Reforms yet to gain traction in NHS

New health secretary Jeremy Hunt will have his work cut out to convince NHS staff of the value of his predecessor’s reforms, eHealth Insider’s latest survey suggests.

The second annual EHI acute survey, which was completed by 120 IT directors, managers, information analysts and clinicians, found respondents are still not convinced by the main arguments put forward by the reforms.

Only 15% of all respondents thought they would have positive effects by either creating a more efficient NHS (4%), delivering more choice for patients (9%) or improving quality (2.5%).

And half thought they would have negative effectives, since clinical commissioners would not have the skills they need (18%), competition would lead to less efficient use of resources (10%), or more providers and tighter budgets would lead to lower quality (26%).

In a small ray of hope for the new ministerial team at the Department of Health, these responses were, at least, less apocalyptic than last year’s.

In 2011, only 5% of respondents thought the reforms would have any kind of positive effect, while a massive four out of ten thought they would lead to lower quality.

Most of the shift seems to be accounted for by respondents who feel the reforms, which were first announced in the ‘Liberating the NHS’ paper two years ago, will make no difference. Just under a fifth of respondents (16.5%) said this, in comparison to a tenth (11.5%) last year.

In free text boxes, one respondent wrote: “I see no discernable benefits or improvements. I believe the current state is more confusing, more demoralising, and less efficient, whether it will be better once it settles down remains to be seen.”

On a more positive note, another comment said: “The NHS will get on and try to improve patient care, despite the reforms causing major problems.”

The reforms – closely associated with the previous health secretary Andrew Lansley – shake-up NHS commissioning by handing it to a new NHS Commissioning Board and clinical commissioning groups that will formally come into being next April.

They also open up the NHS to more competition, through the expansion of foundation trusts and the application of ‘any qualified provider’ policies. Lansley was moved in Prime Minister David Cameron’s first big reshuffle a few weeks ago, along with most of his ministerial team.

Hunt was apparently brought into the DH to better communicate the changes, but he has yet to make any public pronouncement on them.

EHI ran its second annual acute IT survey last month. It was completed by people working in hospital IT departments (31%), shared services (23%), information analysis and clinical practice.

Just under half of respondents worked in the North, Midlands and East and in large trusts with between 500 and 1,000 beds.

The survey focused on the impact of the Lansley reforms of the NHS and the ‘Nicholson challenge’ for the NHS as a whole to make efficiency savings of £20 billion by 2014-15.

Unsurprisingly, it found that trusts and their IT staff are under significant financial strain and uncertain about their futures and jobs.

However, it also found that a quarter are planning significant patient administration system and electronic patient record system investments, and that a third are looking to implement a ‘best of breed’ strategy focused around a portal.

It also found interest in technologies to improve efficiency and mobile communications and to get staff mobile.

Read more about the survey in this week’s Insight.