Quality ranking key to NHS funds

Alan Johnson believes the NHS must do more to help people stay healthy

Patients' rating of the quality of their NHS care will affect hospitals' and GPs' funding in England in the future, ministers have announced.

Information on service quality is also set to be displayed on "dashboards" in hospitals, GP surgeries and on the web.

The 10-year plan also proposes changing the way GPs are funded to make it easier for patients to switch practices.

The review was carried out by health minister and surgeon Lord Darzi.

This is about giving more clout to patients Lord Darzi, health minister Darzi: At-a-glance Reaction to Darzi review

Launching his report, which follows a 12-month review involving consultations with 60,000 patients and staff, he stressed how important quality of care was in the NHS, wherever and however patients accessed it.

He said: "This is about giving more clout to patients, more say to patients.

"By measuring quality across the service and publishing that information for the first time, both staff and patients can work together to make better informed choices about their care."

Health Secretary Alan Johnson told the Commons: "We must have an unwavering, unrelenting focus on quality."

And he said there was an aim to bring "clarity to quality" and streamline the "morass" of existing standards.

How patients' assessment of quality of care is measured has still to be decided, but it is likely to have a major impact on how much money an NHS organisation receives.

For example, quality-linked funding could make up between £7-9m of the average district general hospital's budget of around £250m within a few years.

Information on the quality of a local hospital or GP practice's care will also be available on the NHS Choices website, and on clinical "dashboards".

One existing example in a London A&E displays regularly updated details of how soon patients are seen, assessed and get test results and about patient satisfaction.

Personal budgets

Lord Darzi also published a draft constitution setting out, for the first time, the rights of patients.

In place of vision, we get another list of initiatives: some old, some new, some borrowed, quite a lot of them blue Andrew Lansley Shadow Health Secretary Power to the patient Public 'want interventionist NHS'

One of those rights is to all drugs and treatments approved by the National Institute for health and Clinical Excellence (NICE), and for new drugs to be appraised much faster, so decisions are issued within a few months.

In an earlier report, he proposed 150 GP-led health centres would be introduced across England, open 8am to 8pm, seven days a week.

These have been opposed by doctors' leaders who fear they will harm existing primary care provision.

This final report goes further in changing how GPs work, proposing to remove a minimum income guarantee for practices and linking funding to easy access and high quality care.

It also gives patients greater choice over which GP practice they use, extending 'catchment' areas, changing funding arrangements for new patients and offering more information about practices' services.

Patients will also have the right to express a preference for which GP they see within a practice - a choice with which the practice must try to comply.

Lord Darzi's review also says all 15 million patients with long-term conditions will be given a personal care plan, and 5,000 of them will pilot new personal budgets.

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A campaign urging people aged 40-74 to have their blood pressure and cholesterol checked will also be launched.

There will also be a review of doctors' training, focusing on their first two years after medical school.

But Andrew Lansley, the Shadow Health Secretary, warned the government had spurned an opportunity to create an NHS which was genuinely patient centred and evidence based, in favour of a system that continued to be very much bureaucractic and "top down".

"In place of vision, we get another list of initiatives: some old, some new, some borrowed, quite a lot of them blue."

And Liberal Democrat health spokesman Norman Lamb said: "This statement smacks of a motherhood and apple pie prescription for the NHS, filled with inevitable New Labour jargon such as the "clinical dashboard".

"When the dust settles people will see that little has changed and that the system of command and control diktat by Whitehall lives on."

The Darzi recommendations apply only to England. Northern Ireland has not been carrying out any similar review, while Wales is carrying out a consultation on reorganisation and Scotland published a public health plan in December.