§ Baroness Noakesasked Her Majesty's Government:
Whether they will publish the cost weighted efficiency index figures for 2002–03 on a comparable basis with those published for previous years. [HL2680]
§ Baroness AndrewsTraditionally, efficiency in the National Health Service has been measured using the cost weighted efficiency index but changes in the way healthcare is delivered now mean that it gives an increasingly incomplete and misleading picture. Therefore, an update was not published in the 2004 departmental report.
The main drawbacks of the cost weighted efficiency index are that it:
- fails to count a large amount of NHS activity—for example primary care consultations/procedures, nurse led procedures, family health services prescriptions, NHS Direct calls and walk-in centre visits;
- takes no account of quality such as better health outcomes, shorter waiting times, single sex wards or cleaner hospitals;
- classifies activity in only 12 activity types, two of which (inpatients and outpatients) account for 85 per cent of the cost weights. This limits the ability to measure changes in case-mix; and
- perversely records shifts in activity from inpatients to outpatients and from outpatients to primary or community care as inefficiency.
The Office for National Statistics is working with the Department of Health as part of the Atkinson review of measurement of government outputs to develop new measures of NHS productivity.