New national targets

Assessment of new national targets

Assessment of performance against the new national targets is one component of the ‘Quality’ element of the Healthcare Commission’s 2005/2006 annual health check and covers the targets published by the Department of Health in National Standards, Local Action: Health and Social Care Standards and Planning Framework 2005/2006 – 2007/2008. New national targets are considered to cover what trusts are required to do to demonstrate they are developing and sustaining improvement and carry less weight in the derivation of the overall ‘Quality’ score.

We will assess PCT performance in relation to the new national targets outlined in National Standards, Local Action, using the indicators detailed under the relevant links on the left hand side of this webpage. Where appropriate and practical, we will also assess the contribution of provider trusts in relation to the new national targets, using the indicators detailed under the relevant links on the left hand side of this webpage.

On 21st July 2004, the Department of Health’s publication National Standards, Local Action: Health and Social Care Standards and Planning Framework 2005/06–2007/08 provided details of the new national targets [Annex B] and existing commitments arising from the 2003-2006 planning round [Appendix 1]. The new national targets are framed in terms of ultimate public health outcomes. We recognise that their delivery is dependent on the contribution of each NHS organisation. The development of appropriate measures to assess the contribution of provider trusts to the delivery of the new national targets has not been without challenge. We have worked closely with the Department of Health and other stakeholders to identify those national targets of particular relevance to provider trusts and to construct appropriate measures that will encourage collaborative working across the whole health economy. We will continue to use our experience of assessing performance relating to targets to contribute to improving the understanding of the impact of targets and addressing any unintended effects.

The links on the left hand side of this webpage refer to:

• the names of the indicators which we will use to assess ambulance, acute and specialist, learning disability, mental health and primary care trusts, including details of why the indicator is included, the data source and the period of time assessed by the indicator.

We are aware of the work being undertaken by the Public Health Information and Intelligence Task Force in relation to the health of the population Public Service Agreement [PSA] targets. The Healthcare Commission is represented on the task force and we will liaise with that group as they develop core public health indicators to support evaluation and measure national and local progress against PSA targets and Choosing Health commitments.

Queries

We welcome feedback on, or queries about, the indicators. It would be helpful if issues were raised as soon as possible rather than waiting until we are close to publishing performance ratings in 2006. Please direct any queries to the mailbox:

performance.indicators@healthcarecommission.org.uk

Key Issues

Our approach to targets

New national targets are considered to cover what trusts are required to do to demonstrate they are developing and sustaining improvement.

We will continue to use our experience of assessing performance relating to targets to contribute to improving the understanding of the impact of targets and addressing any unintended effects.

Combined trusts

Combined trusts (those organisations that provide functions of more than one type, for example, primary care trusts which also provide mental health services) should refer to the indicators/targets for all relevant trust types. Their assessment will be based on all of the indicators for each function they deliver.

How do we assess performance relating to new national targets?

The process for assessing performance relating to the new national targets consists of:

• publication of technical specifications for the indicators (constructions)
• data collection from data collectors (as described below)
• data validation by data collectors
• data ratification by the Healthcare Commission
• Healthcare Commission consideration of extenuating circumstances applications
• scoring
• publication of the score as part of the annual health check

Further guidance will be issued on the process as indicated below.

This section outlines key activities and highlights important issues healthcare organisations should take into account in preparing for our assessment.

Data collection

The Healthcare Commission is committed to reducing the burden of inspection and data collection on healthcare organisations. Where possible, we use data from existing, mandatory data collections to support our assessment of performance relating to the new national targets. We therefore commission data from a range of data collectors – for example, the Department of Health, the new NHS Information Centre, the Royal College of Physicians.

In a number of the new national target areas there is little data currently available for provider organisations. Where this is the case we will develop special data collections. As in previous years, we will apply to the Review of Central Returns (ROCR) for permission for special data collections.

PCTs and SHAs should be aware that where PCT local delivery plans are to be used as a data source for particular indicators, a special exercise to collect these data will be put in place. This exercise may be undertaken via the Department of Health or directly by the Healthcare Commission.

Data quality and timeliness

Healthcare organisations are responsible for supplying accurate, good quality data. Complete data must be supplied by the deadlines set by data collectors.

Organisations can be penalised for poor quality data or if complete data are not returned by published deadlines.

Data collectors are responsible for data validation and healthcare organisations should ensure that they take up the opportunities provided for validation, as the Healthcare Commission will only allow changes to data in exceptional circumstances.

Ratification

The ratification process will take place in early summer 2006, commencing May 17th 2006, as relevant datasets become available to the Healthcare Commission. The Healthcare Commission will provide trusts and SHAs with detailed guidance and their unique passwords in advance of the commencement of the ratification process. The process is similar to that used for the ratification of star ratings data in previous years.

Ratification provides organisations with an opportunity to see the data that will be used to construct their performance rating for each indicator in this strand of the annual health check. The object of the exercise is not to provide an opportunity to change data but to enable organisations to check that the Healthcare Commission is using the data they supplied to the data collector.

Extenuating circumstances

The Healthcare Commission seeks to apply its assessments fairly and consistently across all organisations, using criteria and methods that have been developed following consultation with a wide range of stakeholders. Occasionally, due to the impact of an extenuating circumstance, it may be inappropriate and unfair to assess an organisation using a specific aspect of the published criteria and methods. In such cases, an organisation may make a request for the Healthcare Commission to take this into account before undertaking their scoring.

The protocol for extenuating circumstances will be released to trusts and SHAs in May 2006 and will also be available for download from within the ratification website. Trusts must be able to demonstrate that they fully meet the criteria contained within the protocol before the Healthcare Commission will consider any request.

Scoring

The scores for each new national target are aggregated into one overall score, which then contributes to the overall ‘Quality’ element of the annual health check. New national targets are scored on the following four-grade scale:

• excellent
• good
• fair
• weak

Each trust is assessed by a set of performance indicators, specifically designed to measure the new national targets that apply to it. Scoring of the individual performance indicators underlying each target will use a three point scale reflecting the level of achievement.

Not all new national targets apply to all trusts. The number of applicable new national targets varies by health care organisation type and may vary between trusts of the same organisation type. Trusts will only be assessed against the targets and indicators that are applicable to them within their relevant set(s) of indicators.

Please click here for further details on the scoring methodology for new national targets. This document was updated on May 11th 2006, to include allocation tables for each trust type. The document includes the following information:

• outline of the new national targets scoring methodology
• key principles of scoring new national targets
• allocation table for acute & specialist Trusts
• allocation table for primary care trusts (PCTs)
• allocation table for ambulance trusts
• allocation table for mental health trusts
• allocation table for PCTs that also provide mental health services
• allocation table for combined trusts, which provide acute, ambulance and mental health services

As the annual health check is a new system, the Healthcare Commission reserves the right to modify its scoring methods in light of experience. Any changes made would be transparent and intended to promote fairness in the results of the assessment. Rule changes would either apply across all health care organisation types, or might be specific to a particular health care organisation type.

If you have any comments or queries regarding scoring of the existing national targets, please e-mail us at:

performance.indicators@healthcarecommission.org.uk

 

Further guidance

We will publish the following guidance in May 2006:

• handling general data queries
• handling extenuating circumstances
• the ratification process