Nuffield Trust responds to announcement of new "zero tolerance for failure" NHS reforms 

Commenting on excerpts trailed ahead of the Secretary of State’s speech to the NHS Providers conference, Nuffield Trust Chief Executive Thea Stein said: 
 
“It is right that politicians are focused on extracting as much value as possible from the NHS at a time when taxpayers are being asked to dig deeper to fund public services and patients are feeling the pain of a health service under pressure. Finding ways to attract and retain top quality leaders, at the same time as clamping down on unnecessary waste in the system, are unarguable. 
 
“But there is a danger the actions announced by the Secretary of State will worsen some of the patterns that got us into this mess. We know from the special measures for quality regime that “naming and shaming” NHS trusts can make it harder to recruit staff, which doesn’t help patient care at all. It’s unclear what new league tables will measure – a table based on general waiting times doesn’t add much if you need to know how good heart surgery is. 
 
“Many of the drivers of poor productivity are systemic – from the dire state of social care stranding people in hospital, to crumbling roofs and worsening population health. They happen across England – which trust is worst affected is often a matter of luck and history as much as leadership. We need a system that encourages leaders to go to the most difficult and challenged trusts to improve patient care – not one that rewards them for choosing easier places to work.  
 
“Ministers have long warned the NHS against the naive belief in the magic money tree. But they themselves are at risk of falling for the appealing notion of a magic productivity tree which will make the NHS more efficient just by shaking the magic tree harder, rather than by changing the drivers of efficiency. That can only lead to the NHS being forced back into asking for ‘more, more, more’, with patients ultimately paying the price.”