Three - One, final score

Mark Lankshear

The Hallamshire got three stars, the Northern General only one, reinforcing old perceptions of rivalries and inequalities. But then the hospitals joined forces in April to form Sheffield Teaching Hospital Trust, employing 11,000 health workers and responsible for all of Sheffield’s adult hospitals. The new trust, under the leadership the former Northern General Chief Executive, Andrew Cash, claim to be on target for a three star rating next year, but even if they didn’t, where else could we go?

Star quality

The publication of the first NHS Performance Ratings last month mirror the controversial school 'league tables'. They aim to help the Government and public judge how hospital trusts score on 20 key national indicators like waiting lists. "Three star" hospitals will have easy access to extra cash, fewer inspections and be encouraged to develop new services and "spin-out business ventures". "One Star" rating indicates some cause for concern and means a Hospital Trust has to plan improvements with the "Modernisation Agency". If a trust loses all its stars it can be put out to franchise and be taken over by a three star trust.

Last year's problems

The Northern General is one of the largest hospitals in the country and a recognised Centre of Excellence in specialties such as heart, lung and kidney clinical care. It was given only one star although it did achieve 13 out of 20 key targets. Too many people had to wait more than thirteen weeks for an appointment, too many operations were cancelled on the day and there were high rates of staff sickness. Central Sheffield University Hospitals, which includes the Hallamshire, hit 18 out of 20 targets and was given a three star rating.

Rewards or reviews

The Government admits the measures are not yet perfect and they are not an indication of quality of clinical care, but claims they are fair and that the public have a right to know how well NHS organisations are performing. The review will bring over £500,000 extra funding to Sheffield hospitals in 2001/02. Next years Performance Rating will decide whether Sheffield's hospitals will be treated as a "best performer" and get "extra rewards and new freedoms" or if will it have to produce a "performance improvement plan" and undergo regular review with support from the "Modernisation Agency".

Sheffield United?

The new Sheffield Trust, the fourth largest in the country, appears confident of top marks next year and say they are committed to removing the inequalities between the hospitals. Next years stars will only tell us how Sheffield is doing overall and Sheffield residents seeking hospital treatment will be treated by the trust whatever its rating. As they develop, the new National Service Frameworks might be a more useful way of judging whether the care you receive is up to scratch. They will give standards for the kinds of services that you should be offered and how long you should wait.

Next month we will detail the National Service Framework for Mental Health Services and look at what’s available in Burngreave.