Select Committee on Public Administration Appendices to the Minutes of Evidence


Memorandum by the Independent Healthcare Association (PST 39)

INTRODUCTION

  The Independent Healthcare Association (IHA) is the leading trade association for the United Kingdom's independent health and social care providers. Our members include acute hospitals, mental health hospitals and substance misuse units, nursing and residential care homes, providers of domiciliary care, pathology laboratories and screening units.

  The independent sector provides more than one million surgical procedures each year, has 220 hospitals providing acute care, and more than 70 acute mental health hospitals and substance misuse units. In terms of community care provision, there are 17,800 homes caring for over 443,000 people. This translates into 80% of all residential community care beds in the entire healthcare sector. The workforce comprises of three quarters of a million staff.

  The IHA promotes the highest standards in independent health and social care and strives to influence the policy debate on the future of health and social care in Britain. IHA therefore welcomes the opportunity to comment on the Public Administration Select Committee's inquiry into public service targets and league tables and update the Committee on developments in the independent healthcare sector.

GENERAL COMMENTS ON THE CONSULTATION

Practically all the UK's public services (including many organisations that are now that are now in the private sector) are now required to publish information about how well they are doing.

  The IHA has initiated a sector-wide project on the collection of Key Performance Indicators across acute and mental health providers. The work is being project managed by UK QIP (Quality Indicators Project) which is based at the University of Newcastle.

  Independent sector acute and mental health providers also collect patient satisfaction data which the IHA Executive would be pleased to provide examples of should the Committee wish to see them. The IHA Executive is currently working with the National Care Standards Commission on a project whereby patient satisfaction data would become more standardised across the sector.

  Many independent providers also collect SF 36 (Short Form 36) data which has become the most widely used example of a general health status questionnaire. Comprising 36 multiple choice questions, SF-36 allows an individual to give an assessment of eight aspects of their own health, which can be further reduced to a pair of mental and physical summary scores. It is not specific to one specialty, but is a generic tool designed for use in clinical practice and research.

National standards mean working with hospitals, schools, police forces and local government to agree tough targets, and to see performance independently monitored so people can see how local services compare.

  Independent sector providers collect robust and in depth data and follow a collection of National Minimum Standards as set out by the National Care Standards Commission. Furthermore as a condition of IHA membership, all IHA acute and mental health member hospitals are required to have achieved a recognised quality assurance accreditation. The IHA acknowledges the following quality accreditation schemes: Health Quality Service, Healthcare Accreditation Programme and the ISO 9000 series.

  "The Public Service Ethos", the first product of the Committee's overarching inquiry into the Government's programme of public service reform, looked, among other things, at the question of private involvement in service delivery.

  For information, the Independent Healthcare Association is the organisation that signed a Concordat on behalf of independent acute providers with the Department of Health entitled For the Benefit of Patients: A Concordat with the Private and Voluntary Health Care Provider Sector. The Concordat is designed to facilitate independent providers treating NHS patients for acute elective, critical care and intermediate care. The IHA also signed Building Capacity and Partnership in Care: An agreement between the statutory and the independent social care, health care and housing sectors with the Department of Health on behalf of independent long-term care providers.

  Over the past 18 months, the IHA has monitored on a monthly basis the amount of acute elective NHS work undertaken by IHA members across the UK. Should you wish to see this work, please do contact me.

16.  IS THERE A DANGER THAT TARGETS AND LEAGUE TABLES THAT ARE BADLY DRAWN UP AND CRUDELY MANAGED WILL DESTROY MORALE AND MOTIVATION ON THE FRONT LINE (FOR INSTANCE BY IMPLYING THAT PROFESSIONALS CAN'T BE TRUSTED?

  It is critical that in order for data to be credible it must take into account the difference in patient mix between the NHS and the independent sector. The IHA has successfully made this point to the research organisation "Dr Foster", which is the organisation that has published a number of "performance tables" across the NHS and independent sector. "Dr Foster" recognised the different patient mix and adjusted certain of its questions accordingly.

  Finally, should you wish to follow-up any of the points raised in this response, please do not hesitate to contact me at the Independent Healthcare Association.

Sally Taber
Head of Operational Policy

December 2002


 
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