NHS Targets – Is the System Failing?

by Dina Gray (Guest Author)

Over the last few days the press have been preoccupied with the fact that there is great pressure on the A&E departments on the run up to Christmas with the BBC reporting that:

• the lowest percentage of patients seen within four hours since monitoring began in 2010
• just under 90% of patients were seen within four hours in the seven days up to December 14
• just six out of 140 major units met the target to see 95% within four hours.

In addition the ambulance service has been reported to be missing targets because they can’t get patients into A&E.

This fixation on targets means that the reporting of the crisis looks dire; but should the press be berating the hospital boards or are these targets meaningless at such times? To set a sensible target the system itself has to be capable of meeting those targets. If the use of the system has changed, as has been reported, that patients are turning up to A&E because they are unable to see their GP, then the targets need to change to reflect how the whole system is being used. It is not good enough to use outdated targets to apportion blame – that is just measurement madness!

Dr Dina Gray is a Visiting Fellow at the Centre for Business Performance, Cranfield School of Management. For more information on target setting and its consequences see her book “Measurement madness – Recognizing and Avoiding the Pitfalls of Performance Measurement” written with Dr Pietro Micheli, Visiting Fellow, and Dr Andrey Pavlov, Lecturer, Cranfield Centre for Business Performance.

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BBC website, 20^th December 2014 – http://www.bbc.co.uk/news/health-30541135