Hitting the target and missing the point?

04 August 2015

Targets divide opinion. At their best, they focus resource and leadership time on delivering priorities; protect access and quality standards for patients and service users; and provide transparent measures against which the public can hold providers, policy makers, and even politicians to account. A recent example is the access standards which have raised the profile of mental health services and its funding. At their worst, different targets pull in different directions and create perverse incentives; act as a blunt regulatory tool or divert boards’ attention from local priorities.

How might we shape targets which are most helpful to patients and those delivering services?

In a system as politicised as the NHS, national performance targets will continue to play a vital role. However the arrival of a new parliament means it is timely to review the value of national requirements within the system. I am including within that bucket, traditional ‘targets’, indicators, or expectations associated with national guidance such as staffing levels. Recent announcements show a willingness on the part of national policy makers to review existing measures, however there is a need to ensure the messages sent to the system by different targets are aligned. The simplification of referral to treatment targets has been widely welcomed for instance. However at the same time, the accompanying sanctions are being reviewed and the financial context means providers face stricter controls and a greater reporting burden.

Targets serve an important function and there is no doubt they are here to stay

So, how then might we shape targets which are most helpful to patients and those delivering services? NHS providers and primary care colleagues from the NHS Alliance came together at the Health Foundation to review the principles which should underpin national targets. The pros and cons of individual measures continued to generate debate. However there was consensus that constructing targets with the following aims in mind will help us all to hit both the target and the point:

Targets serve an important function and there is no doubt they are here to stay. With that in mind, everyone in the system needs to play their role in making sure they are fit for purpose and ‘hit the point’ of driving sustainable improvements in care. 

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