The government has published an impact assessment of the new Health and Care Bill which it is introducing to bring about the latest NHS re-organisation.
The part of the assessment that hit the headlines comments on the lack of evidence that the current system – GP-led commissioning – was worthwhile. The government document quotes research which says:
“There was no clear evidence that the creation of CCGs [Clinical Commissioning Groups] as GP-led organisations had led to tangible improvements in commissioning, although both clinical and managerial respondents were enthusiastic about the role played by local clinicians.’
Having worked in a Clinical Commissioning Group, I am sure that many colleagues will find this conclusion disappointing. There seemed to be a number of decisions where the input of GPs brought about worthwhile change. Whether GP commissioning was worth the massive disruption and re-organisation it took, is another question.
Which brings us to the latest re-organisation. I guess that the government feels that this point about lack of evidence boosts its case for reform. Except, of course, it doesn’t really have any evidence that it’s new changes will lead to “tangible improvements”.
The effectiveness of policy changes, of course, are never easy to measure – let alone to predict in advance. But it would be nice if there was at least some consensus that evidence is a good idea before making a change. At Verita we come across proposed changes being recommended on very little evidence all the time. Naturally, these are not on the scale of NHS reforms – but they do, nonetheless, take a lot of time and energy to implement.
Serious investigation reports are a classic example. It is such a familiar reaction to read through a report and get to the conclusions and recommendations and think ‘where did that come from??’.
Verita works with a lot of trusts to support them to improve their investigation processes or to clear backlogs of serious incident which need reviewing. Ensuring that conclusions are based on evidence is a key feature of the advice we give. Plucking recommendations out of the air can be satisfying – and make an investigation report appear more substantive – but in the end if doesn’t really help anyone.
Change needs to be based on evidence. Who knows, one day that idea may even catch on!
For more information please call Verita Consultancy Limited on 020 7494 5670 or email [email protected].