Scottish Government

What is Benchmarking?

At its simplest, benchmarking means:

"Improving ourselves by learning from others."

In practice, benchmarking encompasses:

• regularly comparing aspects of performance (functions or processes) with best practitioners;
• identifying gaps in performance;
• seeking fresh approaches to bring about improvements in performance;
• following through with implementing improvements; and
• following up by monitoring progress and reviewing the benefits.

(Definitions from the Public Sector Benchmarking Service, www.benchmarking.gov.uk)

The NHSScotland Benchmarking Project

The NHSScotland Benchmarking Project is supported by the Minister of Health and Community Care, and Dr Kevin Woods, Head of the Health Department and Chief Executive of NHS in Scotland. It is sponsored by John Connaghan, Director of Delivery, Scottish Executive Health Department ( SEHD). Priorities and direction are set by a Project Board which meets three/four times per year and is chaired by the Project Director - John Glennie, Chief Executive, NHS Borders. The Project aims to be service-owned and service-led.

Project management and analytical/specialist support are provided by SEHD and Information Services Division ( ISD).

Benchmarking is a tool to help support Service improvement.

Our Purpose

The purpose of the National Benchmarking Project is:

• to help the Service achieve greater productivity and efficiency; and
• to support the implementation of change and improvement.

We do this by:

• providing information which compares a range of measures on service activities; and
• developing flexible tools to support the investigation and impact of re-design to achieve service efficiency and improvement.

Our Approach

We take a Balanced Scorecard Approach. The balanced scorecard is a strategic management system that requires managers to focus on the important performance metrics that drive success. It balances different perspectives: patient, internal process, financial, and learning and growth. As well as monitoring current performance, it tries to capture information about how well an organisation is positioned to perform in the future.

We combine a high-level strategic overview with specific service-focused projects aimed at identifying operational opportunities for efficiency and improvement.

We use balanced scorecards to help reflect performance more accurately.

Whole System Measurement

The Whole System Measurement balanced scorecard provides a high-level overview of healthcare and health in Scotland from Health Board level to hospital/specialty.

It comprises 100+ indicators, ranging from length of stay to mortality rates, across five domains:

• Cost
• Efficiency
• Patient Experience
• Health Improvement
• Supply and Demand

This is colour-coded to show relative performance as in the table below. The scorecard is updated twice a year: in October/November for Scotland for the preceding financial year, and in April/May when corresponding English data become available - allowing comparison between the two countries.

Example scorecard: restricted primarily to acute ( SMR01) indicators. Traffic lights show relative performance (green - significantly above average, red - significantly below).

The Whole System Scorecard has been developed as a flexible tool: easy to maintain, and with facilities to support sensitivity analyses and rapid re-design.

Whole System Measurement provides a high-level overview…

Service-Specific Projects

Service-specific projects focus on particular areas of the Healthcare System and seek to support performance improvement at an operational level. Typically, they are led by a senior clinician or subject matter expert of similar standing.

… and service-specific projects support operational improvement.

Currently, the following projects are at various stages of development: Theatres, Mental Health, Estates, Orthopaedics, Radiology, and Older People. In addition, we are also supporting development of International Comparators with NHS Health Scotland and the Glasgow Centre for Population Health.

Whole System

The NHS in Scotland is a complex system with many interactions and linkages both within and outwith the Service. Service-specific projects cannot be approached in isolation.

Taking a whole system view is fundamental to our approach. A whole system framework recognises that many interacting factors can influence individual parts of the system, and that solutions to problems have to be developed taking these factors and interactions into account.

Individual services cannot be considered in isolation, a whole system approach is required.

We actively seek to:

• understand and reconcile findings between Whole System Measurement and service-specific analyses; and
• investigate and model the interaction between key parts of the whole system in order that the impact of re-design and change can be fully understood.

Achieving this requires the use and/or development of specialist analytical and modelling techniques.

Project Priorities

Project resources are limited, and at times it is necessary to constrain the number of service-specific projects undertaken or to prioritise activities. To do this we apply the following criteria:

Prioritisation Criteria

• Does the project relate to an area of priority identified within Delivering for Health?
• Is the project clearly aligned with the purpose and approach detailed above?
• Does the project offer significant benefits in terms of more efficient use of resources, or increased productivity?
• Are some of these benefits realisable in the short term?
• Does the project support Boards' local planning priorities?
• Is the project "high profile" and of strategic value to the Service and/or the National Benchmarking Project?
• Does the project relate to an area of work with significant impact on and/or interaction with an existing Benchmarking Project?

Further Information

For further information e-mail: nss.benchmarkingproject@nhs.net