Key points
- Performance in the NHS can mean a number of different things, including the quality of care provided and the financial performance of organisations. Definitions of quality vary and can cover:
- clinical outcomes of care
- patient safety
- patient experience
- health promotion
- value for money and productivity
- access to services
- and equity of service provision.
- NHS performance is directed, regulated, managed and incentivised in a variety of ways by several organisations and at different levels of the system. The Department of Health and central government more widely, the Care Quality Commission, Monitor, strategic health authorities, primary care trusts (PCTs) and NHS providers all play a range of roles.
- Transparency of information on NHS performance has undoubtedly grown in recent years and is likely to continue to grow.
- While a great deal of performance information is available, alternative sources present different information and differing pictures of performance.
- For NHS providers regulated by Care Quality Commission, the 2008/9 Annual Health Check rated 15 per cent of trusts 'excellent', 47 per cent 'good', 32 per cent 'fair' and 5 per cent 'weak' (2007/8 ratings were 26 per cent, 35 per cent, 34 per cent and 6 per cent respectively). In terms of their management of financial resources, 26 per cent were rated 'excellent', 45 per cent 'good', 26 per cent 'fair' and 3 per cent 'weak' (2007/8 ratings were 24 per cent, 37 per cent, 34 per cent and 5 per cent respectively).
- PCT performance was assessed under the world class commissioning assurance system for the first time in 2008/9. Since world class commissioning is a developmental programme, it was not expected that PCTs would score highly in the first year, and indeed most PCTs achieved only levels 1 or 2 out of a possible 4 against each of the 10 competencies. None of the 152 PCTs achieved level 4 for any of the competencies, but level 3 was awarded 37 times.
