Exclusive: DoH rules out local quality frameworks

A locally determined quality framework will not be included in the final stage of the Darzi Review, according to the director general of the NHS.

Dr Michael Dixon
Dr Michael Dixon
Mark Britnell told GP that the advisory board for the DoH's Primary and Community Care Services, together with the BMA, were looking at a number of issues concerning the quality framework.

'We are looking at how to get the right indicators into the quality framework,' he said.

'But we are not looking at whether it will be locally administered.

'There is no suggestion, at the moment, that there will be 152 different quality frameworks across the country.'

Mr Britnell was speaking exclusively to GP at the annual Managing Long Term Conditions conference in Harrogate, Yorkshire, last week.

Active discussions with the BMA and the GPs that sit on the quality framework advisory group are taking place in order to get the right balance of healthcare and prevention into the quality framework, he said.

The U-turn comes just a month after the DoH said that it was working on a locally determined quality framework as a way to help overcome health inequalities (DoH hopes local quality frameworks will beat health inequalities, GP, 4 April 2008).

Giving evidence to the Public Accounts Commission in parliament, Professor David Colin-Thome, national clinical director for primary care, said that the NHS was working on the 'next phase' of the quality framework, which would address local issues.

The National Audit Office also called for part of the quality framework to be negotiated locally (NAO suggests local quality frameworks, GP, 29 February 2008).

GPC deputy chairman Dr Richard Vautrey, said it was 'common sense' to keep the quality framework national, adding it was heartening to hear that the DoH was planning to do this.

'You do not need to re-invent the wheel. Having a national framework is much better for the patients than a local one,' he said. 'A national framework enables you to measure standards of care across the country and allows you to use data from national experts rather than aggregating inconsistent data from individual PCTs.'

But Dr Michael Dixon, chairman of the NHS Alliance, said: 'I always felt that there was some mileage in including a local element into the quality framework.'

But there are other ways of having local incentives such as DESs, he added: 'Perhaps there is a fear that a local quality framework would destabilise the national contract or could lead to PCTs setting lower standards for their practices.'

The final Darzi Review report is expected next month.

sanjay.tanday@ haymarket.com

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