News / Doubts cast over income link

The NHS has cast doubt over government plans to base up to 10% of hospitals’ income on patient satisfaction scores.

In his strategy document NHS 2010-15: from good to great, released on 10 December, health secretary Andy Burnham said the tariff must be used to incentivise providers to offer the highest quality care, move care out of hospitals and improve productivity.

Payments linked to patient satisfaction would rise to 10% of hospitals’ income over time, starting in 2010/11. This will be part of the commissioning for quality and innovation (CQUIN) scheme. The document says that the Department will develop a wider range of ‘clear and simple’ measures of satisfaction that will cover individual services as well as providers as a whole.

The document said: ‘This represents a clear shift from a commod-itised, production-line NHS to one that’s people-centred, where staff are at all times encouraged to see care through the eyes of their patients and their carers. Over time we will consider extending this to other settings.’

NHS Confederation chief executive Steve Barnett said the initiative would involve a lot of work. ‘Although an attractive concept, calculating payments to providers based on patient satisfaction is very challenging to put into practice,’ he said.

‘Variations in people’s expectations of what kind of service they should receive can be considerable. Factors such as geographical location, age, gender and ethnicity can all impact on the kinds of responses received – enormous care and detail would be needed to make this kind of assessment work.’