Please note that a further set of NHS performance indicators was published in July 2000.
Click here to go to this set
Introduction
The new NHS made a commitment to a National Health Service which - by delivering quick, high quality, better-integrated services which reduce health inequalities - will secure better health for the population. It promised to concentrate on assessing what
matters to patients and the public - the delivery of quality and cost-effective care that leads to improved health. Quality and efficiency need to be pursued together, since
just as resources need to be used efficiently and to best effect so must services be provided to consistent standards of quality.
A First Class Service, published for consultation in July 1998, set a three pronged strategy to drive performance improvement by:
- Setting Standards - The National Institute for Clinical Excellence (NICE) will promote clinical and cost effectiveness through guidance and audit, and advise on best practice. National Service Frameworks will set national standards and define service models for a specific service or care group, put in place programmes to support implementation and establish performance measures against which progress within an agreed timescale will be measured;
- Delivering Standards - Clinical Governance, underpinned by modern
mechanisms for professional self regulation and lifelong learning, will
ensure that national standards and guidance are reflected in the local
delivery of services;
- Monitoring Standards - Health Authorities and Primary Care Groups
should use the Framework to monitor service delivery against plans
for improvement across the six areas. The NHS Executive will use the
framework to assess the performance of the NHS. The Commission for
Health Improvement will carry out local reviews to check that systems
to monitor, assure and improve clinical quality are in place. It will
also have a troubleshooting role to help address serious problems.
A National Survey of Patient and User Experience to assess the quality
of NHS care will also be conducted nationally and the results could
be used to initiate action to secure improved services.
Performance assessment is central to all these activities. A First Class Service highlighted the need for a performance framework which would support the drive for higher quality standards by ensuring that performance assessment is focused on the delivery of clinically and cost effective, appropriate and timely health services
to meet local needs.
The Performance Assessment Framework has two main purposes. It has been developed to assist the NHS in work to improve the health of the population and in providing better care and outcomes for the people who use its services by encouraging action across the six areas. It will also be used to assess how the NHS is progressing in the delivery of this work. Using the Framework to make improvements will be a long term process and will require changes both nationally and locally. The high level indicator set presented here supports the Framework. The indicators are not direct measures of quality but should be used to draw attention to issues that may need further investigation or action. This means:
- at the NHS Executive Headquarters, the development of better and more useful
indicators and the encouragement of the appropriate action at local level;
- that the NHS Executive Regional Offices have appropriate performance
assessment processes in place to assist and encourage appropriate action at local
level;
- that Health Authorities, Primary Care Groups and NHS Trusts consider the six areas
in drawing up Health Improvement Programmes and work together to ensure that
robust Clinical Governance processes are in place including clinical audit, that data
are quality assured and that local enquiry and learning is encouraged through CPD
and life-long learning.
The six areas of the Framework remain as outlined in the original consultation
document. From an initial view of the health of the diverse communities of the
local population under consideration (Health Improvement), we need to ensure that
everyone with health care needs (Fair Access) receives appropriate and effective
health care (Effective Delivery) offering good value for money for services
(Efficiency) as sensitive and convenient as possible (User/Carer Experience) so
that good clinical outcomes are achieved (Health Outcome of NHS Care), to
maximise the contribution to improved health (back to Health Improvement).
Specifications Document in Portable Document Format 
High Level Indicator set in Excel 97 format
Please note that this file was updated on 22 July 1999 to include corrections to headings in Tables 1 and 4
High Level Indicator set in Excel 97 format
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