to name.”

After decades in which NHS hospital care has been increasingly centralised, Mr Stevens said modern services should be judged by how well they meet the needs of local populations, not by the size of their buildings.

He said: “Beds are increasingly an anachronistic currency for assessing the clinical content of a local acute hospital, a community or cottage hospital, an urgent care centre, an elective care centre, an expanded primary care centre and so on.”

Other countries had shown that it was possible to deliver better local and community-oriented services, he said, by making better use of new technologies.

Source The Telegraph