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Money for hospitals could be linked to patient ratings, it has been reported, as one of the health bosses tasked with implementing the government’s 10-year plan for the NHS in England warns it faces an existential threat unless it reconnects with the public.
The measure, under which services could lose a proportion of their funding if patients were unhappy, is reportedly part of a package due to be announced by the prime minister next week.
But clinicians have expressed concern that the proposal risks performing surgery on the NHS with a blunt instrument, rather than the scalpel required.
According to the Times, patients would be contacted shortly after their treatment. If they reported themselves dissatisfied, about 10% of “standard payment rates” would be diverted to a local “improvement fund”.
The report suggested it could first be implemented in areas of the service with a poor record of care. Maternity services are said to be among the first to test the system after the health secretary, Wes Streeting, launched a national investigation into NHS maternity services in England, saying “maternity units are failing, hospitals are failing, trusts are failing, regulators are failing”.
But Matthew Taylor, the chief executive of the NHS Confederation, said: “None of our members have raised this idea with us as a way of improving care and, to our knowledge, no other healthcare system internationally adopts this model currently.
“Patient experience is determined by far more than their individual interaction with the clinician and so, unless this is very carefully designed and evaluated, there is a risk that providers could be penalised for more systemic issues.”
It came as the new head of the NHS in England said the service had “built mechanisms to keep the public away”. Sir Jim Mackey told the Telegraph: “We’ve made it really hard, and we’ve probably all been on the end of it. You’ve got a relative in hospital, so you’re ringing a number on a ward that no one ever answers. The ward clerk only works nine to five, or they’re busy doing other stuff; the GP practice scrambles every morning.
“It feels like we’ve built mechanisms to keep the public away because it’s an inconvenience.”
Mackey warned that the disconnect between NHS services and the public could result in the loss of the public health service altogether. “The big worry is: if we don’t grab that, and we don’t deal with it with pace, we’ll lose the population. If we lose the population, we’ve lost the NHS. For me, it’s straightforward: The two things are completely dependent on each other.”
Streeting said on Wednesday that the government’s 10-year plan would also aim to “address one of the starkest health inequalities”, which he claims is the unequal access to information and choice when it comes to healthcare.
Mackey said: “We’ve got to somehow reorientate it; think about how do we find people who need us, how do we stop thinking: ‘It’s going to be a pain in the arse if you turn up because I’m quite busy’ and instead think about how do we find out what you need and get it sorted.”
