CQC to get tougher on NHS spending

The regulator has told HSJ it will be examining financial data to scrutinise variations in primary care trusts’ spending and check they are investing in good quality services and decommissioning where appropriate.

If a PCT is spending ’x’ million, how much is it spending on community nurses and health visitors as opposed to contracts with acute suppliers?

CQC head of commissioner methods Peter West said: “We’ll be holding up a mirror to commissioners and saying ‘what’s the quality of what you’re buying?’”

“We’ll tell them if we think they’re buying the right things.”

The aim is to make assessments of PCTs and councils more closely aligned, with joint annual commissioning reviews a possibility by 2011-12.

Guidance on 2010-11 assessments for PCTs, likely to be issued in November, will include advice on how they will be scored on value for money in the interim.

Mr West said: “[Department of Health director general of social care] David Behan’s team is analysing financial data that councils return. You can ask questions about why council ‘x’ is spending more on supporting people at home than council ‘y’.

“We’d like to look at something similar on the health side. If a PCT is spending ’x’ million, how much is it spending on community nurses and health visitors as opposed to contracts with acute suppliers?”

As part of this work, the CQC has created a new post dedicated to value for money assessments for commissioners. The regulator will also carry out a special review looking at the impact of the economic downturn on quality, likely to be published early next year.

Mr West warned commissioners they will be expected to use resources wisely at a time when public services need to be planning for significant budget restrictions.

He said: “The whole project could be scuppered if councils or PCTs aren’t working together and using resources carefully and getting value for money.”

The plans have been revealed following criticism that value for money has not been a sufficiently strong feature of the regulator’s work, or that of its predecessor the Healthcare Commission.

The former Healthcare Commission head of value for money, also called Peter West, said: “While I worked for the commission, the focus on quality seemed to inhibit many staff from facing up to the limited resources and tough trade-offs that are inevitable in a cash-limited system.”