Benchmarking in UK health: a gap between policy and practice?

Abstract

If you would like to write for this, or any other Emerald publication, then please use our Emerald for Authors service information about how to choose which publication to write for and submission guidelines are available for all. Please visit www.emeraldinsight.com/authors for more information. About Emerald www.emeraldinsight.comEmerald is a global publisher linking research and practice to the benefit of society. The company manages a portfolio of more than 290 journals and over 2,350 books and book series volumes, as well as providing an extensive range of online products and additional customer resources and services.Emerald is both COUNTER 4 and TRANSFER compliant. The organization is a partner of the Committee on Publication Ethics (COPE) and also works with Portico and the LOCKSS initiative for digital archive preservation. AbstractPurpose -This paper aims to bring greater clarity to the debate on the merits (or demerits) of relative performance evaluation through a broad assessment of current UK National Health Service (NHS) benchmarking. It seeks to examine whether benchmarking is being used dynamically to disseminate best practice in healthcare, or whether it is primarily a government tool to enforce static competitive performance standards. Design/methodology/approach -Draws on recent literature and government pronouncements. It charts the development of the health care policy discourse that articulated a move from the internal market of the early 1990s to the metrics approach of New Labour. Findings -Benchmarking is one of the private sector-grown "managerialist" tools whose application and significance is rapidly increasing in the UK public sector. Despite its prevalence, the nature (competitive or comparative), the process (based on indicators or ideas) and the outcomes (standards or "best practice") of benchmarking in public services remain unclear. The findings reveal that benchmarking requirements, imposed by government policy, are articulated in terms of comparative ideas -benchmarking with the stated objective of "sharing best practice", but are operationalised and disseminated in the form of indicator league tables with standardised benchmarks for performance. Hence, there is an apparent "articulated policy -implemented practice gap". Concludes that, whilst benchmarking is a highly desirable policy instrument, its practical relevance to health care improvement is still in doubt. Originality/value -The findings are relevant to both NHS policy-makers and to NHS actors who must engage with the processes and outcomes of benchmarking practices.

Benchmarking: a useful tool for informing and improving care of the dying?

“…Northcott [10] suggests that the discourse that takes place around the data in workshops can enable 'NHS actors' to find meaning and context in and to more fully connect and engage with the evaluation process. Being given the opportunity to reflect on a process allows deeper insight into the usefulness of the outcome of that process [3] and sharing information is integral to continually improving the quality of care [8].…”

Mechanism of Benchmarking and Its Impact on Organizational Performance

“…Also focused on benchmarking, Northcott and Llewellyn's (2005) study examined benchmarking as a practical tool in UK National Health Service. They revealed that benchmarking is still unclear and that the correlation ijbm.ccsenet.org…”

Shared decision making needs a communication record

“…"I wish they would fill out the form properly", said one participant. In other words, and like others have found [30], there can be a gap between policy and practice, or gaps between the work, the patient, and the information representation which may account for adverse consequences for the patient and increased costs for the hospital [38]. This 'wish list' will be further considered in the Discussion section.…”