A new league table will rank every NHS trust in England according to performance metrics, the government has announced.
Each quarter, NHS trusts responsible for the delivery of hospital and community dental services will be ranked against what the government described as ‘clear, consistent standards’. While the exact metrics have not been announced, patient feedback will play a central role.
Top performing trusts will be awarded greater freedoms and investment, allowing them to shape their services around local need. Meanwhile lower ranking trusts will receive targeted support to drive improvement.
The Department of Health and Social Care said this ‘marks a new era of transparency and accountability in the NHS’ which will ‘end the postcode lottery in care’. The initiative is part of the government’s Plan for Change, which it says will create an NHS that is ‘fit for the future’.
‘More power their hands’
Health and social care secretary Wes Streeting said: ‘We must be honest about the state of the NHS to fix it. Patients and taxpayers have to know how their local NHS services are doing compared to the rest of the country.
‘These league tables will identify where urgent support is needed and allow high-performing areas to share best practises with others, taking the best of the NHS to the rest of the NHS.
‘Patients know when local services aren’t up to scratch and they want to see an end to the postcode lottery – that’s what this government is doing. We’re combining the extra £26 billion investment each year with tough reforms to get value for money, with every pound helping to cut waiting times for patients.’
Sir Jim Mackey, chief executive of NHS England, praised the work that NHS trusts are already doing while highlighting the need to reduce inconsistency. He said: ‘NHS staff across the country work flat out to deliver the highest standard of care to their patients and every day we see or hear fantastic examples of this, but we still have far too much unwarranted local variation in performance.
‘Letting patients and the public access more data will help to drive improvement even faster by supporting them to identify where they should demand even better from their NHS and by putting more power their hands to make informed decisions on their choice of provider.
‘The data also supports local NHS trust boards and leadership teams to more easily identify the highest performing services in the NHS and adapt how they deliver care to drive improvement even faster going forward.’
Does the healthcare sector support the new league table?
The government first proposed the introduction of a league table in 2024, with initial responses from the healthcare sector extremely mixed.
Louise Ansari, chief executive of Healthwatch England, said the proposal would be ‘good news for everyone’. She said: ‘People value the hard work of NHS staff, but it’s frustrating when services fail to operate effectively. So, a fresh approach to improving NHS performance is welcome.’
However, former NHS England chief executive Matthew Taylor expressed concern at the lack of context that a league table provides. He said: ‘The prospect of more “league tables” will concern health leaders, as these can strip out important underlying information. NHS staff are doing their very best for patients under very challenging circumstances and we do not want them feeling like they are being named and shamed.
‘League tables in themselves do not lead to improvement, trusts struggling with consistent performance issues – some of which reflect contextual issues such as underlying population heath and staff shortages – need to be identified and supported in order to recover.’
Nick Murch, president of the Society for Acute Medicine, also warned of the league table’s potential for demotivating NHS staff. He said: ‘Penalising and shaming struggling hospitals while rewarding apparently better performing organisations with additional funds and less restrictions could have significant detrimental effects.
‘It is simply likely to create division, damage patient confidence and further demoralise staff who are striving to provide good care in an already poor environment.’
