More funding for hospitals with happy patients

Civitas, 14 September 2009

Health Secretary Andy Burnham is preparing to announce plans to reward hospitals for high patient satisfaction, according to The Guardian. Potential ratings under consideration include those on the bedside manner of doctors, cleanliness of lavatories, quality of food, and helpfulness of receptionists.

Hospitals in England are primarily paid by procedure, each of which is categorised by medical condition or type of treatment into a ‘health resource group’ (HRG) and listed on a national tariff. The more procedures a hospital carries out, the more funding it receives. The intention is that quality improvement should then be encouraged by the need for hospitals to compete for patients—both in the form the broad service packages commissioned by primary care trusts (PCTs) such as maternity care and A&E treatment, and for the business of individual patients who choose where to undergo elective (or non-emergency) surgery. Bonuses for patient satisfaction would be in addition to current funding.

This new initiative seems to be part of a wider government focus on patients as consumers, including such recent policies as financial rewards for GP practices that score highly on ‘patient experience’ measures (based on national survey results), Patient Reported Outcome Measures (PROMs)—self-assessments of health status which all hospital trusts must now collect for certain elective procedures, and the patient rights listed in the new NHS Constitution. The Guardian article states that Burnham wants to end the ‘get what you are given’ culture in the NHS.

Under a pilot programme launching next spring in NHS North West, hospitals will be able to earn a premium of up to 4% of their budgets if patients are happy.

It will certainly be something to keep watching.