How to rate the NHS in a way patients can use

There have been various attempts at introducing a ratings system for the NHS so that the public can tell how well their local healthcare provider is doing.  But so far each system has had inherent problems.

The annual health checks carried out by the Healthcare Commission failed to, for instance, pick up Mid Staffs.

And then there was the star rating system before that, which was deemed too crude and simplistic.

So, last year the Health Secretary Jeremy Hunt asked the Nuffield Trust to look at whether there could be an Ofsted-style ratings system for the NHS. Today, the think tank has published its findings and concluded that it is possible, although probably more easily for GP practices and care homes than for hospitals.

Indeed, the conclusion of the consultation and the report is that an Ofsted system directly comparable with the one used in education would be too simplistic.

Schools are relatively uncomplicated but hospitals have thousands of people passing through their doors every day, many of whom are sick, and some of whom are going to die.

Underpinning it all is the need for the public to have access to as much relevant and understandable information as possible.

Nuffield Trust Chief Executive Dr Jennifer Dixon points out that we have the most incredible data – probably the best in the world – but the information on hospitals is confusing and patients are largely in the dark.

And, as Dr Dixon said, when you are trying to make decisions on which care home to go to or where you should have your cancer care, you are at your most vulnerable as you “scratch around” for information.

Their conclusion, though, is that ratings could increase accountability, improve patient choice and enhance performance.

But there was a warning that a single summary score of a hospital’s performance would risk masking examples of good and poor care across different departments and wards.

So, while the A&E waiting times might be hit, there could be patients suffering on Ward 10.  It is, the Nuffield Trust, said about having a more intelligent system and the public should be educated on what it can and cannot do.

The final decision lies with Mr Hunt on what to do.  The catchy headline of Ofsted Ratings for the NHS may not work with the various caveats introduced by the Nuffield Trust, but the report does confirm the need for the introduction of some form of new ratings system.

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