Source · Select Committees · Public Accounts Committee
Recommendation 16
16
Accepted
Address variations in trust capability to improve patient access and experience nationwide.
Recommendation
There are differences in the capability of individual trusts, including around management, clinical leadership, and technology, that must be addressed to reduce variations in patients’ access to and experience of services.38 We asked witnesses how the worst performing trusts were being brought up to the standards of the best.39 The Department said tackling variability and importing best practice was one of its biggest priorities and NHS England told us it worked more closely with those systems that it has identified as the most challenged, of which there are currently seven, to provide extra help and support including financial assistance.40
Government Response Summary
The government accepts the recommendation and states NHS England is actively working to reduce unwarranted variation in trust performance, focusing on the most challenged systems by providing maximum support, national experts, and improvement teams, with a target implementation date of February 2024. NHS England will also provide further details on causes of variation in a future letter.
Government Response
Accepted
HM Government
Accepted
3.1 The government agrees with the Committee’s recommendation. Target implementation date: February 2024 3.2 NHS England is working to tackle unwarranted variation in performance. Making improvements to Emergency Departments and ambulance performance requires working between secondary, primary, community and social care so the Urgent and Emergency Care (UEC) tiering support offer is taking place at system level to ensure a whole-system approach. 3.3 The UEC recovery plan aims to improve and standardise processes to reduce unwarranted variation in the in-hospital UEC pathway. Specifically, NHS England is working with systems to improve their UEC performance through standardising service in the first 72 hours of care, increasing direct referrals to specialist care and Same Day Emergency Care (SDEC,) including paediatric SDEC, with focus on equitable access and consistency of delivery. 3.4 NHS England’s approach will focus on providing maximum support to the most challenged systems, bringing in national experts, NHS England’s Emergency Care Improvement Team and a range of supporters from best practice organisations. A bespoke offer is provided to each system, helping them align their plans to ensure delivery of local UEC recovery. There has been significant improvement in emergency performance over 2023-24 compared to last year, and there is already evidence of these improvements in emergency performance being fastest in some of the most challenged. 3.5 NHS England will write to the Committee in February 2024 setting out the underlying causes of variation in performance as more information will be available at this time.