• Annual health check shows more improvement by NHS trusts in 2007/08
• Patients praise GPs, but scarcity of NHS dental care a problem for them
• More confidence in community mental health services
• Healthcare Commission calls for joined-up urgent and emergency care services

Annual health check shows more improvement by NHS trusts in 2007/08

On 16 October we published the eagerly anticipated results of our 2007/08 annual health check of the NHS. We rated each of England's 391 NHS trusts for their performance during the twelve months from 1 April 2007 to 31 March 2008.

The annual health check is the most important of our activities to encourage improvements in healthcare for patients and the public. We look at the quality of each trust's services and how effectively it uses its financial resources. When assessing the quality of services, we focus on the things that matter to patients. These include waiting times, infection control and how quickly they receive treatment for cancer after diagnosis.

The results of this year's annual health check showed further improvements in performance by many trusts.  For example, when we introduced the annual health check system in 2005/06, only two trusts scored "Excellent" for both the quality of their services and their use of financial resources.  By the 2006/07 this number had risen to 19, and by this year's annual health check it had reached 42.

However, in 2007/08 a quarter of all trusts failed to meet at least one of the Government's three standards on infection control and only 16% met targets on patient convenience and choice.

More than 150 NHS trusts improved their rating for the quality of their services, but 66 fell to a lower rating and 174 remained the same. For their use of resources, we rated 94 trusts "excellent and 145  "good", but 132 were rated "fair" and 20 "weak".

From the regional point of view, performance by the NHS in most areas of England improved in 2007/08, but trusts in London continue to face major challenges.

Celebrating success and following up poor performance

Our Chief Executive, Anna Walker, said: "There are some extremely tough targets for trusts to meet and this is a testament to what can be achieved when you aim high.

"It is right to celebrate this success. But it is also important to address poor performance at the bottom end. We'll be following up with the 20 trusts rated ‘weak' for their quality of services and to check what progress they are making on plans to lift their performance."

For more information about how the NHS performed in 2007/08 read our press release

To find out how you local trust scored search for an organisation

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Patients praise GPs, but scarcity of NHS dental care a problem for them

The results of our 2008 national survey of patients of local health services shows that most people are "completely" satisfied with the care they receive from GPs and health centres. However, people had concerns about waiting times for local health services, and particularly about access to NHS dentists.

We asked more than 69,000 people about their experiences of GP practices, health centres and dentists, focusing on topics such as appointments, waiting times and relationships with NHS staff.
 
Patients were particularly positive about doctors' personal skills - 93% said that they were treated with respect and dignity all of the time.  Even in the lowest scoring trust, this figure was 81%. However, 43% of respondents said they did not get the advice they wanted on diet and 44% said they did not get the advice they wanted on exercise. But for alcohol and smoking, most respondents got the information they needed.

Problems accessing services

Waiting times remain a problem. Patients should be able to see a GP within two working days, or another primary care professional, such as a practice nurse, within one working day. But 13% of our respondents had waited longer than the 48-hour target time for an appointment. Opening times of GP surgeries were also a problem, particularly for younger people: 25% of respondents said that they put off visiting their GP because they found the opening times inconvenient. This figure rose to 38% for 16 to 35-year-olds. 

People's biggest worry was access to NHS dentists, with more than three-quarters of those who did not receive NHS dentistry saying they would like it.

Our Chief Executive, Anna Walker, welcomed the "high regard" for GP surgeries but highlighted the national concerns about dental care: "If a large proportion of people do not have treatment regularly, we could be facing a significant national health problem in years to come."  The Healthcare Commission will be highlighting gaps in the availability of dental care where they occur.
 
To find out more about our survey of local health services read our press release

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More confidence in community mental health services

People who use community mental health services have more confidence in the services, but need to be more involved in how their care is planned. This is the picture that emerged clearly from the results of our 2008 national survey of service users.

Service users' confidence in mental health professionals had risen since our surveys in earlier years, with 78% now rating their care as "excellent", "very good" or "good". More service users felt that their psychiatrist "definitely" listens carefully (up from 68% in 2004 to 72%) and more "definitely" had trust and confidence in their community psychiatric nurses (up by 2% to 73%).

Access to services

But the survey revealed no real improvement in access to services and the extent to which service users are involved in decisions about their care. Almost a quarter (24%) of people said they were not involved in decisions about their care plan.  Access to counselling also needs to improve - of the 62% of respondents who were not receiving counselling, 32% would have liked to have been.

Our Chief Executive, Anna Walker, welcomed the improvement that our survey results showed, but said more progress was needed:

"Service users' care should be co-ordinated by one person, they should be involved in decisions about their care and they should have access to a range of therapies and services."

We used the survey results when assessing mental health trusts in the 2007/08 annual health check. This assessment included a focus on coordinated care, access to crisis resolution services and mental health data quality,

To find out more about the results of our 2008 survey of community mental health services read our press release

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Healthcare Commission calls for joined-up urgent and emergency care services

In September 2008 we published the results of our national review of urgent and emergency care in England. We focussed on assessing how well the whole system works together: ambulance services, A&E, NHS Direct, urgent care provided by GPs, walk-in centres, and minor injuries units. 

When looking at these services, we grouped them according to the primary care trusts areas (PCTs) that manage them. We found that out of the 152 PCT areas in England, 60% achieved the top two ratings:  33% were rated ‘best' performing (50 areas) and 27%  ‘better' performing (41 areas).

People in the best performing areas are more likely to get the care they need promptly and to have their needs met effectively. Those in the worse performing areas tend to have weaker GP out-of-hours services, wait longer for care, and services are less likely to meet the needs of people with disabilities or long term conditions.

Positive results

New measures, including Government targets and the launch of NHS Direct and NHS walk-in centres, have had a positive impact on urgent and emergency care services. For example, the number of people who received treatment within four hours of arriving at A&E went up to 97.9%, from 91.2% in 2003/04.  The percentage of ambulances that arrived within eight minutes for immediately life-threatening cases was 77.1%, up from 74.6% in 2003/04.

A need for closer working

As a result of our findings, we are calling on PCTs and healthcare providers to work more closely together. We want Government to support the integration of services, and their use of common language, and the simplification of people's access to services.

We recommend that the use of a single telephone number for urgent care services is piloted, as a way to cut the number of people attending the wrong services.

To find out more about the results of our review of urgent and emergency care services read our press release

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