Towards benchmarking in British acute hospitals

The 1997 White Paper - The New NHS - on the future of the National Health Service accorded a high profile to the use of benchmarking as a means of improving efficiency over the following decade. Here, I examine the prospects for the successful adoption of benchmarking in the acute-hospital sector. A benchmarking model is superimposed upon a model of receptive contexts for change, and the components are used to explore the background to the development of benchmarking and likely attitudes towards its implementation. Where appropriate, empirical evidence is introduced to shed light on the ideas explored. I conclude that the wider political agenda accompanying benchmarking has potentially far-reaching implications for the re-distribution of resources on regional, or even national, bases. However, the steady drip-drip on stone is necessary to achieve results at local operational levels. Only by harnessing the strengths of extant cultures will efforts to identify and adopt the most efficient/effective medical practices succeed and potentially conflicting social tensions be resolved.

[1]  C. S. Jones,et al.  Hierarchies, networks and management accounting in NHS hospitals , 1999 .

[2]  D. Berridge,et al.  HRGs for benchmarking and contractual arrangements: a poisoned chalice? , 1998, Annals of the Royal College of Surgeons of England.

[3]  L. Hands,et al.  Trials and tribulations of vascular surgical benchmarking , 1998, The British journal of surgery.

[4]  Kevin J. Leonard,et al.  A proposal for a centralised patient record database: the need to identify patient data elements to measure costs, clinical outcomes and benchmarking , 1998 .

[5]  M. Thorne Being a Clinical Director: First among Equals or Just a Go-Between? , 1997, Health services management research.

[6]  Ian P. Dewing,et al.  The Attitudes of NHS Clinicians and Medical Managers Towards Changes in Accounting Controls , 1997 .

[7]  S. Keenan,et al.  Assessing the efficiency of the admission process to a critical care unit: does the literature allow the use of benchmarking? , 1997, Intensive Care Medicine.

[8]  B. Salter Change in the British National Health Service: Policy Paradox and the Rationing Issue , 1994, International journal of health services : planning, administration, evaluation.

[9]  M. Jelinek Managing change for competitive success , 1993 .

[10]  James W. Fairfield-Sonn,et al.  The Awakening Giant: Continuity and Change in ICI. , 1987 .

[11]  J. Lorsch Managing Culture: The Invisible Barrier to Strategic Change , 1986 .

[12]  R. Kanter The Change Masters: Corporate Entrepreneurs at Work , 1985 .

[13]  M. Tushman,et al.  Organizational Evolution: A Metamorphosis Model of Convergence and Reorientation , 1985 .

[14]  Carl E. Van Horn,et al.  The Policy Implementation Process: A Conceptual Framework , 1975 .