STAR RATINGS Walker blames new initiatives for spoiling picture of widespread improvement

Published: 28/07/2005, Volume II5, No. 5966 Page 7

A£500m black hole in NHS finances was uncovered by this year's starratings, with almost a quarter of trusts failing to break even.

Healthcare Commission chief executive Anna Walker put the overspend down to new initiatives like the GP and consultant contracts, along with the first effects of payment by results.

She said the financial performance of the NHS was a 'fly in the ointment' in a year when most trusts had improved their performance against tougher targets. However, one-third of all acute trusts failed to balance the books.

'The combined deficit of the trusts as a whole is£500m. Set against the NHS budget that is tiny, but that is not the point, ' said Ms Walker.

'There is an overall limit to the budget provided by parliament that goes into the NHS. If a trust doesn't manage its own budget [not only is] there is a potential effect on patients, but the money has to be raided from somebody else's budget.' Ms Walker told HSJ that next year, under the new assessment system, trusts would not only have to break even, but also demonstrate they provided value for money. 'It is not going to be easy to manage, but we will find some way of doing it.' She said that the Healthcare Commission remained concerned about the quality of care in London - in particular, about primary care trusts.

No London PCTs were given three stars. Ms Walker said she was encouraged by the progress at Tower Hamlets PCT, which went from zero to two stars, despite its 'complex and very mobile population' (see page 8).

She also said was worried about the 'poor performance of very many trusts in the South East' which she said was 'quite striking' when figures were compared.

Ms Walker said it was important to recognise that targets had become tougher, and that each year represented a significant improvement for the NHS.

Healthcare Commission chair Professor Sir Ian Kennedy said there was no doubt that star-ratings had been an 'important step on the road to effective measurement of the performance of our health service'.

But he said they had failed to produce a 'comprehensive picture' on safety and the quality of patient care.

'[The new system of assessment] will give us the more comprehensive - and if I might say so - comprehensible picture of performance across the NHS, ' he said.