Content area
Full Text
PERFORMANCE MANAGEMENT
The United Kingdom struggles to integrate the top-down instruments
of performance management with a system of clinical networks.
PROLOGUE: As a part of the Labour government's latest reform of the British National Health Service (NHS), performance management is front and center, as a way to retain some elements of the private market while placing more emphasis on the outcome and accountability of the system by consciously managing it. Although the definition of the term performance management can be vague, the British have adopted a multiprong strategy for improving the performance of the NHS based on empirical evidence, concrete goals, and quantifiable results.
To date, the efforts have been somewhat hampered by the lack of coordination among various directives, professional organizations, and others with a stake in the process. In this paper Peter Smith focuses on the acute care trust (hospital) sector, since this sector has received the most emphasis thus far. He examines performance management instruments that fall under three broad headings: guidance, monitoring, and response.
Regarding progress, Smith writes: "The performance management system has five years in which to deliver appreciable improvements, representing the full term of a national government that has staked much of its political credibility on modernizing the public sector." As has been true of previous NHS reforms, a shifting political climate could bring yet another round of reforms before these have been fully tested and proven a failure or success.
Smith is a professor of economics at the University of York. He holds a degree in mathematics from the University of Oxford and a master's degree from the London School of Economics. His research has focused on the economic aspects of health policy and the public sector. He has consulted with a number of British and international agencies, including the World Health Organization (WHO), the World Bank, and the Organization for Economic Cooperation and Development (OECD). He is a member of the WHO scientific peer review group on health system performance.
ABSTRACT: In its latest attempt to improve performance, the British National Health Service (NHS) has turned to the business models of performance management. A range of managerial instruments has been deployed, signaling national priorities to local managers and seeking to offer the information, incentives, and...