Marshall M, (2002)

‘The Publication of Performance Data in the National Health Service’

NHS research paper, no longer available online.

• Outlines the risks and benefits of publishing performance data (‘report cards’) for the NHS, and reviews the evidence from the US and UK on the impact of report cards.
  Policy Context:
• The NHS does not have a strong history of public disclosure of data.
• Public demands for greater accountability of public services, as well as improvements in the ability to measure aspects of clinical practice, mean that this is now changing
• Public and media concern at recent high-profile examples of the failure of self-policing have also been important in driving demands for evidence of performance standards.
  Evidence on public release of performance data:
• The US has most experience of public disclosure in modern times.
• The evidence suggests that although consumers want more information about provider performance, published data has only a small impact on consumer decision making.
• Lack of interest in and use of performance data appears to be due to difficulty in understanding the information, lack of trust in the data, problems with timely access to the information, and lack of choice.
• There is some evidence that provider organisations are more responsive to performance data than consumers, purchasers or individual doctors.
• Organisations shown in a positive light by performance reports are more likely to use the information for benchmarking and internal performance monitoring. Those identified as poor performers are more likely to criticise the validity of the data.
• Marshall also notes that the design of report cards is crucial, with cognitive science research in the US showing that, irrespective of content, most US report cards are poorly designed and their impact could be considerably improved by applying current cognitive research knowledge.
  

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