HSJ’s roundup of Monday’s top stories and debate

Not quite sunk by the think tankers

Transparency on quality is a key part of the Jeremy Hunt vision, and for at least six months he has been seeking to create a new system for rating clinical commissioning groups or health systems, as well as GPs.

Apparently the plethora of existing frameworks and measurements aren’t good enough for the health secretary, who wants to be able to keep an eye on performance as the NHS tries whacky organisational variations like accountable care organisations and devolution.

Mr Hunt’s latest tactic was, in July, to bring in the think tankers: the King’s Fund was asked to report on measures for health systems and the Health Foundation on GPs.

Reports by both were published on Monday, and were gratifyingly direct about the flaws in the ideas floated by the health secretary. They ruled out single “aggregate” ratings based on metrics, as well as on arbitrary “population groups”, and described the word “scorecard” as “divisive”.

Mr Hunt can be expected to rescue some policy direction from their reviews, however. Both were in favour of identifying a small set of national measures that resonate with the public to focus attention.

For health systems, the King’s Fund said this would give a “single definition of success”, which sounds familiar. NHS England is currently drawing up a new CCG assurance regime and has the task of keeping Mr Hunt happy with some single ratings, and squaring this with the new framework for quality indicators suggested by the King’s Fund’s report.

Scratching the surface

We all know the NHS has got a lot of efficiencies to make - £22bn by 2021, according to the Five Year Forward View - and even the high profile Carter review into productivity is running late.

Monitor has had another go at tackling some of the challenge. Its new report, published on Monday, sketches out how some of that can be achieved in elective care services.

According to the regulator, if good practice already present in the NHS and abroad was consistently implemented, the health service could save £1.4bn.

Monitor arrived at the figure after working with a number of NHS and international providers to scrutinise orthopaedic and ophthalmology procedures. It found savings of 13-20 per cent were achievable across six procedures if trusts took steps such as increasing throughput in theatres and getting nurses to perform tasks currently undertaken by consultants.