Tag: Evaluation

Evaluating NHS policies in political manifestos

As we approach a general election in the UK, the different political parties are all now starting to present their proposed health policies. It is crucial for the public, journalists and health professionals – and also for politicians from other political parties – to rigorously scrutinise these proposals. This assessment should be based on key criteria to determine their effectiveness and value for money. The following essential questions should be considered when doing this:


1. Will This Policy Improve Patient Experience?

Accessibility: Does the policy make healthcare services more accessible to patients, including underserved populations such as poor and ethnic minorities?

Quality of Care: Will the policy enhance the quality of care patients receive, including aspects such as safety, effectiveness, and patient-centeredness?

Patient Satisfaction: How will the policy impact patient satisfaction and overall experience with the NHS?

Equity: Does the policy address health disparities and ensure equitable care for all patients leading to a reduction in health inequalities?


2. Will the Policy Improve Clinical Outcomes?

Evidence-Based: Is the policy based on robust clinical evidence and best practices that are proven to improve health outcomes?

Prevention: Does the policy include preventive measures that can reduce the incidence of diseases and improve long-term health?

Integration of Services: Will the policy enhance the integration of services across primary, secondary, and tertiary care, facilitating better coordination and continuity of care?

Innovation: Does the policy encourage the adoption of innovative technologies and treatments that can lead to better clinical outcomes?


3. Will the Policy Improve NHS Efficiency?

Resource Utilisation: Does the policy promote efficient use of NHS resources, including workforce, equipment, and facilities?

Streamlining Processes: Will the policy streamline administrative and clinical processes, reducing waste and duplication of efforts?

Capacity Management: Does the policy address issues related to capacity management, such as reducing waiting times and optimizing bed usage?

Data and IT Systems: Will the policy enhance the use of data and IT systems to improve efficiency and support clinical decision-making?

Appropriate Skill-Mix: Does the new service use NHS staff appropriately and are there sufficient trained staff to deliver the programme?


4. Is the Policy Cost-Effective?

Cost-Benefit Analysis: Has an adequate cost-benefit analysis been carried out to evaluate the economic impact of the policy?

Sustainable Funding: Is there a sustainable funding model in place to support the implementation and maintenance of the policy?

Long-Term Savings: Will the policy result in long-term savings by preventing costly health complications and improving overall public health?

Allocation of Funds: Are the proposed funds allocated in a way that maximises health benefits relative to the investment?

Alternative Investment: Would investment in an existing service such as NHS general practices be more cost-effective than setting up a new service?


5. Conclusion

At a time when government finances in the UK are under severe pressure, it is essential to ensure that health policies not only address immediate healthcare needs but also contribute to sustainable improvements in patient experience, clinical outcomes, and NHS efficiency.

By asking these critical questions, the public, media, politicians, health professionals, and other stakeholders can better evaluate the viability and impact of proposed health policies. This approach ensures that public resources are used effectively to achieve the best possible health outcomes at a reasonable cost.

Alternative providers of GP services perform worse than traditional practices

A study from Imperial College London reports that alternative providers of primary care in the NHS, including private sector companies, do not perform as well as traditional GP practices when their performance is assessed using a range of measures of quality of care.

Alternative providers have been contracted to offer primary care in the NHS since 2004 under reforms designed to increase competition. These providers performed worse than traditional GP practices on 15 out of 17 indicators after adjusting for the characteristics of the practices and the populations they serve.The study was published in the Journal of the Royal Society of Medicine.

“This study provides data to inform the debate about the growing role of the private sector in the NHS,” said Dr Christopher Millett, lead author of the study, from the School of Public Health at Imperial. “New providers were allowed into the primary care market to stimulate competition, but our findings suggest that their introduction has not led to improvements in quality and may have resulted in worse care.

“The lesson is that increasing diversity does not necessarily lead to better quality. Regulators should ensure that new providers of NHS services are performing to adequate standards and at least as well as traditional providers.”

Three hundred and forty-seven general practices – 4.1 per cent of practices in England – are run by alternative providers, including private companies and voluntary organisations. These practices tend to be smaller, and serve younger, more diverse and more deprived populations than traditional providers.

The study looked at a range of performance indicators from the Health and Social Care Information Centre and the national GP Patient Survey. These included access measures such as how easily patients can get appointments, clinical measures such as how well they manage patients’ blood pressure, and efficiency measures.

Among the differences between types of practices, alternative providers had worse results for patients’ diabetes control, higher hospital admission rates for chronic conditions, and lower overall patient satisfaction.

“So far, alternative providers have not been widely contracted to delivery primary care services,” said Dr Millett. “However, private sector providers have secured a third of contracts to deliver NHS clinical services since the Health and Social Care Act was enacted in 2013. Our findings highlight the need for careful and independent evaluation of how this legislation has impacted quality of care.”

The article was covered by a number of media outlets including the IndependentPulseDaily MailBMJGP OnlineBT.Com and OnMedica.