Zero tolerance for failure under package of tough NHS reforms

Health and Social Care Secretary will outline how government and NHS leaders have a duty to patients and taxpayers to get the system working well

  • Wes Streeting to reveal package of reforms and announce new league table of NHS England providers, with top talent attracted to most challenging areas and persistently failing managers to be sacked
  • Turn around teams sent into struggling hospitals, while best performers given greater freedoms over funding to modernise technology and equipment
  • No more rewards for failure, with reforms to ensure every penny of extra investment into NHS is well spent and waiting times for patients slashed

NHS league tables will be introduced to help tackle the NHS crisis and ensure there are ‘no more rewards for failure’, as part of a tough package of reforms to be announced by the Health and Social Care Secretary Wes Streeting today (Wednesday 13 November).

Addressing the nation’s health leaders at the NHS Providers’ annual conference in Liverpool, he will outline how government and NHS leaders have a duty to patients and taxpayers to get the system working well and get better value for money.

NHS England will carry out a no holds barred sweeping review of NHS performance across the entire country, with providers to be placed into a league table. This will be made public and regularly updated to ensure leaders, policy-makers and patients know which improvements need to be prioritised. 

Persistently failing managers will be replaced and turn around teams of expert leaders will be deployed to help providers which are running big deficits or poor services for patients, offering them urgent, effective support so they can improve their service.

High-performing providers will be given greater freedom over funding and flexibility. There is little incentive across the system to run budget surpluses as providers can’t benefit from it. The reforms today will reward top-performing providers and give them more capital and greater control over where to invest it in modernising their buildings, equipment and technology.

The government will deliver a health service fit for the future, fixing the foundations while delivering change with investment and reform to deliver growth, get the NHS back on its feet, and rebuild Britain.

Health and Social Care Secretary Wes Streeting said: “The Budget showed this government prioritises the NHS, providing the investment needed to rebuild the health service. Today we are announcing the reforms to make sure every penny of extra investment is well spent and cuts waiting times for patients.

“There’ll be no more turning a blind eye to failure. We will drive the health service to improve, so patients get more out of it for what taxpayers put in.

“Our health service must attract top talent, be far more transparent to the public who pay for it, and run as efficiently as global businesses.

“With the combination of investment and reform, we will turn the NHS around and cut waiting times from 18 months to 18 weeks.”

Amanda Pritchard, NHS chief executive said: “While NHS leaders welcome accountability, it is critical that responsibility comes with the necessary support and development.

“The extensive package of reforms, developed together with government, will empower all leaders working in the NHS and it will give them the tools they need to provide the best possible services for our patients.”

The NHS Oversight Framework which sets out how trusts and integrated care boards are best monitored – will be updated by the next financial year to ensure performance is properly scrutinised.

Deep dives into poorly performing trusts will be carried out by the government and NHS England to identify the most pressing issues and how they can be resolved.

Louise Ansari, Chief Executive of Healthwatch England: “People value the hard work of NHS staff, but it’s frustrating when services fail to operate effectively. So, a fresh approach to improving NHS performance is welcome.

“Currently, living in an area with either an outstanding or poorly performing NHS trust feels like a postcode lottery. When a service is underperforming, it often takes far too long for patients to see the necessary improvements.

“This is because the current system focuses on evaluating service performance based on the number of tasks it completes and it does not do enough to measure patients’ overall outcomes and experiences.

“Establishing a better system that encourages NHS managers to focus on delivering the best care as efficiently as possible, and leads to quicker changes at struggling trusts, would be good news for everyone.”

NHS senior managers who fail to make progress will also be ineligible for pay increases. There will be financial implications for Very Senior Managers (VSMs) such as Chief Executives if they are failing to improve their trust’s performance, or letting patients down with poor levels of care.  

A new pay framework for VSMs will be published before April 2025. Senior leaders who are successfully improving performance will be rewarded, to ensure the NHS continues to develop and attract the best talent to the top positions. 

The changes are made in response to Lord Darzi’s investigation into the NHS, which found that: “The only criteria by which trust chief executive pay is set is the turnover of the organisation. Neither the timeliness of access nor the quality of care are routinely factored into pay. This encourages organisations to grow their revenue rather than to improve operational performance.”

The cost to the health service of hiring temporary workers sits at a staggering £3 billion a year. Under joint plans to be put forward for consultation in the coming weeks, NHS trusts could be banned from using agencies to hire temporary entry level workers in band 2 and 3, such as healthcare assistants and domestic support workers. The consultation will also include a proposal to stop NHS staff resigning and then immediately offering their services back to the health service through a recruitment agency.

Rachel Power, Chief Executive, Patients Association: “We welcome today’s commitment to improving NHS performance and accountability. These reforms signal an important drive for positive change in our health system. The focus on tackling poor performance and rewarding excellence sends a clear message about raising standards across the NHS.

“At the same time, we know from the experience of patients, that real transformation comes through genuine partnership with patients. We look forward to working with NHS England to ensure patient voices help shape how any league tables are developed and how success is measured.

“The proposed support teams for struggling trusts could be particularly effective if they include patient representatives and focus on building a culture of patient partnership. This is an opportunity to combine better management with deeper patient involvement – creating an NHS that is both more efficient and more responsive to people’s needs.

“We hope trusts who receive greater funding freedom will use this money wisely – to cut waiting times, make the waiting experience better for patients, and strengthen the ways they work with patients to improve services. These are the things that matter most to people using the NHS.”

Lord Darzi’s investigation into the NHS found that hospital productivity has ‘nosedived’ in the past five years. During that time resources have increased by 20%, but the number of patients treated has only increased by 3%.

This comes a month after the Health and Social Care Secretary kicked off the biggest national conversation about the future of the NHS since its birth, calling on the entire country to share their experiences of our health service and help shape the government’s 10 Year Health Plan. 

Members of the public, as well as NHS staff and experts, are sharing their experiences, views and ideas for fixing the NHS via the Change NHS online platform, which will be live until the start of next year, and available via the NHS App.

LifeCare wins Community Engagement Award at ScottishPower Foundation 10th anniversary charity celebration

The milestone year saw inspiring charities awarded additional funding for their vital projects including Stockbridge-based charity, Lifecare Edinburgh

At the 10th Anniversary ScottishPower Foundation Awards, LifeCare Edinburgh took home the Community Engagement Award for its outstanding Community Care for Everyone project.

This recognition comes with a £10,000 funding boost, which will be used to help the charity continue to fight the pressures caused by the cost of living crisis as well as bring new activities to its service users.

This dedicated service delivers significant, life-changing benefits to the growing population of older people living on low incomes. This includes the CafeLife where people in the community can meet, eat, chat, and feel a sense of belonging.

By providing practical help within the home, companionship, and hot, freshly-cooked meals, LifeCare Edinburgh is making a profound impact on both the physical health and mental wellbeing of over 200 vulnerable older individuals. This support ensures that these individuals feel secure, connected, and enabled to thrive in their own homes and communities.

Lifecare Edinburgh’s Ian McRae also came runner-up in the Charity Champion category for his work over the past six years, providing support to clients with dementia. His commitment and empathy shine through his work, including helping introduce new clients, supporting existing ones, and easing the reintegration of clients post-pandemic.

Ian’s personal experience with dementia in his family helps drive his passion, leading him to create a handbook, “The Importance of Memory,” to help others.

His efforts have been instrumental in raising awareness for LifeCare, and his warmth and understanding make him a beloved figure among clients, staff, and volunteers.

This award has also come with an additional £5,000 which the charity looks to put towards training new volunteers up to the incredible standards Ian has set.

Sarah van Putten, Chief Executive, LifeCare Edinburgh, said“We are so grateful to have been honoured with this award and are excited for what this means for our service users. LifeCare Edinburgh provides vital support and to be able to do what we do is so vital to the population of Edinburgh.

A huge congratulations must also be given to Ian who consistently has gone over and above, impressing us with his commitment, understanding, empathy and support.

“We send our thanks to the ScottishPower Foundation for its continued support through this project, and we cannot wait to put this funding to use.”

Melanie Hill, Executive Officer, and Trustee at the ScottishPower Foundation, said: “A heartfelt congratulations to all our winners at this year’s ScottishPower Foundation Awards. This milestone year is a fantastic opportunity to showcase the incredible work these charities do in our communities.

“Choosing this year’s winners was an immense challenge, given the outstanding quality of nominations we received. The dedication and passion demonstrated by LifeCare Edinburgh truly embodies the spirit of the ScottishPower Foundation Awards. Their unwavering commitment to making a positive difference in people’s lives is inspirational.

“It brings us real joy to celebrate with such highly deserving charities. The additional funding they receive will undoubtedly help them advance their impactful projects even further.

“Once again, a massive congratulations to all our winners. Their phenomenal work continues to make a significant difference, and we are excited to see what they achieve next.”

Further details on the winners and runners-up are available on the ScottishPower Foundation website: scottishpowerfoundation.com.

UK ‘shows international leadership in tackling climate crisis’

UK government announces new climate goals at COP29, including reducing emissions by 81% by 2035, as Prime Minister calls on other countries to bring forward ambitious targets

  • New UK target to reduce emissions by 81% by 2035 at COP29 in Azerbaijan
  • targets support government’s clean energy superpower mission to give Britain more security, deliver jobs and economic growth
  • Prime Minister calls for others to come forward with ambitious targets

Tackling the climate crisis is essential to our national energy security, economic growth, and our efforts to protect current and future generations, the UK government said as it unveils the UK’s new climate goals at the COP29 Summit in Baku, Azerbaijan.  

Yesterday’s announcement will strengthen the UK’s position as a place for investment in the technologies and jobs that are driving growth across the world.   

There are 640,000 green jobs in the UK, growing at a rate 4 times faster than overall UK employment.

To support the industry the government has announced a significant investment programme in homegrown British energy – including renewables, carbon capture and storage, nuclear and hydrogen.  

The UK’s reliance on fossil fuels has also been felt by every family and business in the last few years with the worst cost of living crisis in memory, driven by energy price spikes from international gas markets. 

That’s why the government’s mission is to tackle the climate crisis in a way that makes the British people better off by investing in clean homegrown power and unlocking thousands of jobs, having already seen £34.8 billion of private investment into the UK’s clean energy industries since July.   

This ambitious and pragmatic new target supports the UK’s mission for growth, helping to attract further investment and jobs in low carbon technologies such as solar and wind, electric vehicles and batteries. 

Energy Secretary Ed Miliband said: “The only way to protect current generations is by making Britain a clean energy superpower, and the only way to protect future generations is by tackling the climate crisis.   

“Britain is back in the business of climate leadership, with an ambitious new target that will protect our environment, deliver energy security and restore our global climate reputation.  

“We will cut emissions across the country, delivering for our environment and ending our exposure to spiking fossil fuel markets.”

This ambitious and pragmatic new target – in line with the recommendation from the Climate Change Committee and previously legislated and legally-binding Carbon Budgets for the same period.

The target forms what is called the UK’s Nationally Determined Contribution (NDC): commitments that countries make to reduce their greenhouse gas emissions to mitigate climate change. It is aligned to 1.5C.

The UK has called for other countries to match the UK’s ambition to address the urgency of climate change, following stark warnings from the United Nations that the world is way off track to limit global temperature rises to 1.5C.

Since July the government has:   

  • lifted the ban on onshore wind in England
  • delivered a record number of clean energy projects through its renewables auction
  • consented unprecedented amounts of nationally significant solar – 2GW – more than the last 14 years combined
  • launched Great British Energy backed by £8.3 billion to speed up the deployment of clean technologies 
  • fired the starting gun on the UK’s carbon capture, usage and storage industry, with funding agreed for 2 clusters in Teesside and the North West

Globally, the costs of renewables continue to fall, with solar and wind now cheaper than existing coal and gas power plants in most of the world.  

Recent analysis from the International Energy Agency found that in 2023 for every $1 spent on fossil fuels, $1.7 was spent on clean energy. Global energy investment is set to be over $3 trillion in 2024, with $2 trillion of this on clean energy technologies and infrastructure.

Prime Minister Keir Starmer’s National Statement at COP29 in Baku, Azerbaijan yesterday:

The United Kingdom is determined to stand alongside those countries on the frontline of the climate crisis today…

And to seize the opportunities of tomorrow.

Because action on climate now is the route towards economic growth…

Energy security…

Better jobs….

And national security in the long term. 

To deliver on the Paris Agreement…

And keep 1.5 degrees within reach.

In the first 100 days of my government…

We launched Great British Energy – to create clean British power…

We created a National Wealth Fund – to invest in the green industries and jobs of the future…

We scrapped the ban on onshore wind…

Committed to no new North Sea oil and gas licences….

And closed the UK’s final coal power plant at the end of September – becoming the first G7 economy to phase out coal power.

In line with the international agreement at COP28 to transition from fossil fuels…

and the UK’s ambitious goal to be the first major economy to deliver clean power by 2030. 

Today I can confirm – three months ahead of deadline…

The UK’s 2035 international target –

Our nationally determined contribution –

to reduce all greenhouse gas emissions by at least 81% on 1990 levels….

Aligned with 1.5 degrees. 

And we urge all Parties –

To come forward with ambitious targets of their own…

As we all agreed at the last COP.

We will work in partnership…

to support other countries to develop their own commitments…

And transition through our forthcoming Global Clean Power Alliance – 

And finance will be its first focus. 

We will honour the commitment made by the previous government…

to provide £11.6 billion in of climate finance between April 2021 and March 2026….

But we must use public finance as a multiplier…

To unlock much more private investment…

And reform our international financial institutions. 

Today we launch the new CIF Capital Market Mechanism, listed on the London Stock Exchange…

With the potential to mobilise up to $75 billion…

in additional climate capital for developing countries over the next decade.

Putting the UK’s role as a global financial centre…

at the service of driving the green finance and green energy transitions.

Climate action is at the heart of this government’s mission for the protection and prosperity of Britain and the world. 

Writ large across our domestic and international priorities…

We are taking the urgent action needed – to protect our planet and its people.