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An Open NHS: why our health service should have nothing to hide

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4th September 2012

Tory MP Chris Skidmore says a new hospital scorecard will help 'shine a torch' on NHS performance.

The announcement that health authorities will have to publish data on how many patients are being provided with the latest drugs and treatments in the form of an 'innovation scorecard', has the potential to be a step change in NHS services- creating an open NHS in which no statistic should be left unturned. The creation of the scorecard will reveal for the first time which health authorities are denying the best treatment, raising up the best to what should be standard practice, and exposing the worst. Its effect could be transformative, just as it has been in MRSA rates, which since the decision was taken to publish openly the rates of infection in each hospital, from a peak of 1,652 in 2006, the total number of infections is now down to 364 in England and Wales.

The publication of a scorecard for health authorities is just one of many measures that is being opened up to patients and the wider public, shining a torch upon every aspect of NHS performance. Other new datasets include data on comparative clinical outcomes of GP practices, prescribing data, complaints data by hospital, clinical audit data, and data on staff satisfaction.

It may sound dry stuff, but if we are to ensure that performance, and crucially patient care, is improved, then open data will be the key to making the NHS a twenty-first century service, matching twenty first century expectations. Figures that can reveal which trusts, practices and hospitals are performing well, and which ones are performing poorly, will be vital for the future improvement of the NHS, dragging up standards of care, exposing failure and inadequate care. Sometimes this can be uncomfortable, and illuminate harsh truths that some might prefer to have hidden. However, we have witnessed the tragedy that an excess of secrecy can bring- cases like the Mid-Staffs scandal, where a dearth of information on the outside made it impossible to realise the true extent of the problems until it was far too late.

There is still work to be done- we can go much further, ensuring that we have an NHS in which every trust, every GP surgery, every care home, is open to scrutiny, and that the data collected is of an acceptable standard. One of the problems that I have identified during an ongoing investigation of overseas visitors using the NHS without the costs of treatment being reclaimed is the massive disparity between various NHS trusts when it comes to data collection. I used the Freedom of Information act to ask every acute trust how much debt owed by foreign nationals had been written off, yet many failed to record this basic financial information.

Access to better data will liberate patients, particularly when it comes to GP practices. Historically the only basis for comparison that patients have had is anecdote or personal experience- we know that some practices are better than others but now the government is making it possible to prove it, and for patients to react appropriately. This is an area where we are finally catching up with the rest of the world- for some years now the Dutch government has a run a website where patients can access information on care providers, including waiting lists and success rates for a given procedure.

The NHS is now moving in a direction, quite rightly, towards maximising patients’ choice at every opportunity. However, a choice is only a choice if it is an informed one. A a determined drive towards a culture of openness and transparency can only be good for a health service that has nothing to hide.




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