Ministers have agreed to give the American company responsible for the “unworkable” NHS database NPfIT almost £1 billion in health contracts, The Daily Telegraph can disclose.
The National Audit Office criticised the NPfIT NHS database project for being poor value for money, patchy and long overdue.

Computer Sciences Corporation, (CSC) an American IT firm, previously had a £1.9 billion contract for the national NHS system which was scrapped by Andrew Lansley, the Health Secretary, last year.

The firm is understood to have threatened legal action against the Government and is now thought to have agreed to continue with up to £900 million of NHS work in return for dropping any legal action.

It will run computer systems for the NHS across the north, midlands and eastern England under the deal which is expected to be agreed in the coming days.

Ministers are expected to herald the “compromise deal” as a success which will save the taxpayer about £1 billion. However, it underlines the difficulties faced by the Coalition in extricating itself from previous contracts agreed by the last Government.

It will also add to growing allegations that despite the high profile announcement that the beleaguered national NHS database is being scrapped – it is simply being replaced by a series of similar regional systems which will perform the same function.The NHS database attracted widespread criticism following a series of damning official reports. Last year, the House of Commons Public Accounts committee described the programme as “unworkable”.

When he announced the “acceleration” of the dismantling of the system last year, the Health Secretary said: “Labour’s IT programme let down the NHS and wasted taxpayers’ money by imposing a top-down IT system on the local NHS, which didn’t fit their needs.

“We will be moving to an innovative new system driven by local decision-making. This is the only way to make sure we get value for money from IT systems that better meet the needs of a modernised NHS.”

Computer Sciences Corporation had previously largely written off the value of the NHS contract in its accounts, leading to a reduction in the company’s share price. Last May, David Cameron said the Government would not sign any new contracts with the firm until a review of its work on the NHS IT programme was complete.

However, the firm announced yesterday that it had entered into a non-binding letter of intent with the British Government. The letter “defines a way forward for CSC to deliver healthcare solutions and services, primarily across the North, the Midlands and east of England.”

The company’s share price rose yesterday after falling by more than a third over the past year.

A Department of Health spokesman said: “The Department of Health has secured agreement to an approach which will involve a hugely improved settlement for the NHS with CSC, the company responsible for introducing Lorenzo software in the North, Midlands and East.

“A Letter of Intent has been negotiated which makes clear that a new contract, to be signed this Spring, will ensure that the local NHS has control over whether to introduce Lorenzo. The agreement we have negotiated gives choice to Trusts about taking this software, rather than imposing the decision on NHS organisations.”

From: http://www.telegraph.co.uk/IT-firm-behind-unworkable-NHS-database-keeps-IT-deal

Seven English NHS hospital trusts with debts caused by Labour’s Private Finance Initiative (PFI) debts are to have access to a £1.5 billion government bailout fund.The subsidy will be available over the course of 25 year long contracts.

Trusts will have to show they have improved efficiency and provide good care in order to access the money.

The seven trusts are: Barking, Havering and Redbridge, St Helens and Knowsley, South London, Peterborough and Stamford, North Cumbria, Dartford and Gravesham and Maidstone and Tunbridge Wells.

There are 100 plus PFI schemes, where private firms pay to build hospitals, leaving the NHS to pay an annual fee or “mortgage”.

Coalition ministers have attacked Labour over its deals, but the National Audit Office recently reported that for most trusts with financial difficulties PFI was just part of the problem.

The Department of Health says without the funding, services at the hospitals would be put at risk.

Health Secretary Andrew Lansley said: “We need to balance the accountability of the NHS at local level to live within its means on one hand, with recognising that there is a legacy of debt for some trusts with PFI schemes.”

Carers are to be given legal rights under government plans to increase the assistance available to the six million Britons who look after other people.Ministers want to ensure that carers are given support to continue working or studying and to receive time off.

The rights of carers are expected to be put on the same legal footing as those of the people they look after.

There are estimated to be about six million people caring for husbands, wives, children, parents or neighbours, but the Government admits that “many do not get the emotional, financial and practical support they need”.

Paul Burstow, the care services minister, said: “Without the support of relatives and friends, many people who aren’t able to look after themselves would not be able to stay at home. Carers should have their needs looked after as much as the person they are caring for.

“A carer’s health often suffers because they don’t have time to look after themselves. Some often don’t have time to eat properly. So it’s vital we support them to look after their health and well-being.

He added: “None of this is rocket science. It is about the NHS seeing beyond the patient to support family carers. Carer stress is one of the biggest triggers for admission to care homes. That’s why we’ve given the NHS the clearest ever direction to make carers a priority.”

The details of the new rights for carers will be set out in the spring when the Government publishes its plans for reforming the social care system.

They are expected to include safeguards to ensure carers can work flexible hours and are not discriminated against in the workplace. Carers who are studying are likely to be able to ensure they receive state help at school or college.

A scheme that allows carers to take a break is also likely to be strengthened to protect leisure time.

“Caring is for many a full-time job,” said the Department of Health, “but many carers don’t realise they can get help and support from their community.”

A simple programme of assessing carers’ needs and providing tailored help to address them is expected to be introduced.

Ministers have promised to publish a white paper on elderly care reform in April next year.

From:  http://www.telegraph.co.uk/Carers-to-get-legal-rights-and-support-in-reforms

The Government is trying to reassure women fitted with PIP implants to prevent a rush for NHS surgery to remove faulty breast implants.The adverts, to run in a number of national newspapers at the weekend, will emphasise there is “no clear evidence” that the French made implants cause more harm than other brands.

Almost £135,000 is being spent by the Department of Health on the campaign, which will also run in social media sites. Posters will appear in GPs’ surgeries and hospitals as well.

The advert reads: “The latest advice from the NHS and plastic surgery experts is that women with PiP breast implants do not need to have them removed unless they have symptoms such as pain and tenderness.

“There is no link to cancer and there is no clear evidence of an increased risk of harm compared to other brands of breast implants.”

However, it also states, in large-type at the top of the advert: “The NHS will support women with PiP breast implants.”

Clarifying the situation for those who received implants as part of private breast enlargement operations, it states: “”The NHS will remove your implants if your doctor agrees, but the NHS will not replace implants unless it is clinically necessary.”

It advises those worried about whether they have implants made by Poly Implant Prothese (PIP), which contain industrial-grade silicone, to find out if they have them, to speak to their specialist or GP, and “agree what’s best for you”.

Despite the campaign, Fazel Fatah, president of the British Association of Aesthetic Plastic Surgeons (BAAPS), said the organisation’s stance remained that all 40,000 women fitted with them in Britain should have them removed.

He said: “We remain steadfast in our recommendation to the public of precautionary removal of these defective devices. Although there is no immediate health risk, the gel within these implants is simply not meant to be inside the human body.”

A survey of its 230 members found 95 per cent agreed that “it should be the clinics and hospitals that should pay for the replacement surgery, rather than burden the taxpayer with these costs”.

Women given the PIP implants are due to protest in London on Saturday at the reluctance of private firms like Harley Medical Group, The Hospital Group and Transform Cosmetic Surgery to fund removal and replacement surgery.

Explaining the rationale for the campaign, Andrew Lansley, the Health Secretary, said: “The refusal of some clinics to help their patients has left some of those women worried and confused.

“That’s why we are running this ad campaign, to give women clear, definitive advice about what course of action they should take. I hope it helps women decide what is best for them. We have made it very clear to private companies what we expect of them – to provide their patients with the aftercare that they need and deserve.”

“I do not think it is fair to the taxpayer or other NHS patients for the NHS to foot the bill.  We will pursue private clinics with all means at our disposal to avoid this.”

Professor Sir Bruce Keogh, NHS medical director and leader of an expert group on PIP implants convened by Mr Lansley, said: “At present there is insufficient evidence to recommend routine removal of these implants.

“But I know women will be worried. That’s why the expert group supports the NHS offer and believes the private industry should do the same.”

From: http://www.telegraph.co.uk/Breast-implant-scandal-Government-campaign-to-reassure-women

Alcohol drinkers should have two alcohol free days every week warn MPs- who claim current guidelines give the false impression that daily consumption is healthy.The Science and Technology Committee says current advice on “regular” safe intake is confusing, and wrongly leads people to believe that enjoying a few pints of beer or glasses of wine every day will not harm health.

It wants the Department of Health in England to carry out the first proper review of drinking guidance in more than 15 years, which should follow the example of Scotland in recommending two “dry” days a week.

The MPs also want new rules on what would count as a dangerous night of “binge-drinking”, new lower safe levels for older people and a website where people can work out individual intake based on their age, weight and family history.

They say few people understand what constitutes an alcoholic unit, the basis of the drinking advice, and tell ministers that the guidelines do not seem to change behaviour.

Although the Committee’s report concedes that the drinks industry is needed to help improve labelling on bottles and glasses, it warns of potential conflicts of interest if the Government works too closely with brewers and shops.

Andrew Miller, the Committee’s chairman, said: “Alcohol guidelines are a crucial tool for Government in its effort to combat excessive and problematic drinking. It is vital that they are up-to date and that people know how to use them.

“Unfortunately, public understanding of how to use the guidelines and what an alcohol unit looks like is poor, although improving.

“While we urge the UK Health Departments to re-evaluate the guidelines more thoroughly, the evidence we received suggests that the guidelines should not be increased and that people should be advised to take at least two drink-free days a week.”

The MPs’ report, published on Monday following public hearings and written submissions last year, states that the first Government health advice on sensible drinking was not published until the 1980s.

Originally, the public were told that men could safely have 18 “standard drinks” a week and women half that number, while in 1987 this was revised in favour of weekly “sensible limits” of 21 units for men and 14 for women.

Medical research later suggested that moderate daily alcohol intake could be good for the health, by lowering levels of bad cholesterol in the blood, while giving weekly limits could “mask episodes of heavy drinking”. In 1995, therefore, daily limits were introduced that recommended men should not drink more than three to four units a day, and women two to three.

Some experts, however, raised concerns that this switch from weekly to daily limits appeared to increase the weekly “allowance” of alcohol while also appearing to “endorse daily drinking”.

The MPs say more recent studies have cast doubt on the health benefits of regular drinking, and recommend that England follows Scotland’s lead in urging “at least two alcohol-free days a week”.

They back current specific advice for children and pregnant women, and say “there could be merit” in producing new rules for older people as well as limits for “individual drinking episodes”, but find no evidence for increasing current general safe limits.

The Committee says an expert group, including civil servants as well as scientists, should review current evidence on the health effects of alcohol in order to “increase public confidence”.

They say people should be made aware of the difference between the short-term effects of binge drinking and the long term harm caused by alcoholism, and should be helped to understand how many units are in different drinks.

Interpol is seeking the arrest of the boss of the a French company PIP (Poly Implant Prothese) whose breast implants are at the centre of an international health scare.Jean-Claude Mas, 72, is wanted by Costa Rican authorities for crimes involving “life and health”, according to the international police agency’s website. Mr Mas was reportedly last seen in the Latin American country.

Interpol, which is based in France, issued a so-called red notice for Mr Mas, who ran Poly Implant Protheses (PIP), which is in liquidation.

France on Friday offered to pay for 30,000 women to have their PIP implants removed because of the risk the products could rupture and leak industrial-grade silicone.

But the Department of Health said it was not echoing the French advice as there was no evidence to support it. However they are reviewing the data and more information will be made this afternoon.

The Medicines and Healthcare products Regulatory Agency (MHRA) pointed out that there was no evidence of any disproportionate rupture rates other than in France.

A spokesman said: “We therefore do not believe that the associated risks of surgery from breast implant removal can be justified without further evidence.

“We will continue liaising with the French medicines and medical devices regulator and we are awaiting the evidence to support the decision made in France. This will be evaluated as a matter of priority by our clinical and toxicological experts and we will issue further advice if necessary.

Tens of thousands of women in France, Britain, Italy, Spain, Portugal and other countries in Europe and South America have had implants made by PIP, which has now closed.

The implants are filled with an unapproved non-medical grade silicone believed to be made for mattresses and there have been reports that the protective barriers are faulty.

The British Association of Aesthetic Plastic Surgeons (BAAPS) took a different stance from the Government and said it considered the French advice “not unreasonable”.

BAAPS president Fazel Fatah said: “If women are concerned or experience adverse symptoms they should see their surgeon, to discuss options such as having a scan to determine whether there is any weakening or rupture. If there is, we reiterate our previous recommendations – to have both implants removed.”

Figures from the MHRA suggest 84,300 PIP implants have been sold in the UK since 2001.

Based on the assumption that each woman has two implants, at least 42,000 women in the UK could be affected, according to the regulator.

But the figure could be higher because women undergoing breast reconstructive surgery following cancer may only have had one implant.

There are a host of challenges looming for the NHS in the next 12 months.After 139 days of public hearings, the Mid Staffordshire Public Inquiry closed on 1 December. There is no date yet for the publication of the final report. But already Robert Francis QC, the head of the inquiry, has said the issue threatens to unleash a “tsunami of anger”.

The inquiry has been looking at what happened at Stafford Hospital from 2005 to 2008 during which hundreds of patients died needlessly and why it went undetected for so long. In particular, the findings promise to have major implications for regulation of the health service.

In recent months, the Care Quality Commission, which now regulates quality in the NHS after taking on responsibility for it from the Healthcare Commission in 2009, has come under criticism from the House of Commons health committee for losing sight of what it should be doing. Ominously for the quango, the prime minister was quick to give his backing to the findings.

What is more, during the inquiry the culture and vision of the regulator came under attack from its own officials, prompting the health secretary to order an investigation himself. It seems unlikely that the CQC will survive unchanged.

Politically, the government’s reform of the NHS in England may be over the worst hurdles, but that does not mean it will be an easy ride from now until the big bang in 2013 when GPs finally get control over the purse strings.

There is growing frustration among doctors who are getting involved in the new clinical commission groups. In many ways, they should be the greatest advocates of the plans as they are supposed to be getting more power than ever before.

But the Clinical Commissioning Coalition, which represents the GPs who are piloting the new arrangements, has started reporting that they are being bullied by senior managers in the health service. They say they are interfering with their structures and decision-making process – and this in turn is threatening the whole project. Expect another 12 months of arguments and controversy.

Although it is not part of the NHS, the social care system is closely linked to the fortunes of the health service. Whether it is arranging discharge from hospital or preventing falls in the home, when social services are not working as they should, the effect is felt in the NHS.

When Tony Blair came to power in 1997 he talked about improving social care. But at the end of Labour’s 13 years in power, ministers were still arguing about the best way forward.

After 13 years of labour’s dithering the system is suffering from chronic under funding.

While the NHS enjoys a budget in excess of £100 billion, adult social care has to get by on about £14 billion.

This is topped up by individual contributions – the system is means-tested – but nonetheless councils across the country are cutting back on what they can offer. And so reform will require extra money – something which is of course in short supply at the moment.

It is also likely to require cross-party consensus, but there is still some bad blood between the health secretary and his Labour opponent Andy Burnham over the death tax row which effectively scuppered the shadow health secretary’s plans to reform social care when he was in power.

The budget is increasing by an average of 0.1%, but as inflation in the health service is rising at a much quicker rate to cover costs associated with the ageing population and rising levels of obesity, savings are having to be made.

The NHS has a target of £20 billion by 2015, the equivalent of about 4% a year. That means there is pressure on jobs – unions say tens of thousands are being lost – and front-line services.

In particular, hospitals are coming under pressure. Advances in medicine and the nature of illnesses in the 21st century – many more people are suffering from chronic conditions like diabetes – means more and more can be done in the community.

It has meant an increasing number of hospitals are piling up debts because they are not getting enough patients through the door.

This in turn means managers and ministers are having to make difficult decisions about closing departments and even whole centres. The process will continue in 2012, particularly in and around London which was recently described as being in a “shocking” state by a committee of MPs.

Under Labour, an 18-week waiting time target was set for non-emergency hospital treatment, such as knee and hip operations. Within months of the coalition being formed, ministers said it was being relaxed to move away from the tick-box culture that they say had developed.

But when the government was knee-deep in criticism over its reforms the prime minister made the specific pledge that waiting times would not be allowed to slip. This has resulted in more attention than ever being given to waiting times.

And signs are emerging that hospitals are beginning to struggle to keep up with the 18-week goal. Overall, the NHS is still meeting the target – they only have to achieve it for 90% of patients to reflect the fact there are valid reasons why some wait longer.

But that masks the fact that there is a rising number of places where it is being breached, leaving the best-performers to bring the national figure up.

It means there could be growing dissatisfaction with the waits patients are facing, although it must be remembered a return to the 1990s when waits of six months and even a year were the norm for many patients is still a long, long way off.

The number of NHS patients who have to undergo emergency readmission to hospital within a month of being discharged has increased by more than three quarters over the last decade, the Daily Telegraph has disclosed.Hospitals have been accused by ministers of treating patients “like parts on a production line” after official figures suggested that hundreds of thousands of people every year are being sent home before they are well enough.

More than 660,000 people were brought back to hospital last year within 28 days of leaving, statistics show, sparking allegations that patients are being “hurried through the system” so the NHS can meet waiting-list targets.

The official figures show that some NHS trusts have seen their emergency readmission rate rise more than threefold over the past decade – while some hospitals have seen only a modest increase.

Last night, Andrew Lansley, the Health Secretary, said that the “hugely distressing” trend must stop.

“Patients have a right to expect that when they go in for treatment that they are looked after properly and that the treatment they are given helps them to recover,” he said.

“Having to be readmitted and treated all over again is hugely distressing. These figures show how Labour’s obsession with waiting time targets meant that patients were treated like parts on a production line to be hurried through the system rather than like people who need to be properly cared for.”

The Department of Health has released detailed information on the number of emergency readmissions in every area across Britain.

The figures show that 620,054 patients had to be readmitted in 2009-10 – compared to just 348,996 a decade before, a 78 per cent increase. Over the past five years, there has been a 31 per cent rise and a five per cent increase on the previous 12 months.

The data also highlights the widespread regional variations. The rate of readmission in the Kensington & Chelsea PCT area has risen by 287 per cent over the past decade to 1,582 people.

However, North Lincolnshire PCT has only experienced a 3.37 per cent rise over the same period.

Hospitals within the Hampshire PCT area readmitted 13,239 people last year. The nearby area covered by the Isle of Wight PCT only had to readmit 1,098 people.

The figures, do not include patients suffering from cancer or mental health problems or maternity patients.

Most of the areas with the highest increases in readmission numbers are in London and the south east, where pressure is greatest on the NHS. The Department of Health has analysed the social make-up of each area and concludes that the so-called “thriving London periphery” – the relatively wealthy commuter hinterland around the capital has suffered the biggest recent deterioration.

About 10 million people are admitted to hospital wards each year. Critics claim that government targets, such as the demand that patients be admitted to hospital for treatment within 18 weeks of seeing their GP, mean hospital managers are pressured into releasing patients early to make beds available.

Earlier this month, The Daily Telegraph disclosed that the Government is moving from a system of targets for hospitals based on waiting and treatment times – to a system of so-called “outcomes” which measures the success of treatment.

In a criticism of previous targets which he blames for the increase in emergency readmissions, Mr Lansley said: “Instead of focusing on the results which actually matter for patients, they focused on narrow processes to the detriment of patient care. That is why we have taken action to address these increases in emergency readmissions.

“One of the new goals we are setting the NHS is reducing emergency readmissions. In order to help achieve this we have created a re-ablement fund of £300 million and we have taken action to stop hospitals being paid when they readmit a patient after discharging them too early. These steps will turn Labour’s poor performance around.”

Under the Government scheme, hospitals will effectively be responsible for people’s care in the weeks after they return home and will be financially penalised for discharging patients too soon.

From:  http://www.telegraph.co.uk/Scandal-of-NHS-production-line-as-readmissions-soar

Andrew Lansley has called on the NHS to focus on “what really matters” as he prepares to announce plans to judge hospitals and doctors against 60 new goals that are designed to save more than 20,000 lives a year.The Health Secretary has unveiled a new system to assess success in the health service based on the quality of care patients receive – not merely the speed at which they are treated.

Comprehensive data on hospital death rates, the individual performance of GPs and surgeons and patients’ experiences under their care are to be published in an attempt to improve standards.

Mr Lansley has set out 60 benchmarks that will replace Labour’s system of targets and will be used to define success in the NHS.

These include a commitment to preventing unnecessary early deaths, a pledge to enhance the quality of life for people with long-term conditions and a drive to ensure that people have a positive experience when using the health service.

If the new standards are achieved, 24,000 early deaths a year could be prevented from cancer and other long-term conditions, Mr Lansley believes.

In addition, fewer people with long-term conditions including asthma and diabetes will be treated in hospitals, he will claim, while patients undergoing routine hip and knee operations will no longer be left in pain or unable to walk.

Access to NHS dentists will also be improved, he will say.

The Cabinet minister said the record on unnecessary early deaths varied across specialties as he urged the health service to focus on “what really matters” – the results achieved for patients and their experiences while being treated.

“If you look at the question of how many patients in this country die who could live if they got the best health care, it is literally over 10,000 patients a year if we were simply to get to a place which is better than the average across the OECD (Organisation for Economic Co-operation and Development) countries.”

In an interview with The Daily Telegraph, Mr Lansley says his tenure as Health Secretary will have been a “failure” if the 60 new “outcome” targets do not improve by the next election. He pledges that the benchmarks will now “define what the NHS is setting out to achieve”.

“We have to clear the decks and be clear this is what we are focusing on,” he says. “People say in three and a half years’ time, in 2015, at the next election, how will we know whether you’ve succeeded or not? The answer is ‘have the outcomes improved?’

“It will be my failure if we haven’t improved them and the NHS should feel that it has not succeeded, that is what we are setting out to do.”

Next week, the Government will set out current performance for each of the 60 indicators. It will then set out national targets for improvement “by the time of the next election and beyond”.

The new NHS Commissioning Board and the Care Quality Commission will also intervene directly to address problems that are highlighted by the data.

In today’s interview, Mr Lansley says that the long-running row over NHS reform must end and the health service must concentrate on improving patient care.

“We’ve really got to get into the big picture, which is delivering improvements in the results we achieve for patients right across the board,” he said. “We know that we can do it.”

The benchmarks will be monitored partly through studying clinical data – for example, to ascertain whether mortality rates for cancer, liver and heart disease are improving — and partly through surveying patients to gauge whether they were satisfied by the standard of care they received and the speed of their recovery.

The Health Secretary says: “This is literally saying to patients ‘if you were in hospital, if you were being looked after by your general practitioner was the service and experience you had good or not?’ It’s not like some other kinds of medical model where you kind of treat people and they get better. This is different.

“This is really where you begin to kind of focus on the experience of care.”

For the first time, the views of bereaved relations and even children will be surveyed so that the quality of NHS care from early years until death can be assessed.

“We’ll be undertaking a consistent national survey of the bereaved relatives of people who received end of life care,” Mr Lansley said. “Asking them, after a suitable passage of time, what was their loved one’s experience of care and how well were they looked after towards the end of life.”

From: http://www.telegraph.co.uk/Andrew-Lansley-sixty-step-plan-to-help-NHS-focus-on-what-matters

Huge regional inequalities in the quality, quantity and costs of health care have been revealed by a new website.Treatments for cancer and dementia and access to care homes are among the areas highlighted in the NHS Atlas of Variation, which was published yesterday.

The annual study carried out across England is a detailed survey of the “postcode lottery” in NHS treatment.

Ministers say the results will help identify “unjustified” disparities and drive up standards resulting in “consistently high quality care”.

The report shows a stark contrast in the rate of prescribing anti-dementia drugs.

Patients in north Lancashire are being described 25 times as many treatments and tablets to help “temporarily improve or stabilise symptoms” than in Kent.

The report suggests that one possible reason is the lack of awareness some GPs have about how to spot early symptoms of Alzheimer’s disease – a concern shared by campaigners for those living with the illness.

It also highlights worries that some breast cancer patients are staying in hospital too long in some parts of the country as compared with others.

The survey notes that most patients undergoing breast cancer surgery can be “safely managed as day cases or with a single overnight stay” but that currently more than 20 primary care trusts have average lengths of stay “in excess of three days”.

For example, the same surgery carried out in parts of south Wales resulted in patients staying in hospital for a few days where in Hertfordshire they stayed only one night.

Access to care homes – paid for by the NHS for those receiving end-of-life care or round-the-clock intensive care – also varied considerably.

In Devon and Cornwall, with its high elderly population, the admission rate for those aged over 74 to care homes funded by the NHS was just under three per 100,000 of the population. The figure in Northumberland was 190.

Meanwhile the rate of angioplasty operations – which tackle blocked and narrowed arteries – was three times higher in Peterborough than County Durham.

The report measures 71 key indicators, including hospital admission rates, what treatments health trusts choose to fund, and how children are managed in the NHS.

It attempts to map the “utilisation of healthcare services that cannot be explained by variation in patient illness or patient preferences”.

Health minister Lord Howe said: “The Atlas of Variation lets us look at how the local NHS is meeting the clinical needs of their local population.

“This will help commissioners to identify unjustified variations and drive up standards so patients are receiving consistently high quality care throughout the NHS.

“We are committed to improving results for patients and our new NHS Outcomes Framework will hold the NHS to account for this. Commissioners will be able to apply contractual penalties if any organisation is failing to deliver improvements for patients.”