Close call at DoH's final performance

The last set of performance indicators published by the Department of Health before the Commission for Health Improvement takes on data collation has shown increasing overlap between the different methods used to measure trusts.

On the whole, the more successful trusts which won two and three stars in last September's performance ratings perform best in this year's performance and clinical indicators. But the figures show wide variations in the performance of a number of trusts given a no-star rating.

With data covering different periods, direct comparisons remain difficult, but several indicators suggest that some trusts could be neglecting areas where they met last September's targets in order to address their failing areas.

A number of no-star trusts which met targets on inpatient waiting have shown a slight deterioration during the year ending in quarter two of 2002.

Figures measuring the percentage improvement on patients waiting less than six months for an inpatient admission show performance at Portsmouth Hospitals trust worsened by 8 per cent, Barnet and Chase Farm Hospitals trust by 4.8 per cent, Stoke Mandeville Hospital trust by 0.2 per cent, Dartford and Gravesham trust by 2.5 per cent, and East and North Hertfordshire trust by 0.5 per cent.

The clinical indicators paint a mixed picture. On the percentage of patients discharged within 28 days following treatment for a fractured hip, figures covering the period from 1999-2000 to 200001 show a 64 per cent improvement at Medway trust. Dartford and Gravesham improved by 3.7 per cent, and Oxford Radcliffe Hospitals trust by 6.6 per cent.

The same indicator showed worsening performance at United Bristol Healthcare trust - by 5.3 per cent - and by 9.4 per cent at East and North Hertfordshire, and 10. 5 per cent at Barnet and Chase Farm Hospitals.

NHS chief executive Nigel Crisp said reports would be sent to each trust and health authority giving details on their achievements.

Where performance was poor, he expected organisations to investigate why the problems had emerged. He added: 'The quality of information we are publishing is improving all the time, and these figures are among the most robust we have published. But it is not perfect and we are carefully considering how to adjust for the severity of the cases seen by different hospitals.

'Every hospital and health authority must take a long, cold look at these figures and take real action to deal with the problems.'

Later this year, the DoH will bring the increased number of performance indicators used in these figures together with the star rating process to ensure a more accurate assessment of trusts' performance.

The next set of star-ratings - due out this summer - will apply not just to non-specialist acute hospital trusts but include specialist trusts, ambulance trusts, community and mental health trusts and primary care trusts, and will be published jointly by the DoH and CHI, before CHI takes on full responsibility in 2003.

As well as performance indicators for trusts and HAs, the DoH published reference costs for 2001.

Community at a price The fourth national reference costs index revealed Mancunian Community Health trust as the most expensive - given a score of 212 compared to the 100 average.Since last April, the trust's services have been run by Central Manchester primary care trust.

This year all five of the most expensive trusts run community services, many of which are in the process of major structural change, as the document flags up.

Chorley and South Ribble trust, with a score of 54, was the cheapest.For the first time, figures are also provided on the costs of PCTs.