Briefing Paper P038 - Government NHS White Paper Proposals: Transparency in Outcomes – A Framework for the NHS


As part of its work Hastings Voluntary Action have produced this briefing - as part of a series on the Governments NHS White Paper.

Outcomes Replacing Targets

Throughout the General Election campaign conservative health spokespeople were consistently critical of the number of national targets set by Government these they argued created an obsession with measuring small details, soaked up resources on monitoring and did not provide patients with enough information to properly review performance. The consultation seeks views on the creation of national outcomes which will provide an indication of the overall performance of the NHS. It is relevant to patients and communities as it will be against this framework that the Secretary of Health for State will be held to account for the performance of the NHS

Principles Under-pinning the Outcome Framework

The following principles will guide the development of the NHS Outcomes Framework:

  • Accountability and transparency
  • Balanced
  • Focused on what matters to patients and healthcare professionals
  • Promoting excellence and equality
  • Focused on outcomes that the NHS can influence but working in partnership with other public services where required
  • Internationally comparable
  • Evolving over time

5 Key Performance Domains

The Government pledged to replace a target driven culture with one focusing on outcomes by producing an outcome framework for the NHS via which the impact of activity – rather than its processes - could be assessed. This is focussed on the following broad areas or “domains”:-

  • Domain 1: Preventing people from dying prematurely
  • Domain 2: Enhancing the quality of life for people with long-term conditions
  • Domain 3: Helping people to recover from episodes of ill health or following injury
  • Domain 4: Ensuring people have a positive experience of care
  • Domain 5: Treating and caring for people in a safe environment and protecting them from avoidable


It is proposed that the first NHS Outcomes Framework will be published towards the end of 2010 / early 2011 alongside the NHS Operating Framework for 2011/12.

Improved Integrated Working

Many of the outcomes in the Framework will require the NHS to work in partnership with adult social care services, childrens’ services and other local services. The approach to outcomes in these joint areas will be based on the same principles as above, to ensure that outcomes are aligned across the NHS and local partners. The NHS Outcomes Framework should be designed so that it encourages more integrated care.

Further Information

A full downloadable copy of the consultation paper can be found via the Department of Health website:-

Responding to the Consultation

Responses to the questions in this consultation document should be sent to or to the White Paper Team, Room 601, Department of Health, 79 Whitehall, London SW1A 2NS by 11 October 2010.

Group Support: