The Conservative Party has promised an “information revolution” in the NHS by replacing Labour targets and “tick-box medicine” with a focus on health outcomes.
The party’s green paper on health, ‘Delivering some of the best health in Europe’, also suggests that the Quality and Outcomes Framework (QoF) for GPs might face an overhaul under Conservative leader David Cameron.
Launching the white paper at the Royal College of Surgeons David Cameron said his party would scrap Labour’s “self-defeating top-down targets” and replace them with outcome measures.
He added: “What this Green Paper is all about is how we can improve our health outcomes by ushering in a new era of patient-doctor accountability through an information revolution.”
The Conservatives say they will mandate hospitals, trusts and other providers to collect and publish information about the health outcomes they achieve. They argue that these will lead to improvements in healthcare including a rise in cancer survival rates plus improvements in after-care service and patient satisfaction and enable patients and commissioners to shop around more effectively for the best care.
The green paper criticises what it describes as the current process-driven targets in both secondary and primary care, including some aspects of the QoF.
It says: “The system which links GPs’ pay to performance (which we support in principle) measures their performance more on administrative processes than clinical ones. For example, GPs have been awarded more points for updating records and information systems than for looking after patients with chronic lung disease and stroke. Any system which prioritises box ticking above the provision of life-enhancing care is unacceptable.”
The green paper says that outcome information published will also include feedback from patients in the form of Patient Reported Outcome Measures (PROMs), a method already used by private providers such as BUPA. It says such data should be published in a standardised format and be open to the public to use it whatever way they see fit.
It says the initiative will begin by collecting PROMS from those with long term conditions and says companies such as CHKS and Outcome Technologies have already implemented systems to collect and analyse PROMs.
The paper adds: “Such organisations, and no doubt other entrants to this market, can be called up for assistance. There is also some infrastructure already in place in GP surgeries. For example, computers are currently used in many areas for electronic check-in, and could very easily include outcomes questionnaires for patients.”
The green paper highlights existing websites which enable patients to submit their hospital experiences from food to car parking.
It adds: “Recently, Microsoft, Google and AOL have created personalised health record spaces to assimilate such information. These represent social movements that could, with even better information provision about healthcare outcomes, bring about a transformation in the way patients use the NHS and help it achieve the highest possible standards of care.”
The Conservative’s plans for the health service include the rejection of some government imposed targets but the retention of practice-based commissioning and patient choice.
In a comment seemingly directed at the existing Choose and Book system the Conservative Party leader argues that publishing outcome information will enable patients to make much more informed decisions.
David Cameron said: “No more five-minute chats in your GP’s surgery picking a hospital based on its waiting times and availability. But the power – the ability – to really compare and contrast different care providers on the things that really matter to you and are easily understandable – survival rates, after care service, patient satisfaction.”
This week the Conservative’s also launched a consultation paper on urgent care and called for patients to be given a simple choice of whether their call was an emergency or not.
This would be reflected in two national phone-lines: the existing ‘999’ number for medical emergencies and a new number such as ‘116 116’ for all other urgent requirements.
The Conservatives suggest that the new number would be the single gateway to access NHS Direct, GP out-of-hours services or urgent care services, and would link to other provision, including dentistry, pharmacy, walk-in centres and self care.