Published: 22/04/2004, Volume II4, No. 5902 Page 15

Emphasis on broader patient experience is the right way forward

The policy work underway at the Department of Health is a logical development of 2000's NHS plan. Its essential ingredients are also no great surprise. A concentration on patient experience and chronic-disease management has already been signalled by ministers.

But nobody should underestimate the importance of the planning taking place in readiness for the next phase of NHS reform. The fact that both patient experience and CDM look likely to be incorporated into the targets the DoH agrees with the Treasury underlines the seriousness with which these issues are taken throughout government.

With the battle on elective waiting lists being won, policy makers know that action on broader patient experience is now needed if the public is to be convinced that the planned continued increases in NHS spending will be worth it. As chronic disease affects the greatest number of people and consumes the greatest amount of NHS resources, any meaningful action needs to be focused there.

However, there is significant confusion and concern in the service about how new incentives, in particular payment by results and foundation trust status, will enable the shift of treatment into primary care which most believe is the secret to successful CDM - and enhanced patient experience.

It is not that either policy provides an inherent barrier - it is possible to see how both might be used to deliver the new priorities. But many believe the policies, as currently envisaged, will encourage acute trusts to hang onto work.

Improving CDM and broader patient experience will not be achieved by the blunt targets which have driven the cuts in waiting lists. Aligning incentives in a way which is clear to all is the only answer to this complex puzzle. l