NHS managers must not conduct their own “mini spending reviews” in advance of political decisions about NHS funding, the health secretary has warned.
Andy Burnham said today: “The decisions on spending will be political decisions, once the full facts about the economy are known later this year. It is important that everyone does not conduct their own spending review and come up with their own conclusions.”
Speaking at the King’s Fund this morning, he told the audience he did not want to see “any of that [glass] half empty thinking”.
But he said the Department of Health would not “dictate” how to make savings. “Decisions are best made on the ground.”
He said that in the coming months he would issue a multi-year tariff for the next for years, that would help managers deliver the £15 - £20bn savings that NHS chief executive David Nicholson has said are necessary by 2014, “building up over time, with the most demanding savings coming later”.
“It will give the NHS certainty and a longer run at the challenge,” he said. “Quality and prevention are the best routes to financial stability.”
The emphasis of payment by results will shift to encompass a greater focus on patient experience. “We must step back from measuring everything that moves to measuring less but with a relentless focus on what matters - clinical quality, patient safety and overall patient satisfaction.”
Mr Burnham said he wanted to see patient satisfaction measured in each hospital service. “A hospital can appear to be doing well, ticking all the right boxes but not good enough in the eyes of its local public,” he said.
He announced that he is today launching a consultation on what quality accounts will cover. The accounts would, in time, be published by all NHS organisations. “This information, linked to a new payment system will start to transform the way clinicians and managers drive up quality.”
Staff satisfaction will also be measured “more systematically”, he said. The NHS should publish comparative staff satisfaction data, which would act as a “barometer” of quality, and an “early warning system”, as well as empowering staff.
In answer to a question from the union Unison, Mr Burnham said the NHS is the preferred provider of community services and services would only be put out to tender where NHS provision was deemed to be of poor quality and had not taken chances to improve. “This is fair to all. It means everyone knows where they stand.”
He said the health service needed to look at whether more services should be provided in the community, and said next year the DH would introduce a “best practice tariff” on a range of treatments as an incentive.
As widely trailed, Mr Burnham announced that within the next year he wanted to abolish GP practice boundaries to allow patients to choose any family doctor.
The health secretary said he wanted the NHS to have a new level of ambition for the next decade, to take the service “from good to great”. This meant ensuring the service is “people centred” and that quality is “at the heart of all it does”.
He said: “The time has come for us to set out a better way of pursuing reform in the NHS. Top down reform was right for its time but it can only go so far.”