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Measuring the performance of local health systems

A review for the Department of Health

In June 2015, The King’s Fund was commissioned by the Department of Health to review how the performance of local health systems could be assessed.

Our review looks at how to measure the performance of health services within clinical commissioning group (CCG) areas, including how well these services work with social care and public health services.

We recommend that there is a radical simplification and alignment of existing NHS performance frameworks.

A number of national bodies are involved in assessing performance, resulting in duplication of effort and unnecessary complexity. Rather than create an additional new way of measuring performance, we argue that a better approach would be to consolidate the three national Outcomes Frameworks into a single framework covering the NHS, public health and adult social care.

We recommend that a small set of headline indicators are selected to present key performance information to the public. It is important to engage with the public to determine what indicators should be used and what domains to be covered as this is an evidence-free zone.

A larger set of indicators should be available to enable patients and the public to drill down into population groups and medical conditions of particular interest to them and to support commissioners and providers in quality improvement.

We do not recommend using this data to provide an aggregate score of performance – aggregate scores can mask good or poor performance on individual indicators and therefore may not be a meaningful picture of performance. Instead, we recommend that a wide variety of data should be made available for the purpose of transparency and to support the improvement in care by commissioners and providers.

We also recommend that there is a consolidation of the disparate array of websites presenting information about local health system performance.