Labour’s NHS reforms ‘put elderly patients at risk of worse care’

Vulnerable elderly patients are likely to be hit hardest as failing hospitals are named and shamed in NHS league tables, medics have warned.

Health Secretary Wes Streeting told trust leaders at the NHS Providers conference in Liverpool that failing hospitals will be revealed in league tables as he looks to “recover and renew” the health service.

He said the NHS is living on “borrowed time” and will not survive if Labour cannot improve it.

NHS England will undertake “a no-holds-barred sweeping review of NHS performance across the entire country, with providers to be placed into a league table”, the Department of Health and Social Care (DHSC) said.

Trusts can expect to be ranked on a range of indicators such as finances, delivery of services, patient access to care and the competency of leadership. In addition, NHS managers will be sacked if they cannot improve patient care and take control of finances.

However, frontline medics said the plan would backfire without reform elsewhere.

Dr Nick Murch, president of the Society for Acute Medicine, said failing hospitals could become “stuck in a vicious cycle” unless social care was significantly improved, with some hospitals and vulnerable elderly patients impacted by issues such as delayed discharges.

He said: “Penalising and shaming struggling hospitals while rewarding apparently better performing organisations with additional funds and less restrictions could have significant detrimental effects.

“It is simply likely to create division, damage patient confidence and further demoralise staff who are striving to provide good care in an already poor environment.

“Individual hospital performance is also heavily influenced by numerous factors not directly related to its own management. There is a real risk such an approach will adversely impact more vulnerable and at risk patients by condemning struggling hospitals in a vicious cycle they are unable to break free from.”

Although some medics believed league tables could encourage a sense of competition among trusts and a determination to outdo rivals, more doctors appeared to oppose the plans.

Consultant Dr Dan Goyal said: “Streeting’s plan for hospital league tables could make things worse. Focusing on the same metrics that take NHS leadership’s attention off the needs of the patients. What’s a priority to you? Waiting time for your knee replacement or surviving the knee operation?

“But it could be helpful. If trusts were judged on actual patient outcomes – survival, preventing disability, control of disease, then waiting times automatically improve but crucially the trusts must invest in staff training and disease prevention.”

Referring to league tables drawn up by the then Tony Blair government in 2001, before they were scrapped four years later, Dr Steve Taylor, from the frontline lobbying group Doctors’ Association UK, told i: “We’ve been here before, haven’t we? And there’s no evidence that having league tables improved patient care.

“I’m not entirely against them. There is good evidence that shows when you know what the problem is, you can then sort out the problem, but it encourages a culture where you’re trying to occasionally massage the figures and improve how your trust looks.

“And are we going to measure the things that actually matter to patients? You can go online now and find out all the available information you need from NHS Digital.“

Under the Government plans, the best NHS performers will be given greater spending control to help modernise their buildings, equipment and technology.

The DHSC said there is currently little incentive for trusts to run budget surpluses as NHS trusts are unable to benefit from them, but that will now change, with top-performing trusts given more cash.

Streeting has already announced that failing NHS managers will be denied pay rises if they do not improve patient care or get their finances in order. A new pay framework for very senior managers will be published before April next year, with those who do well given financial rewards.