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King’s Fund warns of ‘misleading’ quality reporting

By Gareth Iacobucci

Quality measures used to measure GPs’ performance such as league tables and balanced scorecards risk misleading patients, distorting priorities and damaging staff morale if not used correctly, the King’s Fund has warned.

The think tank said that greater use of quality measures in the NHS has ‘real potential’ for improving the quality of care, but warned that care must be taken to avoid potentially damaging pitfalls.

The discussion paper Getting the measure of quality sets out the key issues to consider when developing and using indicators for measuring quality.

Among these are the need to secure clinical engagement, to ensure doctors are ‘empowered’ to use data and to understand where and how to improve their own performance.

It stresses the importance of minimising the risk of ‘misinterpretation and confusion’ when publishing data, and says the NHS should be clear about the who the different audiences for quality measures are, and how they will use them.

The report calls for improvement in measures used for performance management and external assessment to reduce ‘gaming of the system’.

It also suggests that the scope of quality measurement should be widened beyond those defined in Lord Darzi’s next stage review – which focussed on effectiveness, safety, and experience – to also include productivity, efficiency and inequality.

Veena Raleigh, lead author and senior fellow at the King’s Fund, said: ‘While openness and transparency are desirable, the increase in published information measuring the quality of care means it is imperative that adequate consideration is given to the selection, presentation and interpretation of complex data.’

‘Where such measures are used as performance indicators they must be interpreted with care in order to avoid unintended consequences, such as gaming, risk-aversion or distortion of clinical priorities.’

‘It is also important to remember that meeting performance indicators is not necessarily the same as good care for the individual patient.’

Quality measures used to measure GPs’ performance risk misleading patients, the King’s Fund has warned Quality measures used to measure GPs’ performance risk misleading patients, the King’s Fund has warned