|
Health services is another area where governments in the English-speaking world have sought to use performance measurement and reporting as a means of driving through reform. The UK government has been measuring and benchmarking performance in the National Health Service for more than a decade.
(Please note: links on this page will open the page in a new browser window)
| Payment by Results Data Assurance Framework 2008/09 (PDF) |
| Audit Commission, 2009 |
|
| This report presents the key findings and analysis of the 2008/09 national clinical coding audit programme managed by the Audit Commission under the Payment by Results (PbR) Data Assurance Framework. It shows that the number of errors made by NHS trusts under PbR is falling. |
|
| UK |
| |
| Patient Power (PDF) |
| Thomson, Ben and Mawdsley, Geoff, 2009 |
| Reform Scotland |
| A report which puts forward reforms for greater patient choice in Scotland's health services based on analysis of European systems of social insurance. |
|
| UK |
| |
| Foundation Trusts and Monitor (PDF) |
| House of Commons Health Select Committee, 2008 |
| The Stationery Office |
| NHS foundation trusts were first established in 2004 to improve local accountability and management efficiency through devolved power. Up to the end of 2008 over 100 such trusts have been established but this report is the first systematic analysis of their impact. |
| HC 833-I |
| UK |
| |
| High Quality Care for All: NHS Next Stage Review (Web Page) |
| Lord Darzi, 2008 |
| Department of Health |
| This report is a wide-ranging examination of the UK's National Health Service, making an extensive series of recommendations for the future direction. It advocates a locally-led, patient-centred service with quality as its priority. Freedom to focus on delivering this quality is highlighted as essential: devolving power to front-line staff. |
| ISBN 978-0-10-174322-8 |
| UK |
| |
| A Healthy Choice: Building a Stronger NHS (PDF) |
| CBI, 2008 |
|
| A report on improving the quality and efficiency of the NHS through patient-focused reforms. It suggests that commissioners must become the key players in promoting innovation, choice and faster access to healthcare through fair market managment. |
| ISBN 978-0-85201-685-5 |
| UK |
| |
| NHS Reform: National Mantra, Not Local Reality (PDF) |
| Bosanquet, Nick; Haldenby, Andrew; Rainbow, Helen, 2008 |
|
| This report argues that while the NHS is in need of the government's professed reform, the government is in denial about its progress on the ground. It suggests that reform is the only way to unlock the value of the NHS budget but the government's programmes remain embryonic, and in some cases in full retreat. It proposes that the solution is an economic constitution which defines duties to create value at all levels of the NHS. |
|
| UK |
| |
| The Right Result? Payment by Results (PDF) |
| Audit Commission, 2008 |
|
| This report examines the NHS's experience with Payment by Results. It finds that hospitals are paid the same for a procedure regardless of the quality of care provided and recommends that the NHS consider rewarding those hospitals that meet the highest standards of quality for patients. |
|
| UK |
| |
| ISTCs and the NHS: Sticking Plaster or Real Reform? (PDF) |
| Confederation of British Industry, 2008 |
|
| This report examines the record of Independent Sector Treatment Centres (ISTCs), the elective and diagnostic care units encouraged by the UK government. It finds that ISTCs are an NHS success story and that changing NHS behaviour and expanding patient choice will bring further benefits. |
|
| UK |
| |
| Independent Sector Treatment Centres: Evidence So Far (PDF) |
| Pollock, Allyson M and Godden, Sylvia, 2008 |
|
A paper assessing the evidence on ISTC performance in the first two waves of the programme. It found that due to a lack of data collected or provided by the Department of Health it was not possible to determine any changes in value for money or quality of care.
|
|
| UK |
| |
| Measure for measure: Using outcome measures to raise standards in the NHS (PDF) |
| Hamblin, Richard; Ganesh, Janan and Lockhart, Gavin (ed.), 2007 |
| Policy Exchange |
| This report examines the ways in which the provision of more and better information about the quality of health services to the public may lead to an increase in the quality of healthcare generally. Through a comparative analysis of different types of measurement schemes in Britain and the US and the qualities that make them successful, the report makes recommendations for policy reform in this area leading to increased accountability, patient trust and overall performance. |
|
| UK |
| |
| Public Services at the Crossroads |
| Brooks, Richard (Ed.), 2007 |
| Institute for Public Policy Research (ippr) |
| This report argues that UK public services in 2007 are "at a crossroads" with a new government offering the opportunity to steer a new course in reform. It focuses on the health, education and criminal justice sectors to outline "a progressive agenda" in which social justice is placed at the heart of public service policy. It is cautiously optimistic about the role played by (quasi-)markets in public services, arguing that the principle reason for private and voluntary sector involvement "is not the inherent superiority of one type of provider over another, but rather the opportunity that such diversity offers to generate competitive pressure for improvement among providers from all sectors". |
| ISBN: 978-1-86030-315-9 |
| UK |
| |
| Just What The Patient Ordered: Better GP Services (PDF) |
| Confederation of British Industry (CBI), 2007 |
|
| The CBI report sets out recommendations to General Practioners for patient choice, better GP services and improvements across the NHS, outlining the need for an effective, responsive and properly funded National Healh Service and states that in order for GP service improvements to be made, patients must be in the driving seat. |
| ISBN: 978-0-85201-670-1 |
| UK |
| |
| A Rational Way Forward for the NHS in England (PDF) |
| BMA Working Group, 2007 |
| British Medical Association (BMA) |
| This report aspires to setting out a rational way forward to secure the long-term future of the NHS in England. First it outlines where and why the current reform programme is "going wrong". Then it outlines the BMA's "rational way forward" for health service reform in England. Key recommendations include greater independence for the NHS, and the establishment of a set of core services to be provided universally with rationing on supplementary services. |
| BMA 48647 |
| UK |
| |
| NHS Autonomy and Accountability: Proposals for Legislation (PDF) |
| Conservative Party (UK), 2007 |
|
| This Conservative Party White Paper proposes legislation to "free the NHS from day-to-day interference by politicians" while remaining accountable, democratic and needs-based. It proposes an independent NHS board, the abolition of certain targets and greater autonomy for primary care commissioners and trusts, but was criticised for failure to depart further from the centralised post-WWII model. |
|
| UK |
| |
| An Independent NHS: A Review of the Options (PDF) |
| Edwards, Brian, 2007 |
| The Nuffield Trust |
| This report analyses the options for establishing independence for the NHS, and those options' respective costs and benefits. All ideas are in line with the service's founding principles - available on the basis of need, and paid for by taxation - and take account of recent increases in private and voluntary sector involvement, but at the same time aim to propose a new governance paradigm. |
| ISBN: 978-1-905030-23-1 |
| UK |
| |
| Funding Health Care: 2008 and beyond (PDF) |
| Appleby, John (Ed.), 2007 |
| King's Fund |
| This paper summarises the discussions and conclusions of a King's Fund conference on health care funding. Contributions cover not only the source of funding but the processes and framework by which this ought to be achieved. Five key recommendations are made: (i) measure what counts, (ii) reduce variations in performance, (iii) improve productivity, (iv) design effective incentive systems, and (v) engage clinicians. |
| ISBN 978 1 85717 553 0 |
| UK |
| |
| The Provision of Out-of-Hours Care in England (PDF) |
| Public Accounts Committee (PAC), 2007 |
| The Stationery Office |
| This report examines the impact of the Government policy to raise standards in out-of-hours care by allowing GPs an opt-out and placing responsibility for this care with the local Primary Care Trust. While services have begun to improve, the report is scathing in its verdict on the preparation, performance and costs resulting from the policy shift. |
| HC 360 |
| UK |
| |
| Dr Foster Intelligence: A Joint Venture between the Information Centre and Dr Foster LLP (PDF) |
| Public Accounts Committee, 2007 |
| Stationery Office HC368 |
| This report follows up on an earlier NAO report on the joint venture between the Department of Health information centre and Dr Foster LLP, a private company specialising in data dissemination. It re-affirms earlier findings that the public-private partnership has not delivered. In particular the report stresses that the apparent favouritism in procurement represents a disregard for both best practice and the rules governing the use of public money. |
|
| UK |
| |
| Dr Foster Intelligence: A Joint Venture Between the Information Centre and Dr Foster LLP (PDF) |
| National Audit Office (NAO), 2007 |
|
| This report examines the joint venture between the Department of Health information centre and Dr Foster LLP, a private company specialising in data dissemination. The aim of this partnership was to improve strategy through heightened data analysis and application. However, it is found that the DoH cannot demonstrate optimal value-for-money improvements, primarily because the contract did not go out to tender to encourage fair competition. |
|
| UK |
| |
| The Future Hospital: The Politics of Change (PDF) |
| Farrington-Douglas, Joe with Brooks, Richard, 2007 |
| Institute for Public Policy Research (IPPR) |
| This report analyses the politics and process of hospital change at a local level, seeking to improve these mechanisms to raise standards of care. The findings and policy recommendations are based on a combination of case studies, theoretical framework-building and stakeholder interviews. |
|
| UK |
| |
| Investment and Reform: Transforming Health Care (Web Page) |
| Hewitt, Patricia, 2006 |
| London School of Economics (LSE) |
| This speech explains how New Labour's health sector reforms are intended to create a patient-led NHS, where improvements to standards of healthcare are driven by patients not politicians. The then Secretary of State addressed issues such as use of the private sector to deliver NHS services, greater choice for patients, and getting efficiency, productivity and better value for money. |
|
| UK |
| |
| Charging Ahead? Spreading the Cost of Modern Public Services (Web Page) |
| Asato, Jessica (Ed.), 2006 |
| Social Market Foundation (SMF) |
This collection of essays discusses whether there is a case for introducing or extending co-payments in UK public service provision. It considers the economic and political principles that underpin the use of co-payment in UK public services, and in particular the impact on equity. The potential for extending co-payment or introducing new charges is investigated in three sectors: health, higher education and local government. The full publication can be downloaded via this web page link.
|
|
| UK |
| |
| The Provision of Out-of-Hours Care in England (PDF) |
| National Audit Office (NAO), 2006 |
| The Stationery Office |
| This report examines the Department for Health's progress in providing high-quality out-of-hours services. In particular it looks at the effect of General Medical Services contracts, which allowed GPs to opt out of the responsibility of organising out-of-hours care entirely from 1 April 2004. It finds that there is considerable room for improvement but that services are getting better. This report was followed by the PAC report of the same name, which is also available on the Resource Centre. |
| HC 1041 |
| UK |
| |
| Spending on Health Care - How much is enough? (PDF) |
| Appleby, John and Harrison, Anthony, 2006 |
| King's Fund |
| The Blair Government raised health spending to record levels between 1997 and 2006. Given this empirical fact and the expectation that at some point the marginal returns on investment must diminish, this report attempts to define a desirable limit on health spending. In addition, it asks what evidence ought to inform such a decision given that it has political as well as economic dimensions. |
| ISBN 1 85717 543 3 |
| UK |
| |
| Assessing the New NHS Consultant Contract: A Something for Nothing Deal? (PDF) |
| Williams, Sally and Buchan, James, 2006 |
| King's Fund |
| This report examines the new NHS consultant contract, which was intended to increase productivity through more flexible working hours and better-motivated workers. It draws on a literature review as well as interviews and case studies to deliver a critical verdict - benefits are not yet being realised - as well as recommendations to improve future performance. |
| ISBN 978 1 85717 547 9 |
| UK |
| |
| To the Point: A Blueprint for Good Targets (PDF) |
| Targets Commission, 2005 |
| Social Market Foundation (SMF) |
| This is a summary of a report into the Government's use of targets in four public service sectors: education, health, housing and criminal justice. It concludes that as a rule, observed empirical failures have been the result of specific design problems and not intrinsic; thus targets ought not be abandoned as a policy tool. Rather, well-designed targets can be a very useful tool in improving performance - and particularly when other forms of service improvement such as user choice are absent. The report concludes with a range of practical proposals to improve target-design in future. |
| ISBN 1-90489931-5 |
| UK |
| |
| Measuring NHS Success (PDF) |
| Appleby, John and Devlin, Nancy, 2005 |
| King's Fund |
| This research asks whether routinely measuring patients' health outcomes through patient questionnaires would help the health service to self-evaluate more effectively. It examines the costs of implementing such a system and asks whether it would be cost-effective in the long run. |
| ISBN 978 1 85717 528 8 |
| UK |
| |
| Road Map to Reform: Health (PDF) |
| Goldsmith, Michael, and Gladstone, David, 2005 |
| Adam Smith Institute (ASI) |
| This report is the second in the ASI's 'Road Map to Reform' series seeking to promote a new strategy for diversity and competition across government and public services. The authors argue that the best of the NHS can be retained under public-private co-operation, espousing a new model which will unleash innovation and enterprise in healthcare provision. |
| ISBN 1-902737-48-2 |
| UK |
| |
| An Independent Audit of the NHS under Labour (1997-2005) (PDF) |
| King's Fund, 2005 |
|
| This briefing paper was commissioned by the Sunday Times newspaper to assess the New Labour Government's attempts during their first two terms of office to fulfil their promise "to save the NHS". Overall, the verdict is positive with more and better services realised through increased spending and central targets. However, there are still important problems to be solved and it is too early to predict whether market incentives coupled with regulation will bring about the desired improvements. |
| ISBN 978 1 85717 488 5 |
| UK |
| |
| Private Payment for Health: Boon or Bane? (Web Page) |
| SMF Health Commission, 2004 |
| Social Market Foundation (SMF) |
| This report argues that the role private payments could play in health care has often been hindered by over-simplistic ideology and that partial exit from a monopolistic state provider has encouraged excellence in provision, paving the way for health care that is more responsive to individual patients. It also argues that the economic arguments for encouraging employers to pay more towards health care are more powerful than those for individual tax relief. It does not advocate policy change but argues that private payments ought to be recognised as an important factor in NHS financing. The full report can be downloaded via this web page link. |
| ISBN 1-874097-63-1 |
| UK |
| |
| User Charges for Health Care (Web Page) |
| SMF Health Commission, 2004 |
| Social Market Foundation (SMF) |
| This paper reviews the advantages of user-charges in health care, including driving more efficient services, making providers more accountable for service quality and promoting patient choice. It also concedes disadvantages of charges, such as the possibility of inefficiency, lack of fairness and high administration costs. The full report can be downloaded via this web page link. |
| ISBN 1-904899-09-9 |
| UK |
| |
| Can Market Forces Be Used For Good? (PDF) |
| Dixon, Jennifer; Le Grand, Julian; Smith, Peter, 2003 |
| King's Fund |
| This paper asks whether a highly centralised healthcare system can sit comfortably alongside a market-led approach, and whether market forces can respond effectively to meet the demands of the UK's ageing population. It is comprised of the views of three experts: Le Grand writes on stronger market incentives for secondary care providers; Smith argues against even modest experimentation with stronger market incentives; and Dixon looks at the plausibility of combining the best aspects of market disciplines with planned provision. |
| ISBN 1 85717 477 1 |
| UK |
| |
| Partnerships for Health (PDF) |
| Butler, Eamonn, 2002 |
| Adam Smith Institute (ASI) |
| This ASI briefing paper argues that real improvements in UK healthcare can most effectively be achieved through a broader policy scope encouraging "real partnerships" between the NHS, the private sector and patients themselves. |
|
| UK |
| |
| Report on Government Services 2002 - Part C: Health (PDF) |
| Productivity Commission, 2002 |
|
This report was produced by the Steering Committee for the Review of Commonwealth/State Service Provision (SCRCSSP). This link is through to 'Part C: Health', which analyses the performance of publicly-funded hospitals and general practitioners (GPs) with efficiency data.
|
|
| Australia |
| |
| The New Shape of Public Services Volume I: Health and Education (PDF) |
| Butler, Eamonn and Pirie, Madsen, 2001 |
| Adam Smith Institute (ASI) |
| This report outlines a new vision for the NHS and state education, aiming to make both markets more innovative and consumer-focused. "Free-standing, self-owned and independent" providers would manage their own budgets and set their own policy and priorities. Driven by the demands of their customers, public services would utilise this autonomy to improve quality and efficiency. |
| ISBN 1-902737-23-7 |
| UK |
| |
| Paying for Medicines (PDF) |
| Senior, Ian, 2001 |
| Adam Smith Institute (ASI) |
| This report suggests that Britain should follow Sweden, Norway, Holland and Belgium in asking people to pay their first £60 in annual prescription bills. This would bring an extra £2 billion into the NHS and cut the waste of 'free' medicines that are never taken. It would also allow patients to weigh up whether expensive new medicines - unavailable on the NHS today- were really worth paying for. |
|
| UK |
| |
| Inappropriate Adjustments to NHS Waiting Lists (PDF) |
| National Audit Office (NAO), 2001 |
| The Stationery Office |
| This report follows up on 'Inpatient and Outpatient Waiting in the NHS' (NAO, 2001), which found six NHS trusts where waiting lists had been inappropriately adjusted. It highlights a further three trusts in which waiting list reporting is a problem and makes a series of recommendations for future investigation and clarification of such irregularities. |
| HC 452 |
| UK |
| |
| The World Health Report 2000-Health Systems: Improving Performance (PDF) |
| World Health Organisation, 2000 |
|
| This report gives information on assessing and improving health systems. It looks at their performance and goals and the different methods used to finance these systems. Findings from the report show that governments tend to focus too much on the public sector, disregarding private provision of care. |
| ISBN 92 4 156198 X |
|
| |
| What A Performance: Performance Related Pay In The Public Services (PDF) |
| French, Stephen; Marsden, David, 1998 |
| Centre for Economic Performance, London School of Economics |
| This report is among the earliest studies to examine performance-related pay schemes in the public services. It examines data from the Inland Revenue, the Employment Service, NHS Trust Hospitals and Head Teachers and finds that while performance-related pay can increase productivity it can also foster distrust and feelings of injustice among workers. |
|
| UK |
| |
| The Health Alternatives (PDF) |
| Pirie, Madsen and Butler, Eamonn, 1988 |
| Adam Smith Institute (ASI) |
| This ASI report considers potential improvements to management of the NHS. It suggests evolutionary rather than revolutionary reform, to be achieved through the judicious use of competition, choice and incentive. The authors argue their reforms can improve the efficiency with which healthcare is delivered while safeguarding the NHS's major achievements. |
| ISBN 1-870109-23-6 |
| UK |
| |
| Managing Better Health (PDF) |
| Goldsmith, Michael and Pirie, Madsen, 1988 |
| Adam Smith Institute (ASI) |
| This report attempts to draw out the lessons from managed healthcare systems in use in the USA with a view to application in Britain. It suggests that a restructured management system with greater emphasis on choice and incentives would bring significant improvements for the NHS. |
| ISBN 1-870109-22-8 |
| UK |
| |
Back to top
|
