NHS trusts to face tougher ratings tests

A new two-tier system will replace the old star ratings system, and will see trusts' performances graded from 'weak' to 'excellent' in the two areas: 'quality of care' and 'use of resources'.

The decision taken by health secretary, Patricia Hewitt, on the advice of NHS watchdog, the Healthcare Commission, follows repeated warnings from the National Audit Office and Audit Commission that the NHS needs to take control of its finances, which are expected to result in record budget deficits this year.

The financial 'crisis' has already led to the early retirement of Sir Nigel Crisp, NHS chief executive, and prompted Hewitt's unexpected acknowledgement that she should be judged on the future financial performance of the health service.

A spokesperson for the Department of Health told Pharmaceutical Marketing: ìEssentially, the DoH, working with the Healthcare Commission, is making this year's ratings (05/06) much tougher than ever before on financial performance.î

Explaining the reasons behind the increased stringency, Hewitt said: ìI believe that robust financial management is an essential part of providing better quality services.î

She also stressed that trusts with a poor financial performance would not be able to bid for foundation status, which would give them greater freedom from government control. Overall, she said she hopes to use ìevery pound of public money as effectively as possible [to release] more resources for new drugs, better prevention and faster treatment.î

Both the NHS Confederation and the BMA welcomed the ratings alterations. The Confederation's chief executive, Dr Gill Morgan, said: ìIt is right that from now on we are completely transparent about the financial situation.î

Dr Paul Miller, chairman of the BMA's Consultants Committee, commented: ìIt is [also] important to assess how NHS management act as stewards of taxpayers' money which pays for the services patients experience.î

The change has also been welcomed by Hewitt's political counterparts - the Conservative's Andrew Lansley, and the Liberal Democrat's Steve Webb. Webb welcomed the move away from the previous ìabsurdî system although he warned that the new measurements were also very simplistic measures of performance.

Since 2001, hospitals, ambulances and primary care services in England have been rated by a hotel-style star system, graded on a wide range of criteria.