The Performance Assessment Framework: experiences and perceptions of NHSScotland

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The Performance Assessment Framework: experiences and perceptions of NHSScotland

Appendix B: Schedule used for the NHS Board interviews

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1. INTRODUCTION

1.1 A current trend in the public sector is to systematically assess performance of organisations. What do you think of the usefulness of this approach in general?

[Big general/ideological question to help place the other responses in context].

1.2. What do you think of the PAF compared to earlier attempts at managing performance in the NHS?

  • Purchaser-provider split

  • The previous AR process

  • Resource Management Initiative

  • CRAG (clinical outcome indicators), etc?

1.3 What do you think of the Scottish PAF compared to other systems, for example the English star system?

2. SENSITIVITY AND SCOPE OF THE INDICATORS

2.1 Do the performance indicators adequately represent your Board's performance? Are they a useful way of measuring performance?

  • Appropriate/inappropriate

  • Performance over time

  • Change/improvement not covered by indicators?

2.2 As you probably know the PAF data is collected at the NHS Board level. Do you think this is the right level at which to collect data and implement the PAF?

  • Trust level? - this what they do in England

2.3 What affects whether you can progress towards meeting the targets in the PAF?

  • resources

  • factors beyond the board's influence [socio-economic, etc]

  • other organisation

  • too many targets

  • variation within the Board?

2.4 How would you describe your NHS Board in terms of location and socio-economic factors?

  • urban/rural/remote

  • poor

  • mixed

  • small/large

[prompt them re why they were chosen for close examination - is this how they see themselves?]

2.5 How would you describe your NHS Board in terms of the management leadership style (across your senior team)?

  • how does this affect the implementation of the PAF?

  • how does the PAF affect the style?

2.7 What are the relationships like between the managers and the clinicians in your Board?

  • are they affected by the PAF?

  • do these affect the implementation of the PAF / hinder of help?

3. RELATIVE IMPORTANCE OF THE INDICATORS

3.1 Which do you see as the most important indicators - from your Board's perspective/from the Scottish Executive's perspective?

  • Is there a difference between the two? Why? Does this have any affect on the way that you respond to the PAF, to your Board?

  • If they are the same, why?

    • agreement

    • responding to incentives in the system

    • complying for other reasons

4. Incentives and the accountability review

4.1 One of the objectives of the PAF is to support and encourage improved performance. Does your experience of the PAF support this?

4.2 Were you involved in Accountability Reviews prior to the integration of the PAF? Has the integration of the PAF into the Reviews changed the nature of them?

4.3 What lessons (if any) came out of your accountability review and will this affect your activity in the coming year?

  • are there changes in priority/focus

  • Examples

4.4 How will you take these changes forward?

4.5 What effect (if any) is that likely to have on the rest of the service?

4.6 Is this what you as a Board would have chosen to focus on if it were not for the PAF and/or your accountability review?

  • Did the accountability review change your direction or complement what you were doing anyway?

4.8 I'd like you to think about possible rewards and penalties associated with performing well or poorly on the PAF. Does the NHS Board experience any such penalties or rewards?

  • Financial incentives/budgetary changes

  • Non-financial incentives

  • Explicit/implicit

  • How do they work?

  • How are they intended to work?

  • Examples

  • Opportunities/restrictions

4.9 What about for you as an individual? Are there rewards and penalties in the system for you which are affected by how well the board performs with respect to PAF?

  • Financial incentives

  • Non-financial incentives (e.g. promotion)

  • Explicit/implicit

  • How do they work?

  • How are they intended to work?

  • Examples

4.10 Are there any rewards or penalties associated with the PAF for other individuals within the Board or the Trusts?

  • Financial incentives

  • Non-financial incentives (e.g. promotion)

  • Explicit/implicit

  • How do they work?

  • How are they intended to work?

  • Examples

5. Implementing the PAF

5.1 How much input/guidance have you as a Trust been offered to help you to understand and implement the PAF?

  • Where from (Scottish Executive, other Trusts, your NHS Board, peers)?

  • Useful?

  • What else could have been done to help?

5.2 The Scottish Executive carried out a consultation process on the PAF in 2001 and 2002.

  • Did you take part?

  • Did they seem to listen to you?

  • Was this useful?

5.3 What steps has your NHS Board taken to implement the PAF? Plans for the future?

5.4 How does your Board intend to use the PAF?

  • As a set of incentives

  • As a set of instructions

  • As a set of constraints/targets

  • As a management tool which can be used internally within the Board?

5.5 Does the PAF influence decision-making within the Board? On a regular (weekly or monthly) basis?

5.6 How wide is the PAF's influence within the Board? Has it influenced its relationship with your Trusts or hospitals?

  • How far does the PAF filter down and how does it do this?

  • What mechanisms does the Board have available to it to ensure that it and its Trusts perform on the PAF, does it use them?

5.7 How much time is committed to addressing the PAF?

LOCAL AND NATIONAL ACCOUNTABILITY

6.1 One of the objectives of the PAF is to enable the NHS to be accountable to local people and to the Scottish Parliament. Do you think that it assists this aim and how does this accountability work for your Board?

Finally

7.1 Looking back at your achievements over the past year, can you tell me about one thing that you do well in this NHS board that other Boards could learn from?

7.2 Are there any aspects which you feel that we haven't covered? Any other comments which you would like to make about the PAF and the accountability review process?

7.3 Finally, how have you found taking part in this interview?

END

Page updated: Friday, June 10, 2005