Healthcare standards neglect public health

The government’s standards for better health are too vague and fail to put a clear emphasis on the importance of staying healthy, according to the King’s Fund.

In its reply to the consultation on Standards for Better Health: Healthcare Standards for Services under the NHS, the health think tank said that it would have sent out a positive signal ‘if standards concerning public health were set out first rather than languishing at the bottom of the pile’.

The consultation says that health bodies will only have to take the standards into account rather than having to achieve them. This may be a significant ‘stumbling block’ to the new Healthcare Commission in its role as assessor of standards, said the fund.

It added that to bring about ‘real decentralisation’, the standards need to be accompanied by a clear statement that future responsibility for meeting them lies with authorities at local level rather than with the government or the Department of Health, and monitoring and sanctioning power with the Healthcare Commission or other independent body.

The standards set the foundations for a common high quality of health care throughout England, according to the consultation document. They intend to clarify what the NHS ‘can and should be reaching for in its ambitions both for the public and for health care professionals’.

Twenty-four core and ten developmental standards cover what the consultation calls the ‘entire spectrum of NHS health work – from measures to improve public health through to primary care services and specialist care’. Health inequalities and health are covered in just one developmental standard under public health.

The core standards are intended to establish a level of quality of care which can be expected by all NHS patients regardless of where they are treated. The developmental standards are ‘broad’, says the consultation, and ‘designed to enable the overall quality of health care to rise as the additional resources being invested in the NHS take effect’.

But the King’s Fund recognised that the document was part of a process of redefining the roles of the DH and its newly-created arms’ length agencies – particularly the Healthcare Commission.