Managers' leaders this week welcomed the government's promised new NHS performance assessment framework as a 'more useful indication of the quality of patient care than crude league tables'.
Health minister John Denham said the framework would provide 'a much fuller assessment of how the NHS is making progress' and claimed it would be a powerful tool in enabling health authorities, primary care groups and trusts to monitor and compare performance.
But NHS Confederation chief executive Stephen Thornton said HAs and trusts would need to standardise costing methods to allow the public to make ' realistic and sensible comparisons' between them.
The framework, which has been revised after consultation last spring and a 'road test' with HAs last summer, is intended to be implemented immediately.
It covers six areas - health improvement, fair access, effective delivery of appropriate healthcare, patient and carer experience, health outcomes and efficiency.
The framework sets 41 performance indicators covering those areas, and the first results are to be published later this year.
Mr Thornton welcomed the framework's emphasis on quality assessment, but said some of the indicators, such as suicide rates, were questionable. 'It is difficult to see how this could be an effective measure of the performance of mental health services,' he said.
'We are also concerned that some important services, such as learning disability, appear to be outside the performance framework.'
Mr Thornton added that health improvements were related to wide socio- economic trends and depended on the activities of local authorities as much as the NHS.
Ministers would have to accept that it would cost more to collect the data and that 'some work will be needed to develop and refine the indicators', he said.
But Dr Kieran Walshe, senior fellow at the health services management centre, Birmingham University, said the indicators would not present collection problems. 'This is existing routine data . It is not hard to collect. The problem is that there are gaps in data. Care is based on inpatient data - we have a lot of that but we have nothing on outpatient clinics.'
While there were no great surprises in the indicators, it was not clear whether they would make comparisons between HAs and trusts easy, he added.
But Dr Walshe said the indicators should not be used as a crude 'naming and shaming' device because that might lead to some trusts attempting to 'subvert data'.
'If you use it in a punitive way then that can have a negative effect on performance and patient care,' Dr Walshe said.
The Association of Community Health Councils for England and Wales was 'disappointed' that indicators for patient and carer experience remained focused on routine statistics. A spokesperson said the framework should facilitate patient choice, local accountability, openness and 'responsiveness to the needs and aspirations of local communities'.
The NHS Performance Assessment Framework www.open.gov.uk/doh/coinh.htm