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“Alcohol misuse constitutes a heavy and increasing burden on the NHS. If services to tackle alcohol misuse are going to make a bigger difference, Primary Care Trusts need to understand better the scale of the problem in their local communities. With its increased focus on the prevention of lifestyle-related illness, the Department of Health could, for example, do more to convince Trusts about the value of timely advice to help people develop safer drinking patterns.”

“The complaints systems for health and social care are not yet as accessible and responsive as they could be. There is a lack of learning from complaints, and providers are not making clear to users that services are being improved as result. Adequate staff training; proper tackling of complaints; and evidence of improvements in response to complaints are key pointers for the planned introduction of a new comprehensive complaints system across health and social care next year.”

“There is no doubt that a new GP contract was needed and there are now 4,000 more GPs than five years ago. But in return for higher pay, we have yet to see real increases in productivity. The extra money flowing into practices has largely benefited GP partners rather than rewarding other important members of the practice team. Primary Care Trusts now need to deliver to patients the benefits that were expected in return for GPs increase in pay.”

“The Department should be commended for its management of the review, having achieved its savings targets. But there are lessons to be learnt more generally about making sure that targets are clear and focused on delivering value for money and improving performance. And it is essential that departments are able to measure their progress against a clear set of baselines, which need to be identified before projects start.”

“The NHS achieved a surplus in 2006-07 after a period of rising deficits. But this is not a time to be complacent; both the Department and the NHS accept that a number of challenges remain.

“The national picture is one of financial balance, but there remains a relatively small core of NHS organisations that continue to report significant deficits. There is no doubt that good financial management is linked to good patient care in the long term. A failure to keep a tight grip on financial performance will undermine service quality, an area in which the NHS must not let patients down.”

“Crisis Resolution Home Treatment teams are really beginning to prove their worth in the NHS. They are providing significant benefits and increased satisfaction for service users and reducing pressure on hospital beds.

“However, a lack of resources and a lack of multi-disciplinary support are limiting what these teams can do. And not all of those who would benefit from this service are being considered for it. These issues need to be addressed if the service is to improve.”