PERFORMANCE RATINGS 'Lenient' approach for first year of new system

Published: 18/08/2005, Volume II5, No. 5969 Page 8

Primary care trusts will not be judged on the performance of services they commission against the 24 core standards in next year's ratings, the Healthcare Commission confirmed this week.

But they will continue to be held accountable for their performance against existing national targets, such as accident and emergency waits.

The commission said PCTs will only have to prove to the regulator's new regional teams that they have taken the core standards 'into account' in their commissioning arrangements.

The decision not to hold PCTs to account for acute trust and independent sector performance reflected the need to be 'realistic about the tools PCTs have at their disposal' in the first year of the star-ratings' replacement, the commission said.

A spokeswoman said a decision had yet to be made on whether PCTs would be held accountable for these services in 2006-07, although she said it was 'definitely the direction of travel'.

'What we want to see...is that PCTs have taken the standards into account in their commissioning arrangements, ' said Healthcare Commission head of standardsbased assessment Robert Cleary.

'That is a general test we will be asking them to keep in mind rather than something that requires them to be assured that each and every standard is in place at all times.' He said trusts could demonstrate they had taken 'reasonable steps' to take the standards into account by showing they had responded well to feedback on commissioned services and involved patients in commissioning arrangements.

Trusts could also show they were using data from the quality and outcomes framework and working with their professional executive committees, he said.

'What we have said about taking reasonable steps applies to all independent contractors and all commissioning arrangements.' NHS Alliance chair Dr Michael Dixon said it was appropriate that the inspectors were 'relatively lenient' in the first year because many PCTs were still trying to establish robust commissioning.

'There is so much going on in the system that if you have to dot every i and cross every t, then we will get bogged down in the process of assessment.' South Leicestershire PCT director of service development Chris Boyce said the decision would allow PCTs to get the most out of the new system. 'It is beneficial so we can get the processes and systems in place to ensure that the services we commission meet the standards.' National Clinical Governance Support Team director of board development Paul Stanton said the new system was about encouraging improvement.

'The commission recognises that the last thing this process is meant to do is beat PCTs with a stick for things that they couldn't reasonably have expected to do, ' he said.

PCTs escape custodial sentence

Primary care trusts with prisons on their patches greeted the Healthcare Commission's decision with relief.

PCTs had told HSJ they were not confident of signing the declaration that they were meeting the core standards because those standards were not yet being hit by prisons, which were only brought under the responsibility of PCTs in April.

Chris Boyce, director of service development at South Leicestershire PCT, which has responsibility for Glen Parva young offenders' institute (pictured), said: 'To expect PCTs to assure themselves that prisons are complying with the core standards is a step too far.' Daventry and South Northamptonshire PCT acting director of public health Carole Dehghani said it would not have been 100 per cent compliant with the standards in prisons this year. 'Historically prisons have a completely different culture to the NHS, ' she said.