Hitting the Target and Missing the Point?

Spicer's report in this issue of IJCP should make you stop and reassess how you perceive the quality of care within the English National Health Service (NHS). It provides a striking counterpoint to the claims by the incumbent government that quality of care has improved substantially since 1997 when it took office, not least that the NHS has managed to hit a series of centrally imposed targets relating to access and waiting times. No one reading Spicer's report can fail to be concerned that some patients, children in this case, have been and are being failed by the NHS. Doctors, nurses and patients know that the reality of care, when assessed across the continuum, often falls short of what is claimed, yet Spicer's report is valuable because it offers a rare insight into a problem that is invisible to routine measures of quality.