Managing by numbers: using outcome measures in the NHS Available to Purchase

The paper explores the literature concerning outcome measures used in health services. The need to measure outcomes subsequent to encounters with health services has been identified and occurs as a result of the current “value for money” approaches being used within the NHS. Provider units are required to establish the effects which interventions have had on the health of each individual using their services, despite the fact that definitions of health outcomes used by both professionals and managers are problematic. It is suggested here, however, that outcome measures which answer all requirements will remain elusive, and their effectiveness will vary according to the circumstances of their generation and use. Moreover, the very use of outcome measures as management tools can lead to a subversion of the meaning which led to their selection in the first place. Managing by (outcome measure) numbers is not a realistic way forward.