Performance management in British health care: will it deliver?

In its latest attempt to improve performance, the British National Health Service (NHS) has turned to the business models of performance management. A range of managerial instruments has been deployed, signaling national priorities to local managers and seeking to offer the information, incentives, and capacity they need to respond appropriately. The arrangements are intellectually coherent and offer the prospect of major improvements in the quality of British health care. However, implementation is at an early stage, and some key issues have to be addressed. The various performance management instruments have not yet been properly aligned, and greater conceptual clarity in implementation is required. Performance management will not be fully effective unless adequate capacity--in information, leadership, and managerial resources--is made available.