Creative use of existing clinical and health outcomes data to assess NHS performance in England: Part 2—more challenging aspects of monitoring

In the second of their two articles about using existing routine data to assess performance in the NHS, the authors make practical suggestions about using data for mental health care, potentially avoidable deaths, and forecasting coronary heart disease outcomes, and raise issues about assumptions and technical aspects for discussion Introduction There have been recent calls for better data on NHS outputs and outcomes in England. 1 â[euro]" 4 However, this will require new data collection that could take several years. Summary points More rigorous analysis of existing routine clinical data would allow assessment of NHS performance across a wide range of services Examples of such performance indicators include mental health care, potentially avoidable deaths, and forecasting coronary heart disease outcomes Various assumptions and technical issues need discussion and debate-that is, the selection of indicators and targets, methods, interpretation of data, and application in productivity measurement Application in productivity assessment Practical ways need to be found to incorporate multiple indicators in productivity assessment: they may overlap or interact; some may be more important or relevant than others and may need to be weighted; some may reflect mismatching performance for a given time (see the above discussion on stroke).