The NHS will have fewer performance targets and a stronger emphasis on the quality of patient care from next year, the health secretary, John Reid, has announced.
Mr Reid reaffirmed the government's commitment to "simple to understand performance information" for the public - but did not specifically mention the controversial star ratings system.
Instead he referred to last year's Health and Social Care Act, which states that the new Commission for Healthcare Audit ands Inspection (Chai) will "award a performance rating" to each NHS body. Professor Ian Kennedy, chairman of the new inspectorate, which starts work in April, has said he wants to move to "intelligent information" about NHS performance, taking local conditions and wider determinants of health into account.
Mr Reid prefaced his announcement with a robust defence of the government's current target regime, claiming that NHS targets "are working", as he launched a widely trailed consultation paper on healthcare "quality standards" at a meeting of senior NHS managers in London today.
The emphasis on targets has been criticised by clinicians and managers for distorting clinical priorities. But Mr Reid credited it with boosting the recruitment of NHS staff and pushing forward the hospital building programme, as well as improving healthcare.
"NHS targets are working," Mr Reid said. "They are driving forward the recruitment of more doctors, nurses and other NHS staff. They are ensuring that we have the biggest hospital building programme in the history of the NHS," Mr Reid said.
"Above all, targets have delivered speedier access to healthcare. Seven years ago, the maximum waiting time for treatment was over 18 months. By next month, it should have fallen to half this."
Mr Reid also reiterated the government's claim that nine out of 10 patients were being seen and treated within four hours in accident and emergency - a target that has attracted particular controversy because of repeated changes in the way it is measured.
He said: "Above all targets have saved lives. Both in the shorter waiting times and as part of a programme of work which has led cancer death rates falling by 10% and coronary heart disease by over 20% in less than six years."
But he added: "Now is the time to begin to move to another stage, to build on that success and to recast our ambitions for healthcare in England."
It was "precisely because the NHS is delivering through the huge initial impetus", that targets had provided, that the health service could now shift to "enhanced quality standards", he said.
Targets would still have a role to play, he said, and the government still aimed to cut waiting times to three months by 2008. "But increasingly the means by which we achieve the high standards we all seek will lie in the hands of frontline staff themselves," said Mr Reid.
The "natural and beneficial consequence of a reformed NHS" would be the need for fewer targets, Mr Reid added. "Because we are giving power to patients we will need fewer targets from the centre. And because NHS patients will need quality information to exercise their increasing power of preference we remain committed to publishing on all NHS organisations, as Section 50 of the new Health and Social Care Act 2003 makes clear."
The consultation document proposes a set of 24 "core standards" covering the quality of care that every patient should expect. These would be supported by 10 "developmental" standards, setting out what the NHS should aspire to deliver for patients as extra investment into the NHS continues.
The developmental standards would cover seven key areas: safety, clinical cost effectiveness, governance, patient focus, accessible and responsive care, healthcare environment & amenities and public health.
