NHS Operating Framework - the way forward

The recently published ‘Revision to the Operating Framework for the NHS in England 2010/11,’ has summarised the way forward for the National Health Service (NHS), giving details on all areas of management of the NHS, including future direction, finance and efficiency, and performance management.

Steve Black, PA Consulting Group Healthcare and Information expert says: "We welcome the thrust of the revisions to the NHS operating framework, especially the increasing focus on outcomes, quality and the commitment to be more open with data. The principle of moving away from bureaucratic central control and performance management is good and the idea of a system driven by patient choices should make the NHS much more responsive to those who use it.

We have two areas of concern, however:

• It is not yet clear that the proposed alternative to targets for maintaining performance are mature enough to be effective. E.g. the ‘4hr target’ has delivered vast improvement in the patient experience in A&E. The relaxation of the target threshold from 98% to 95%, however, is the equivalent of allowing and additional 7,500 patients to wait more than 4hrs every week. Similar issues will arise with Health Care Associated Infections (HCAI) and waiting list targets.

• The new focus on openness with data is expected to retain standards and drive future improvements through bottom-up pressure. PA’s experience in making sense of NHS data suggests it requires a significant amount of effort to make data visible and comprehensible. With the need for efficiency in all areas of the NHS, managers need to make sure that cost reduction does not undermine the drive for open useful data."

To speak to a consultant about our performance management work with the NHS or our experience in public sector health please contact us now.