We’ve been doing a lot of looking at statistics recently. It’s got me thinking about how targets and performance measures are used. Public services are, of course, accountable for how they spend our money. One of the most visible ways that government holds NHS services to account is through targets.
The amount of money services get depends in part on how well they score on the targets. Each service must supply information on their performance against a range of measures. Groups of measures get acronyms – QOF, CQUIN and so on – which become part of the vocabulary of the NHS, while remaining a mystery to the rest of us.
Targets don’t just work through financial incentive – the aim of publishing information showing which services are doing better or worse against target is to drive competition. It enables commissioners and the public to challenge services, asking why their local service is not as good as a neighbouring one, or falls below the national average.
Targets can work – bringing waiting times for some surgical procedures down from years to weeks, for example. Experience has shown that they can also put pressure on staff to treat people with less serious conditions ahead of those with more serious conditions. So it is important that targets are used in a way that works for the patient.
What should a local Healthwatch like ours in Camden do about targets? Should we spend time monitoring the targets that are not getting met in Camden? For instance, that no one with cancer should wait longer than two months from being referred by a GP to starting treatment – the “62 day” target. Locally, UCLH is a cancer specialist centre and it does not always meet the target. Is monitoring this a good use of our time, when these figures are reported publically by the trust and checked by Camden CCG’s Quality and Safety Committee?
We think it is important that local people are able to ask questions about quality, and check how well their own services are doing. So, if you want to know the places to look online for this information, get in touch, we’ll do our best to signpost you to the sort of information you will find most useful.
But we think it is a more valuable use of our time to focus on some of the areas not covered by targets – the issues you have brought to us about equal access to services, or about getting a real say in services.
What do you think about targets? Should we be monitoring them locally? Should Healthwatch nationally be asking for fewer of them, so NHS staff can spend less time filling in monitoring information? Are there local targets you would like to see? As always, we’d like to hear from you.
Either comment below or contact us.