NHS Chief Executive David Nicholson today set out the priorities for the NHS over the next year, with a greater role for local NHS staff to decide and deliver on local health and healthcare improvement targets.
The NHS in England: the operating framework for 2007/08 details the expectations for progress on reform and improving services to patients.
The main priorities set out in the framework are:
– making further progress towards the 18 week maximum wait from GP referral to treatment and setting new milestones to achieve this;
– continuing to reduce hospital acquired infections, including a new drive on Clostridium difficile with targets to be agreed and delivered locally;
– achieving financial health and delivering a net surplus of ?250m across the NHS by the end of 2007/08; and,
– reducing health inequalities and promoting health and well-being – with targets to be agreed and delivered locally.
The key milestones on the 18 week target are being set for Primary Care Trusts (PCTs) and all providers. By March 2008, 85 per cent of patients admitted for hospital treatment and 90 per cent of patients that do not require admission should be treated within 18 weeks.
These milestones come ahead of the target for all patients being treated within 18 weeks by the end of 2008. Under contracts between PCTs and NHS providers, PCTs would make smaller payments if providers underachieve on the 18 week milestones.
The framework makes clear that faster progress is needed to reduce MRSA infections and steps up the fight against hospital acquired infections by ruling that local targets should be agreed between PCTs and providers to reduce levels of Clostridium difficile.
Ministers and David Nicholson are confident that the NHS is turning the corner and will return to overall balance by the end of the current financial year and now the Chief Executive has announced that this must be turned into a surplus twelve months on.
PCTs will also be required to agree local priorities with local authorities to tackle health inequalities and address the issues that require most urgent attention.
David Nicholson, Chief Executive of the NHS said:
‘The Operating Framework for 2007/08 provides consistency of purpose for the NHS, setting out the key targets that our staff need to focus on in order to improve patient experience, reduce health inequalities and achieve financial health.
“Although there are no new national priorities for the service, there will be no let up in the pace of implementation and I make no apologies for being ambitious on behalf of patients and tax payers.
“Greater clarity and consistency of purpose means that we can increasingly devolve the way in which change is delivered at a local level. For example, the Operating Framework sets out the importance of tackling all healthcare associated infections, and instead of setting a new national target requires PCTs to engage with clinicians to agree local targets for reducing levels of Clostridium difficile.
“Ultimately my ambition is to create an environment whereby the health care reforms, local organisations and patients create an inbuilt dynamic for continual service improvement, no longer requiring traditional top down performance management as we know it. But we can only do this if the NHS continues to deliver better patient care and better financial management. By the end of this financial year I expect the NHS to return to net financial balance and the modernised financial regime set out in the Operating Framework will provide a stronger foundation for the future.
“We are deliberately moving towards a more rules based system which will bring some much needed rigour and transparency to the NHS. But NHS organisations and individuals will still be expected to work in partnership for the benefits of tax payers and patients.
“The Operating Framework for 2007/08 provides timely clarity for the service not just about what needs to be done but why we need to do it. This is a national framework designed to help local NHS staff shape services around the needs of their local communities. But the degree of transformation and change that our patients and citizens require can only be delivered by our greatest resource – the staff who work for NHS patients.”
Health Secretary Patricia Hewitt said:
“Progress since the NHS Plan was published six years ago has been significant. We have significantly increased the workforce, built new hospitals and through the hard work of staff reduced waiting times and deaths from the big killer diseases.
“But there is much more to be done. We need to improve patients’ experience and reduce waits further and make progress against the 18 week target. Health care services also need to be much more responsive and convenient to the patients who use them. This framework provides the levers for reform to improve patient care further.”
Alongside the new local target on Clostridium difficile, Ms Hewitt also announced that ?300,000 would be available to all acute trusts this year to further help tackle healthcare associated infections. The money is available for simple ward level improvements to tackle infection such as toilet refurbishment or the conversion of older wards to provide more single rooms. Trusts must submit applications for funding by 12 January.