The Performance Assessment Framework: experiences and perceptions of NHS Scotland. A Report to the Analytical Service Division, Directorate of Performance Management and Finance, Scottish Executive Health Department

Abstract

The new Performance Assessment Framework (PAF) was introduced in NHSScotland in October 2001 and used in the annual NHS Board Accountability Reviews in 2002 and 2003. The PAF was assigned three objectives outlined in Our National Health: (1) ‘Support and encourage sustained improvement in the performance of NHS Scotland by focussing on key measures in relation to health priorities.' (2) ‘Reinforce and support the role of the 15 NHS Boards in managing the performance of their local NHS systems.' (3) ‘Enable NHS Scotland to account systematically for its performance both locally and through the Scottish Executive to the Scottish Parliament and to the people of Scotland.' The success with which the PAF appears to be meeting those objectives forms the focus of this investigation. A key element determining how and whether the PAF affects the behaviour of decision-makers within the organisations and subsequently NHS Scotland performance is the perception of the PAF and the signals it generates. Thus it is important to determine what these perceptions and understandings are. It is necessary to capture these views in order to appreciate fully the impact of the PAF within the NHS in Scotland and to appraise its salience and power as a performance tool.