Performance measurement in health care: History, challenges and prospects

A confluence of forces has resulted in massive changes to the collection and use of performance data in the UK health system over the past 25 years. Performance measurement offers major potential benefits for clinical professionals, managers, regulators, politicians, researchers, patients and citizens. However, uncritical reliance on performance data can lead to a number of unintended and adverse consequences. The National Health Service has pioneered the assembly and dissemination of performance data from the early 1980s. This article summarizes the history of performance measurement in the NHS, assesses its effectiveness to date, discusses the major challenges in deploying performance measures, and highlights priorities for policy-makers.