A project that aimed to reduce death rates in hospitals using financial incentives has seen its initial period of success tail off, research reveals.
Under the Advancing Quality scheme - which began in 2008 - 24 hospitals in the North West of England were initially offered financial rewards for reducing the number of patients that died within 30 days of admission.
While this resulted in a significant reduction in mortality rates within its first year and a half, improvements linked to the incentive scheme have now tailed off, according to a study published in the New England Journal of Medicine.
Matt Sutton, a professor at the University of Manchester and one of the study’s authors, said early evaluation of the project had found “significant reductions death rates in the short term” but that continued reductions were “no longer larger than the national trend”.
One possible cause was the decision to switch from a bonus to a financial penalty scheme in 2010.
A spokeswoman for the Advancing Quality Alliance, the NHS membership body which runs the programme, said the change was necessary to comply with the Department of Health’s commissioning for quality and innovation payment framework.
Ruth McDonald, professor of governance and public management at Warwick Business School, said while the switch to fines “could make a difference”, the researchers did not find any evidence that people were treated differently.
David Fillingham, chief executive of the alliance, said it was keen to work with researchers to understand the longer term effects of the programme.
“[The scheme] is the first English programme at such scale to receive such independent scrutiny and we value this rigour which will help direct the future of the programme,” he said.
The research was funded by the National Institute for Health Research and examined 1.8 million emergency admissions for heart attack, pneumonia and heart failure.
The research, carried out by the universities of Cambridge, Manchester and Warwick, compared the number of deaths that occurred within 30 days of admission at the 24 North West hospitals with 137 across the rest of England.