The effects of the NHS reforms on quality of care

Abstract

The Health and Social Care Act 2012 (HSCA2012) has altered the operational and business environment in which NHS trusts in England operate. The Shelford group is one of the leading multi-specialty NHS trusts in England. The aim of this study was to assess the impact of HSCA2012 on the quality of care provided by the group. Annual quality of accounts produced by each of the Shelford group trusts for financial years (FYs) 2012–13, 2013–14 and FY 2014-15 were reviewed. The key performance indicators (KPIs) for each organisation were collected and classified in line with NHS Quality and Outcomes Framework (QOF). KPIs for the period just prior to enactment of HSCA2012 (FY2012–13) were compared with the corresponding values for the period after the enactment of HSCA2012. The benchmarking model used in the study was validated against the Hospital Intelligent Monitoring Report used by the Care Quality Commission. The clinical services provided by the group increased year on year by 7.5%, 6.4% and 4% respectively. In the FY2014–15, the group collectively provided 14 735 000 patient care episodes There was no significant difference in the value of the KPIs before and after enactment of HSCA2012 along the six domains defined by the QOF. Good correlation was observed between the benchmarking method used in the study compared with the HIMR (r2 = 0.86). The quality of care provided by the group did not change following enactment of HSCA2012.