NHS league tables and cancelled pay rises for managers among government health reforms
NHS league tables revealing failing NHS trusts and cancelled pay rises or dismissal for managers who don’t turn things around are to form part of the government’s plans to improve the health service.
Health Secretary Wes Streeting is confirming new measures he hopes will boost failing hospital trusts and encourage successful ones.
The changes form part of the Labour government’s strategy to reduce waiting lists “from 18 months to 18 weeks”.
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Health and the state of the NHS were consistently among the most important issues for voters at this year’s general election – with Labour blaming the Conservatives for “breaking” it.
As health is a devolved area, any reforms proposed in Westminster would only apply to England.
Chief among Mr Streeting’s proposals is a “league table” for NHS trusts.
An announcement from the Department for Health and Social Care said: “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.”
It also promises to replace “persistently failing managers” – with “turn around teams” being sent in to improve trusts running sizeable deficits or offering poor service to patients.
The government says “senior managers” who fail to make progress will not be eligible for pay rises.
There will be “financial implications” for more senior figures such as chief executives if their trust does not improve.
On the flip-side, those trusts that are deemed to be “high-performing” will get “greater freedom over funding and flexibility”.
Senior leaders at these trusts will also be “rewarded”.
The government says the current system is not incentivising trusts to run a budget surplus, as they cannot benefit from it.
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Mr 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.”
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Concerns from health representatives
Amanda Pritchard, the chief executive of NHS England, 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.”
Further plans on how monitoring will be published by the start of the next financial year in April 2025, the government said.
Matthew Taylor, the chief executive of the NHS Confederation – a body that represents all NHS trusts – said healthcare leaders welcome the “government’s ambition”.
However, he said he was concerned league tables and reducing pay may “strip out” the nuance of what’s going on.
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Mr Taylor said: “NHS staff are doing their very best for patients under very challenging circumstances and we do not want them feeling like they are being named and shamed.
“League tables in themselves do not lead to improvement, trusts struggling with consistent performance issues – some of which reflect contextual issues such as underlying population heath and staff shortages – need to be identified and supported in order to recover.”
Millionaire Tory donor Malcolm Offord has defected to Reform UK, saying he would be campaigning “tirelessly” to “remove this rotten SNP government”.
Nigel Farage announced the former Conservative life peer’s defection during a rally in the Scottish town of Falkirk, where regular anti-immigration protests have taken place outside the Cladhan Hotel – which is being used to house asylum seekers.
Mr Farage, Reform UK’s leader, said he was “delighted” to welcome Greenock-born Lord Offord to Reform, describing his defection as “a brave and historic act”.
He added: “He will take Reform UK Scotland to a new level.”
During a speech, Lord Offord, who previously donated nearly £150,000 to the Tories, said he would be quitting the Conservative Party and giving up his place in the House of Lords as he prepares to campaign for a seat in Holyrood in May.
The 61-year-old said he wanted to restore Scotland to a “prosperous, happy, healthy country”.
“Scotland needs Reform and Reform is coming to Scotland,” he told the rally.
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“Today I can announce that I am resigning from the Conservative Party. Today I am joining Reform UK and today I announce my intention to stand for Reform in the Holyrood election in May next year.
“And that means that from today, for the next five months, day and night, I shall be campaigning with all of you tirelessly for two objectives.
“The first objective is to remove this rotten SNP government after 18 years, and the second is to present a positive vision for Scotland inside the UK, to restore Scotland to being a prosperous, proud, healthy and happy country.”
The latest defection comes as Mr Farage finds himself at the centre of allegations of racism dating back to his time in school.
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Claims made against Nigel Farage
Sky News reported on Saturday that a former schoolfriend of Mr Farage claimed he sang antisemitic songs to Jewish schoolmates – and had a “big issue with anyone called Patel”.
Jean-Pierre Lihou, 61, was initially friends with the Reform UK leader when he arrived at Dulwich College in the 1970s, at the time when Mr Farage is accused of saying antisemitic and other racist remarks by more than a dozen pupils.
Mr Farage has said he “never directly racially abused anybody” at Dulwich and said there is a “strong political element” to the allegations coming out 49 years later.
Reform’s deputy leader Richard Tice has called the ex-classmates “liars”.
A Reform UK spokesman accused Sky News of “scraping the barrel” and being “desperate to stop us winning the next election”.
The European Commission’s proposal to expand the powers of the European Securities and Markets Authority (ESMA) is raising concerns about the centralization of the bloc’s licensing regime, despite signaling deeper institutional ambitions for its capital markets structure.
On Thursday, the Commission published a package proposing to “direct supervisory competences” for key pieces of market infrastructure, including crypto-asset service providers (CASPs), trading venues and central counterparties to ESMA, Cointelegraph reported.
Concerningly, the ESMA’s jurisdiction would extend to both the supervision and licensing of all European crypto and financial technology (fintech) firms, potentially leading to slower licensing regimes and hindering startup development, according to Faustine Fleuret, head of public affairs at decentralized lending protocol Morpho.
“I am even more concerned that the proposal makes ESMA responsible for both the authorisation and the supervision of CASPs, not only the supervision,” she told Cointelegraph.
The proposal still requires approval from the European Parliament and the Council, which are currently under negotiation.
If adopted, ESMA’s role in overseeing EU capital markets would more closely resemble the centralized framework of the US Securities and Exchange Commission, a concept first proposed by European Central Bank (ECB) President Christine Lagarde in 2023.
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EU plan to centralize licensing under ESMA creates crypto and fintech slowdown concerns
The proposal to “centralize” this oversight under a single regulatory body seeks to address the differences in national supervisory practices and uneven licensing regimes, but risks slowing down overall crypto industry development, Elisenda Fabrega, general counsel at Brickken asset tokenization platform, told Cointelegraph.
“Without adequate resources, this mandate may become unmanageable, leading to delays or overly cautious assessments that could disproportionately affect smaller or innovative firms.”
“Ultimately, the effectiveness of this reform will depend less on its legal form and more on its institutional execution,” including ESMA’s operational capacity, independence and cooperation “channels” with member states, she said.
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The broader package aims to boost wealth creation for EU citizens by making the bloc’s capital markets more competitive with those of the US.
The US stock market is worth approximately $62 trillion, or 48% of the global equity market, while the EU stock market’s cumulative value sits around $11 trillion, representing 9% of the global share, according to data from Visual Capitalist.
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