Yet more performance ratings for the NHSBMJ 2017; 358 doi: https://doi.org/10.1136/bmj.j3836 (Published 10 August 2017) Cite this as: BMJ 2017;358:j3836
All rapid responses
We entirely concur with the messages conveyed by Hugh Alderwick and Veena Raleigh.
If we go back to basics: “if you can’t measure it then you can’t improve it”- Peter Drucker (1).
But it is also crucial for those in the centre to consider what these performance metrics are for! It is imperative that the way it is measured and quantified is fit for purpose towards driving quality upwards and not primarily influenced by a political agenda or that the main objective is to reduce cost. It appears to us that the only purpose is to gain access to additional funding, which has to be fundamentally flawed given the constraints of the performance metrics as eloquently described in this article. The concept of only offering funding to those who meet cost saving objectives is going to be littered with perverse incentives and the potential use of public funding where it is least required. But that is also not to say that we do not agree with the concept of rewarding success.
Healthcare workers in the front line delivering within the STPs need to be engaged in what would be the most appropriate performance ratings as opposed to being decided centrally. Within the context of STPs, the imposed, what is to all intents and purposes cost savings by an ill understood methodology, does not help and it is critical to engage with the relevant stakeholders within the programmes to decide on realistic and achievable plans in the interests of our patients.
Competing interests: No competing interests