Should 'Ofsted-style' ratings be used for NHS? BMA comment on ratings review
Commenting on the Nuffield Trust review into whether the Government should introduce ‘Ofsted-style’, performance ratings, Dr Mark Porter, Chair of BMA Council, said:
"It’s important that patients have access to meaningful information about the quality of services, and the Nuffield Trust has adopted a refreshingly thoughtful approach to a possible new ratings system.
“It is particularly welcome that the Trust has taken on board concerns about ratings for entire hospitals. As the BMA and many others pointed out, hospitals are highly complex organisations and their ‘performance’ cannot be measured in any simplistic way.
“However, there are always going to be problems constructing indicators that measure quality in any meaningful way, and do not result in a target-driven culture.
“GP surgeries often have many staff and offer a range of different services, the quality of which would be difficult to reduce to a meaningful single score.
“Any system for measuring performance would also need to take into account the different demographic and financial challenges facing different practices. Data will only be useful if patients can make sense of it, and if it allows GPs to make improvements. It would also need to be used developmentally rather than punitively - we are concerned about the risk of demoralising staff in organisations with low scores, particularly given the link between morale and quality of care.”
"It’s important that patients have access to meaningful information about the quality of services, and the Nuffield Trust has adopted a refreshingly thoughtful approach to a possible new ratings system.
“It is particularly welcome that the Trust has taken on board concerns about ratings for entire hospitals. As the BMA and many others pointed out, hospitals are highly complex organisations and their ‘performance’ cannot be measured in any simplistic way.
“However, there are always going to be problems constructing indicators that measure quality in any meaningful way, and do not result in a target-driven culture.
“GP surgeries often have many staff and offer a range of different services, the quality of which would be difficult to reduce to a meaningful single score.
“Any system for measuring performance would also need to take into account the different demographic and financial challenges facing different practices. Data will only be useful if patients can make sense of it, and if it allows GPs to make improvements. It would also need to be used developmentally rather than punitively - we are concerned about the risk of demoralising staff in organisations with low scores, particularly given the link between morale and quality of care.”
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