Ofsted rating approach 'too simple' for the NHS

Nuffield Trust chief executive Jennifer Dixon was asked to look into developing a rating system by health secretary Jeremy Hunt in November. Her review is ongoing.

However, she told HSJ this week that the lack of data currently available about performance meant it would be difficult to compile an aggregate rating at present. She said a slower approach would be needed.

The Nuffield Trust has convened a group of senior clinicians and other sector leaders to join Nuffield researchers in considering the issue.

Dr Dixon said there had been more enthusiasm for a rating system for social care than for the NHS so far during the group’s engagement process, which runs until 15 February. She said the group was considering recommending different approaches for health and social care.

She told HSJ: “The complexity of operations of a school is very low compared to the depth of complexity in a hospital where when things go wrong people die.

“The analogy with Ofsted is valid but it’s too simple because the stakes are so much bigger.”

The group has looked closely at how Ofsted works and has found they have much more consistent data at their disposal than in health and social care.

Dr Dixon added: “What I think we probably need is not just to start now but a tentative road map for at least the next few years.

“If you think there is a place for aggregate ratings, how they can develop over time to get into these complex clinical areas to assess quality?” She said regulators and commissioners may be able to “nudge” the service to make better data available.