20 Jul 2004
Star ratings are an important indicator of overall performance in the NHS but they must be seen as a crude measure of individual trusts' changing performance as shown by the volatility in the system, commented the Confederation in response to today's announcement.
Gill Morgan, chief executive of the NHS Confederation said, "We welcome the Healthcare Commission's overall assessment that the NHS is improving against tougher targets. This supports an ever-growing weight of evidence from independent commentators that the NHS is improving. Patients and the public should also be reminded that a poor star rating should not be seen as an indicator of poor clinical services."
However, she said that the star ratings should be treated as a wake up call to bring mental health into the mainstream agenda. Gill Morgan said, "The focus on a range of other targets, in particular access, has led to mental health being neglected."
Commenting on the significance of changes in individual star ratings, she said, "We need to keep in perspective the fact that it is often very small changes in performance, sometimes outside the control of the Trust that can change the number of stars awarded. Patients and the public should not believe that such changes necessarily indicate a sudden deterioration in services. Indeed it could indicate that whilst they have improved the threshold has been set even higher. Finite thresholds and the relativity of the system is a real weakness of the current system - losing a star does not necessarily indicate the trust has moved backwards just they have not moved forwards as fast as others."
Gill added: "The trusts which have started their application process to become Foundation Trusts but have now received fewer stars should be allowed to continue - they should have the opportunity to demonstrate they understand the reasons and are making changes."
She concluded, "Generally, and for PCTs, in particular, given the very high level of volatility and apparent sensitivity to small changes, we must question the validity of the measures".
The Confederation is looking forward to working with the Healthcare Commission to produce a new approach for 2006. On refining the current methodology, the Confederation commented that we need to ensure that data is accurate and that poor data provided by individual trusts does not impact upon the performance of other trusts rating. Also, whilst the introduction of dispute resolution is welcome this year the Confederation would like to see this done before ratings go public as public confidence in an individual organisation can be damaged once the rating have gone public.
ENDS
The NHS Confederation represents the organisations that make up the NHS. Our members include the majority of NHS trusts, primary care trusts and health authorities in England; trusts and local health boards in Wales; trusts and NHS boards in Scotland; and health and social services trusts and boards in Northern Ireland.
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Last reviewed 3 Nov 2006