We’re all familiar with league tables – comparing everything from football teams to universities these days. In 2024, the Secretary of State announced that NHS England would bring in new performance criteria and publish a NHS Trust performance league table, ranking organisations ‘relative to their peers’.
A complex series of comparators and ranking mechanisms was devised, but as not all NHS Trusts are created equally, and the communities they serve can be very different, the league tables recently published don't really offer the ability to draw direct conclusions. It's interesting though, to see that specialist hospitals take the top eight places within the league table and it's a rural Healthcare Trust- Northumbria, that is the first large NHS Trust on the list, at position 9.
It's no surprise really that NHS trusts in central London perform well generally within the league table. It's often felt, and very often evidenced, that city-based institutions have advantages in access to skilled labour pools, retention of talent, given city amenities, and a higher proportion of resources being available/invested. As a Midlands businessman I was dissatisfied to see key regional trusts sitting way down the list - University Hospitals Leicester only appearing at rank 101, following Nottingham University Hospitals at rank 100. University Hospitals of Derby and Burton, Worcestershire and United Lincolnshire respectively achieve a ranking of only 108, 110 and 122.
I was interested to read that the Department of Health officials were quoted as saying “This isn't naming and shaming…” but it's easy to see how discontent with ‘the NHS’ could be exacerbated by these snapshot rankings. There are so many facets to an NHS service, so many services in fact within any individual Trust. Single number rankings will hide areas where there are key strengths if these are drowned out in the numbers calculation by perhaps financial or administrative poor performance. Whilst the latter is definitely linked to aspects of patient experience in the long term, if these hide, say, excellence in access to cancer care, it's a potentially unhelpful read-out for patients, trying to choose service providers in an informed way.
I'm hopeful that Trusts take the initiative and challenge their rankings by promoting individual areas of excellence, which doubtless there are across many of our NHS Trusts. That would be truly helpful information for patients (you and me!) to have at their fingertips. I'm hopeful too, that those finding themselves at the top of the list, because of excellence or perhaps serendipity, don't rest on their laurels either.
