The Healthcare Commission’s latest annual performance assessment of English NHS Trusts, examining the performance of all 391 NHS Trusts in the year to March 31, 2008 against 24 core standards (with 44 parts), reveals that the overall compliance rate declared rose from 94.2% the previous year to 95.7% in 2007/2008.
While, for the second year running, the percentage of acute and mental health Trusts declaring full compliance rose (by 1.7% and 10.5% respectively), just under 8% fewer primary care Trusts achieved the same result. In contrast, however, nearly 84% of primary care Trusts achieved 90% or more compliance, compared with 74% in 2006/2007.
This is the third successive year that every English NHS Trust has publicly declared how they think they are performing on meeting the Government’s core standards. The Commission “rigorously cross-checks” the declarations using information from sources including clinical audits, survey and performance data from other regulators. Also taken into account is “local intelligence” from regional assessors. Having carried out the analysis, it then inspects “at least one in five” Trusts.
The latest assessment suggests areas where Trusts are making the biggest performance improvements include compliance with guidance from the National Institute of Healthcare Clinical Excellence (NICE), patient privacy, and “learning from things that go wrong”. Conversely Trusts appear to be “struggling” with issues including decontamination of medical devices, records management, tackling discrimination, and staff development and training.
Interestingly, 34.9% of Trusts believe they fully met the standards in 2007/08, compared with 40.1% in 2006/2007, while positive comments from the public on Trust declarations rose from 65 to 71%.
Despite the ever-increasing hospital hygiene focus, 21% (70 Trusts in all) reported not being able to properly decontaminate all reusable medical devices and “well manage” risks with decontamination facilities. This compares with figures of 14.3% last year and 12.6% in 2005/2006. Just over 14% of Trusts also admitted to “not having a systematic and planned approach” to their patient record management, although this was down from 17.6% in 2006/2007.
Anna Walker, Healthcare Commission CEO, said: “When it comers to assessing NHS performance, these declarations offer us and the public a critical piece of the jigsaw. Overall, the picture, if confirmed, is encouraging. More Trusts are declaring compliance against core standards. They are claiming improvements in areas that really matter to patients.
“However, the picture on hospital-acquired infection is mixed. There were improvements in two out of the three relevant standards. But overall we are still in a situation where too many Trusts have self-declared non-compliant.”
