Headlines: November 8th, 2001

The NHS Confederation, which represents managers in trusts and health authorities, believes that the Government’s approach to performance management is not working and is causing short termism. The Confederation argues that much of what managers do to measure performance in the NHS undermines attempts to improve it. They are told to be innovative and take risks, but don’t fail. They are urged to change from the bottom, but directives continue to come from the top telling them what to do.The Confederation’s challenge is supported by the launch of three reports arguing that to improve performance the government must focus less on detailed specific targets and more on identifying key pointers that show how the whole is performing. The reports recognize that the Government is
struggling to get out of a continuous cycle of micromanagement of the NHS and they argue that failure to break the cycle will mean that attempts to turn round the NHS may fail.

.The three reports represent a first attempt to articulate a different way of improving services. They argue that politicians should set a few standards which are really important and managers should then have the autonomy to deliver. The reports are: ‘Why the NHS won’t do what its told – and what might we do’; ‘Aligning what we say and how we behave – looking at the contradictions between what we know about the NHS and how the performance management system is set up’, and ‘Rethinking the system – exploring the minimum specification or principles needed to underpin performance management systems capable of delivering real improvement’.

Copies of the papers can be obtained from rufus.latham@nhsconfed.co.uk