Cutting costs in the NHS is now more important than ever, and trusts around the country are finding it hard to lower their budgets without lowering their level of care. This creates problems with staffing, resources, and the time they can give to each patient.
The Dr Foster 2012 Hospital Guide has published findings from an investigation into the country’s most efficient NHS trusts – and the least. The main points of these results included the facts that only a few hospitals deliver both efficient and high quality care, four trusts scored very well with both measures (of quality and efficiency) – these were Airedale, Cambridge University Hospitals, Frimley Park Hospital and Hinchingbrooke Health Care – and two unfortunately scored badly in both measures – The Princess Alexandra Hospital and University Hospitals Birmingham.
In order to assess these hospitals, the guide took 13 efficiency indicators and compared them to mortality ratios in order to see if there was any relationship with the quality and efficiency of care.
The indicators used by the guide are as follows:
• Readmissions within a week
• Readmissions within 28 days
• Procedures with limited clinical effectiveness
• Short-stay admissions without a diagnosis
• Scheduled operations that weren’t performed
• Use of day case surgery
• Long-stay elderly patients
• Long-stay surgical patients
• Excess bed days
• Outpatients: rates of follow-up
• Outpatients: rates of attendance
• Operations not performed at the weekend
• Scans available at the weekend
While the results didn’t show any particularly strong connections with clinical efficiency, it did show that some trusts had the best mortality rates in the country, as well as being efficient in how they use their allocated resources. The comparisons enabled the guide to distinguish between the most and least efficient trusts, as listed here:
Most efficient NHS trusts:
• Weston Area Health
• Royal Devon and Exeter
• Ipswich Hospital
• Dorset County Hospital
• The Queen Elizabeth Hospital, King’s Lynn
• East Cheshire
Least efficient NHS trusts:
• Pennine Acute Hospitals
• East and North Hertfordshire
• Lancashire Teaching Hospitals
• Royal Free London
• Leeds Teaching Hospitals
• Ealing Hospital
So what else does the report tell us? Some trusts are better than others at dealing with the current financial crisis and subsequent reduction in resources and have become more efficient out of necessity. However, none of the hospitals had high efficiency results for each of the 13 indicators, so there is room for improvement in every trust, and this improvement must not come at the expense of the quality of care provided.
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