David Oliver: Stop naming and blaming hospitals for whole system problems

In advance of the chancellor’s financial statement, the UK press has trailed the government’s intention to protect NHS funding while pushing the health service to improve its performance and efficiency.1This is nothing new for the Treasury, and both the previous and current health secretaries have pointedly highlighted major performance variations between acute hospitals. One figure doing several rounds of news recently is that just 15 of England’s 135 acute non-specialist hospital trusts account for 40% of ambulance handover delays outside emergency departments, with one large NHS trust experiencing one in 20.23There’s also nothing new in highlighting variations in data on activity and outcomes. We’ve had national databases on variation for several years—such as the NHS atlas of variation,4 focusing on local level data, and the Getting it Right First Time (GIRFT) programme, which is more concerned with hospital services.5 A range of national clinical audits also show variations in processes…
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