Measuring performance in the NHSBMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7128.322 (Published 31 January 1998) Cite this as: BMJ 1998;316:322
Good that it's moved beyond money and activity but many problems remain
- Martin McKee, Professor of European Public Healtha,
- Trevor Sheldon, Directorb
- a London School of Hygiene and Tropical Medicine, London WC1E 7HT
- b NHS Centre for Reviews and Dissemination, University of York, York YO1 5DD
Last Wednesday the government launched its consultation paper on assessing performance,1 the latest element of its strategy to reform the NHS.2 It proposes moving from a narrow focus on activity and financial targets to a wider view of what the NHS is seeking to achieve and suggests a framework for achieving it. The intention to concentrate on issues that concern patients and health professionals, rather than meaningless measures such as the efficiency index,3 is welcome. But the paper is strangely silent on how to make these new measures work.
The paper proposes six areas where performance should be assessed: improving the health of the general population; fair access to services; effective delivery of appropriate care; efficiency; patient-carer experience; and the outcome of NHS care. Comparative information will be published, and targets for improvement in each of these areas will be an integral part of performance management in the NHS. Although the consultation document does not mention it, …