NHS spending 'is not evidence-based'

Up to 40 per cent of NHS programmes, worth around £20 billion annually, have no national data on their effectiveness, a DoH report says.

Professor Haslam: findings 'scary' (Photograph: Solent News)
Professor Haslam: findings 'scary' (Photograph: Solent News)

There is almost no national quality data for primary care other than the QOF, and none whatsoever in community care, a report by the DoH's National Quality Board (NQB) reveals.

Unveiling the report to delegates at the NHS Confederation conference in Liverpool last month, NQB member and Cambridgeshire GP Professor David Haslam said that 10 per cent of trust boards 'never' discussed the quality of their clinical services.

'Could it be these boards have forgotten what business they are in - the business of providing quality care for patients?' the former RCGP president said.

The report also criticises the QOF, saying it is designed for 'administering payment' rather than assessing quality.

'It is not able sufficiently to discriminate between performance - most GPs score more than 90 per cent - nor are there are any links to secondary care data,' says the document.

The NQB, chaired by NHS chief executive David Nicholson, has been investigating what information is available to measure the quality of services.

It found that the annual budget for gastrointestinal disorders and musculoskeletal problems is more than £8 billion, greater than the entire policing and prison budgets combined, yet there is no national data on the effectiveness of services. Professor Haslam called the findings 'scary'.

The report recommends all providers should be contractually obliged to produce quality data. Organisations that produce and assess quality data should be combined into one or clarify which role they will focus on, it adds.

Professor Haslam called for trusts to consider developing departments devoted to clinical excellence and more clinicians to be involved at board level

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