News / CQC targets 2017 roll-out for use of resources assessment

The new assessment approach is being developed in partnership with NHS Improvement and Professor Richards said it would build on Lord Carter’s work on improving productivity in NHS hospitals. But he added that the issue was complex. ‘It is not simply a question of achieving financial balance or achieving a control total,’ he told the conference.

Once the approach is developed, Professor Richards said the CQC would ‘almost certainly’ introduce a sixth question about efficiency and use of resources into its ratings process. The assessment, which would be undertaken at least at a trust level, would sit along the five existing questions asking if an organisation is: safe; effective; caring; responsive; and well-led. However the ‘well-led’ assessment would also be extended to cover financial leadership.

NHS Improvement has recently published proposals for a single oversight framework covering both foundation trusts and NHS trusts, including a use of resources assessment. Initially this four metric assessment will closely resemble the financial assessment in the existing foundations trusts risk assessment framework. However three further metrics will operate in shadow form in 2016/17. This will include the change in one of the Carter proposed efficiency metrics – the cost per weighted activity unit.

Professor Richards said that a number of approaches were being considered for a broader use of resources assessment. These could involve an assessment of the appropriateness of admissions, length of stay and timely discharge. It might also look at the efficient use of staff, procurement efficiency and the efficient use of estates. These could all draw on Carter-identified metrics such as care hours per patient day.

An examination of use of resources at core service level could potentially draw on the expanded ‘Get it right first time’ work being taken forward by Professor Tim Briggs (surgery) and Professor Tim Evans (medical care).