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Performance 99 Wednesday, 16 June, 1999, 10:37 GMT 11:37 UK
Tough tests for health authorities
Cancer treatment
Health authorities will be assessed on cancer survival rates
The 41 performance indicators that measure health authority performance have highlighted regional variations.

The measures - known as Higher Level Performance Indicators - cover a broader spectrum of health care than the indicators used to assess the performance of individual hospitals.

NHS Performance 99
They look first at background quality of health in an area and work through a series of indicators until they look at the effect the area's health services have on health problems.

Some figures suggest that where you live plays a large part in your chances of good health - as might be expected.

One example is the indicator for avoidable deaths, where a low score is good and a high score is bad.

Prosperous West Surrey gets minus 33 compared to industrial Manchester's 80.

But some are less predictable. The survival rate following breast or cervical cancer score is rated differently - in this case a high score is good and a low score is bad.

Bedfordshire gets one of the lowest scores in the country - minus 33 - even though it is classifed as prospering.

Meanwhile the "maturer" Isle of Wight - with a higher proportion of elderly patients - comes top with a healthy 46.

Another indicator shows that variations occur even within the same locality - the average five-year-old in England has 1.5 decayed, missing or filled teeth, but in Knowsley, West Midlands, the figure rises to 2.9 while in neighbouring Walsall it is as low as 0.9.

What the indicators aim to do

The government divides the 41 indicators into six key areas, reflecting its NHS performance assessment framework:

  • "Health improvement" Looks at the general level of health in an area, even in areas outside NHS control such as deaths from accidents
  • "Fair access" Records whether or not people are getting access to care when they it - includes figures such as registration with an NHS dentist and the size of waiting lists
  • "Effective delivery of appropriate health care" Measures whether, once people have access to care, they are getting the most appropriate care - includes information on disease prevention and surgery rates
  • "Efficiency" Looks at cost-effectiveness of practice - in terms of money, staff and equipment - and includes figures on the average cost of maternity, the average length of time inpatients spend in hospital and use of cheaper generic drugs
  • "Patient-carer experience" Deals with issues such as waiting times, non-attendance at appointments and cancelled operations
  • "Health outcomes of NHS care" Examines directly how well the health authority is maintaining and improving the care of local people - uses figures for avoidable deaths, teen pregnancies and survival rates following cancer

The government hopes managers will use the indicators to identify areas in need of improvement.

The NHS Confederation, which represents hospital management, wants more general information published.

Stephen Thornton, chairman of the confederation, said: "We are sitting on a goldmine of information about excellence, but not yet mining it - this is what we need to do."

He called for more information about primary care in the patient-carer experience category, as this is where most patients interact with the NHS.

See also:

01 Apr 99 | Health
01 Apr 99 | Health
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