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NHS performance assessment needs radical simplification – King’s Fund

The number of national bodies that asses performance in the NHS is causing duplication and “unnecessary complexity”, according to a new report from the King’s Fund

The think tank’s review, commissioned by the Department of Health in June, recommends a “radical” simplification of the assessment process and greater alignment. 

It says the three national outcomes frameworks – The NHS Outcomes Framework, Public Health Outcomes Framework and Adult Social Care Outcomes Framework – should be consolidated into a “single entity” covering the NHS, public health and social care. 

The ‘Measuring the performance of local health systems’ review notes: “We would particularly emphasise the need for alignment between the metrics used to assess local health system performance and those used in the CCG Assurance Framework developed by NHS England.”

“Disparate” public-facing websites should be rationalised to help people searching for an integrated view of services in an area, it adds. 

Chris Ham, CEO of The King’s Fund, said: “We strongly support the secretary of state’s commitment to promoting intelligent transparency in the NHS. 

“Done well, performance assessment can help to strengthen accountability to patients and the public, as well as to support commissioners and providers to improve care. A radical simplification and alignment of the current frameworks and better presentation would do this.” 

Simplification and alignment would provide a “clear line of sight” from the health secretary and the Department of Health through NHS England and CCGs to the performance of local health systems, based on indicators that reflect what really matters to patients and the public, the King’s Fund says. 

It recommends that information be available at three levels of detail. First, a small set of headline indicators should be selected to let the public see how the local health system is performing. Second, a broader group of indicators should be developed based on existing frameworks. The final level would include more detailed indicators allowing commissioners and providers to assess the quality and effectiveness of local services.

However, the Fund does not recommend producing an aggregate score of performance using performance indicators alone. The review said this can mask good or poor performance on individual indicators and therefore would not be a meaningful picture of performance. 

Responding to the King’s Fund review, and a report by the Health Foundation reviewing indicators in general practice, a Department of Health spokesperson told NHE: “We are determined to make our NHS the safest healthcare system in the world. Improving transparency and using data are key to achieving this and we are pleased to see both the King’s Fund and the Health Foundation endorse this approach.” 

Dr Amanda Doyle, co-chair of NHS Clinical Commissioners (NHSCC) and chief clinical officer of NHS Blackpool CCG, said it supported the government’s efforts on transparency and CCG accountability, and added: “The King’s Fund report highlights the complexity of the current healthcare system that CCGs work in, and therefore how difficult it is to simply rate them with an aggregate score. We welcome the recommendations to provide information for patients and the public at various levels of detail, which would offer a more rounded and realistic view of a local health system.” 


Linda   12/10/2015 at 15:16

And put in context one size does not fit all and there will always be outliers that reflect local circumstances not as is almost invariably suggested poor performance

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