Input versus output‐based performance mesurement in the NHS – the current situation

The concept of service provision through output specifications rather than input‐based specifications is currently occupying directors and managers within the service. While the debate continues, little research has been undertaken to find out the current spread of the new output specification and how it operates in NHS Trusts compared to the longer established input‐based service specification. This paper presents a study of around one‐third of the Trusts in England and provides a comparative analysis of the different specifications in use, whether in‐house or outsourced providers deliver the services to these Trusts, and how these providers are assessed for satisfactory performance. In addition, through a series of structured discussion forums, users’ requirements for the development of standardized performance metrics are established for the future management of output specifications.