Intended for healthcare professionals

Education And Debate

Health targets in the NHS: lessons learned from experience with breast feeding targets in scotland

BMJ 1997; 314 doi: (Published 05 April 1997) Cite this as: BMJ 1997;314:1030
  1. Harry Campbell, senior lecturera,
  2. Anne Gibson, chief community dietitianb
  1. a Department of Public Health Sciences, Edinburgh University, Edinburgh EH8 9AG
  2. b Fife Healthcare NHS Trust, Markinch Clinic, Markinch, Fife KY7 6AA
  1. Correspondence to: Dr Campbell
  • Accepted 22 November 1997


Goal and target setting is a basic precondition to effective management and the basis for accountability for both the use of health services and for achieving health care outcomes1

Target setting has long been seen within business as an essential part of formulating any strategy. Targets should be related to actions known to be effective, be achievable but challenging, and be able to be monitored through indicators (see box).2 Targets can highlight key aspects of policy and act as a stimulus to increase commitment to policy implementation. Careless target setting, however, based on inadequate data or unrealistic short term objectives, can be counterproductive in that the resulting targets may discourage action and place unnecessary stress on those expected to achieve them.3 4 5

Health targets: desirable features

  • Should provide an overall goal and sense of purpose

  • Should be related to actions known to be effective

  • Should be achievable over a specified time

  • Should be realistic but challenging

  • Should be measurable and be able to be monitored

  • Should be agreed by those who have a part to play in their achievement

  • Should be expressed in terms of health improvements or reductions in risk factors in the population

The publication of the consultative documents The Health of the Nation in 1991 and Scotland's Health: A Challenge To Us All in 1992 heralded a new government approach to health planning, central to which was a need to identify clear objectives and specific targets for improving health.6 7 These targets were to be identified in each of the key areas of greatest health concern and where the greatest opportunity for real improvements in health could be realised. Their main aim is to stimulate and direct coordinated action.6

Although it was envisaged that the results of target setting would be assessed, no published reports …

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