Doubts cast over validity of PCT ratings criteria

Concerns have been expressed about the validity of performance ratings for primary care trusts as the Department of Health races to publish the data before Parliament breaks for the summer.

The DoH is hoping to publish the star-ratings in the week of 15 July, and needs to do so before Parliament rises on 24 July. This follows criticism that last year's star-ratings, which only applied to acute trusts, were published when the House of Commons was in recess and were therefore not open to parliamentary debate.

Trusts which existed before 1 April this year have been sent data to validate ahead of publication of the ratings later this month.

For PCTs - rated for the first time, along with ambulance trusts - have been asked to validate data on over 50 indicators, including inpatient and outpatient waiting times, delayed discharge, finance, access and re-admissions.

But PCT executive directors said they were confused about some of the information sent back to them, as they were not sure where some of it came from.One said: 'It is not entirely obvious to us where some of the figures have come from. I am not sure that some of the information that we sent up seems to have appeared in here.'

And NHS Alliance chair Dr Michael Dixon warned against blaming PCTs - most of which are less than 18-months-old - for factors beyond their control and turning the ratings into a deprivation index. 'We are very much in favour of transparency, but misleading evidence is worse than no evidence.

The system needs to be very different [from acute trusts]. There is a one-size-fits-all attitude.'

It is understood that the criteria for star-ratings for acute trusts will be broadly similar to those used last year - concentrating on finance, access and waiting-list targets.

The star-ratings system will be taken over by the Commission for Health Improvement next year.

HSJ understands that the methodology used by CHI for the 2003 set of ratings is unlikely to change because trusts are already part way through the year on which data would be based. But changes are likely to be made the following year.

A CHI spokesperson said: 'Our concern about most of the performance indicators is that what they measure is general finance and activity, and not quality. One of the things we will aspire to do is to be open with the service about what indicators we will use, and to include measures of quality.'