Best-performing hospitals will be given greater freedoms over funding to modernise equipment under NHS reforms
NHS league tables will be introduced to help tackle the NHS crisis and ensure there are ‘no more rewards for failure’, as part of a new, tough package of reforms announced by the Health and Social Care Secretary, Wes Streeting.
These reforms are designed to get the NHS working well and get better value for money for patients and taxpayers.
NHS England will carry out a sweeping review of NHS performance across the entire country, with providers to be placed into a league table. This will be made public and regularly updated to ensure leaders, policymakers, and patients know which improvements need to be prioritised.
Persistently failing managers will be replaced and turnaround teams of expert leaders will be deployed to help providers which are running big deficits or poor services for patients, offering them urgent, effective support so they can improve their service.
High-performing providers will be given greater freedom over funding and flexibility. There is little incentive across the system to run budget surpluses as providers cannot benefit from it. The new reforms will reward top-performing providers and give them more capital and greater control over where to invest it in modernising their buildings, equipment, and technology.
The Health and Social Care Secretary said: “The budget showed this government prioritises the NHS, providing the investment needed to rebuild the health service. Today we are announcing the reforms to make sure every penny of extra investment is well spent and cuts waiting times for patients.
“There’ll be no more turning a blind eye to failure. We will drive the health service to improve, so patients get more out of it for what taxpayers put in.
“Our health service must attract top talent, be far more transparent to the public who pay for it and run as efficiently as global businesses.
“With the combination of investment and reform, we will turn the NHS around and cut waiting times from 18 months to 18 weeks.”
The NHS Oversight Framework, which sets out how trusts and integrated care boards are best monitored, will be updated by the next financial year to ensure performance is properly scrutinised.
Deep dives into poorly performing trusts will be carried out by the government and NHS England to identify the most pressing issues and how they can be resolved.
NHS senior managers who fail to make progress will also be ineligible for pay increases. There will be financial implications for very senior managers (VSMs), such as chief executives, if they are failing to improve their trust’s performance or letting patients down with poor levels of care.
A new pay framework for VSMs will be published before April 2025. Senior leaders who are successfully improving performance will be rewarded to ensure the NHS continues to develop and attract the best talent to the top positions.
The changes are made in response to Lord Darzi’s investigation into the NHS, which found that: “The only criteria by which trust chief executive pay is set is the turnover of the organisation. Neither the timeliness of access nor the quality of care are routinely factored into pay. This encourages organisations to grow their revenue rather than to improve operational performance.”
The cost to the health service of hiring temporary workers sits at £3 billion a year, according to the UK Government. Under joint plans to be put forward for consultation in the coming weeks, NHS trusts could be banned from using agencies to hire temporary entry level workers in bands 2 and 3, such as healthcare assistants and domestic support workers. The consultation will also include a proposal to stop NHS staff resigning and then immediately offering their services back to the health service through a recruitment agency.
Rachel Power, Chief Executive of the Patients Association, commented: “We welcome today’s commitment to improving NHS performance and accountability. These reforms signal an important drive for positive change in our health system. The focus on tackling poor performance and rewarding excellence sends a clear message about raising standards across the NHS.
“At the same time, we know from the experience of patients that real transformation comes through genuine partnership with patients. We look forward to working with NHS England to ensure patient voices help shape how any league tables are developed and how success is measured.
“The proposed support teams for struggling trusts could be particularly effective if they include patient representatives and focus on building a culture of patient partnership. This is an opportunity to combine better management with deeper patient involvement – creating an NHS that is both more efficient and more responsive to people’s needs.
“We hope trusts who receive greater funding freedom will use this money wisely – to cut waiting times, make the waiting experience better for patients, and strengthen the ways they work with patients to improve services. These are the things that matter most to people using the NHS.”