Goals replace targets in DH paper

The Department of Health has set out its plans to scrap centrally, set performance managed targets – and to hold the NHS to account using ‘national outcome goals’.

The NHS Outcomes Framework, which is now out for consultation, will set goals against which health secretary Andrew Lansley will hold the new NHS Commissioning Board to account.

The board will allocate resources and issue commissioning guidelines to GP consortia, following the abolition of strategic health authorities and primary care trusts.

The DH said data about each of the goals in the framework will also be made publicly available, providing greater transparency about the quality of local health services.

It said this would deliver “broader and more locally relevant information” for use by patients, their carers and the public.

The document suggests five outcome domains which would then be underpinned by specific outcome measures.

The five proposed domains are: preventing people from dying prematurely; enhancing the quality of life for people with long term conditions; helping people to recover from episodes of ill health or injury; ensuring people have a positive experience of care; and treating and caring for people in a safe environment and protecting them from avoidable harm.

As well as specific indicators for each domain, the NHS Commissioning Board is expected to commission Quality Standards from the National Institute for Health and Clinical Excellence to provide more detailed commissioning guidance to consortia.

NICE published its first three Quality Standards last month and the plan is to produce 150 over the next five years.

The dcoument says indicators will include clinical outcome measures and patient reported outcome measures (PROMS), but that the NHS will only be held to account for the indicators that it alone can influence.

The DH wants to shift the focus from what it describes as the ‘national process targets’ of the previous government – such as 18 week waits and access to a GP – and instead judge the NHS on the outcomes it delivers for patients.

It says providers will not be performance managed against the Outcomes Framework.

Health secretary Andrew Lansley added: “I want to free doctors and nurses to focus on what really matters – better results for their patients – instead of them being stifled by top down targets.

“Instead of politically motivated targets which lack clinical evidence, we will measure the outcomes that are most important to patients and that are relevant to healthcare professionals.

"These will be backed up by authoritative, evidence-based quality standards that will ensure everyone understands how those outcomes can be achieved.”

More details about how data on outcomes will be made available to the public are due be included in the DH’s information strategy, planned for publication in the autumn.

The first Outcomes Framework is expected to be developed in 2011-12 and will then be reviewed annually.

The consultation on the framework runs until 11 October and is the first of several consultations on aspects of the white paper due to be published in the next two weeks.