Trusts using quick fixes to function

Many NHS trusts keep services going only by using money meant for long term reforms, a new report has said.

The Audit Commission report also warned there are too many piecemeal targets and some of the 29 three-star trusts approved to apply for foundation status have weak management and financial arrangements.

These three or four trusts might not be able to sustain high performance and could have deficits in the future.

The Commission called for a more rounded system to judge if trusts are eligible for foundation status, looking at financial capacity and management as well as performance.

The spending watchdog assessed progress made by all health trusts in England since the NHS Plan was published in 2000.

It found major improvements in areas such as being able to see a GP within 48 hours, reducing outpatient waits to 21 weeks and waiting no more than a year for an inpatient operation.

But inaccuracies in some waiting list data meant this could not be stated with certainty.

The Commission also questioned whether improvements could be sustained in the long term. Many trusts were using quick-fix solutions to keep everyday services going by taking money away from the longer term modernisation of the NHS.

More than half of trusts diverted money away from IT, medical equipment and building maintenance to keep services running. They also relied on paying private hospitals to carry out their work or paying consultants for extra sessions to meet targets.

James Strachan, chairman of the Audit Commission, said: "There are too many piecemeal targets and furthermore, the pressure put on waiting time targets has led to a tremendous amount of distortion of the system. Having too many targets risks obscuring where the real priorities lie."

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