Ministers this week outlined what they called a 'demanding' but 'realistic' timetable for implementing the next stages of their health service reforms.

But they faced criticism for giving health authorities 'too tight' a deadline to road-test the new national framework for assessing NHS performance.

NHS Executive guidance, issued last week, spells out what action is needed this year to fulfil the 'NHS development agenda' (see panel).

One circular, from NHS planning director Alasdair Liddell, identifies key goals for 1998-99 on planning and performance, finance and commissioning, and 'developing the capacity of NHS organisations and their staff'.

It says managers should continue through the summer to 'lay the groundwork' for primary care groups and health improvement programmes.

Mr Liddell writes: 'While the agenda for 1998-99 will be demanding, the NHS Executive and ministers recognise the importance of pacing the longer- term programme and setting realistic targets for the service this year.'

But the timescale for HAs to pilot the new national framework for assessing NHS performance has come under fire.

Plans to road-test the system follow concerns about how the framework and high level performance indicators should be used.

In a separate circular issued last week, NHS director of finance and performance Colin Reeves said road-test results would form part of a revised framework to be published in the autumn for application across the NHS from next year.

But Keiran Walshe, from the Health Services Management Centre at Birmingham University, said: 'Given that it is the height of the summer holidays, setting up initial meetings could be a problem. I think they will realise that they might need to spend more time on a meaningful evaluation.'

An Institute of Health Services Management spokesperson said: 'We are concerned about the pace and workload for health authorities given that this has to go on at the same time as PCGs are set up.'

Timetable for action


Discussion document on improving collaboration 'at the health-social care interface'.


Health authorities and primary care groups to identify baseline spending for PCGs on hospital and community health services, prescribing and cash- limited general medical services.

HAs and PCGs to set up clearing houses to 'help get primary care management staff into the right places for the establishment of PCGs'.


Baseline PCG spending on specialised services identified.

Further guidance on longer-term service agreements.


Health Improvement Programmes to be agreed by all parties.

HA cash allocations decided.


PCG cash allocations decided.

Talks to begin on service agreements for 1999-2000.