Measuring the performance of local health systems

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Read the review

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

About the review

We were asked to stock of progress already made in this area by national bodies and other groups, and to assess what metrics are available. This builds on the Secretary of State’s ambition to promote ‘intelligent transparency’ in the NHS to facilitate improvements in care.

We were asked to:

  • consider how a health systems scorecard could be developed to align with other national work on measurement and metrics
  • consider the merits of basing metrics on five population groups: people over 75; people under 75 with long-term conditions; maternity, children and young people; mental health; and the generally well
  • draw on international best practice of performance measurement from countries and international agencies
  • draw on past experiences of related initiatives in this country.
  • identify gaps in this work that would need to be filled to provide a rounded picture of local health system performance
  • engage with a small number of key stakeholders to inform our work
  • advise on the ‘first principles’ of a health system scorecard, including: clarity about the aims of measurement; the domains and population groups to be measured; the unit of measurement; the approach to measurement; and data and technical issues that need consideration.
  • advise on ranking and scoring using aggregated metrics.

To do this, our review has drawn on the published literature, past experience in the NHS, examples from other counties and a preliminary trawl of what indicators might be available. We have also consulted with a small number of technical experts and key stakeholders while recognising that more extensive engagement work will need to be undertaken by others after our review has reported.

Main contact

For more information about this work, please contact Hugh Alderwick