Performance indicators in the UK National Healthcare Service: keeping the balance?

The changing context in the UK Labour Government policy and legislation to deliver healthcare reflects a discontinuity in the way that the National Health Service (NHS) organisations are controlled. The analysis in this paper shows that the use of Performance Indicators (PIs) dominates as a means of keeping the balance between resource constraints and the service delivery. The implication is that the intensification of PIs has led to dysfunction of behaviour and contradictions at the organisational level. There are indications that the pressure to meet key targets has distorted clinical priority and, hence, there is the need to pay close attention to the way that the local-level organisations are interacting. The paper adds to our understanding of control in the UK NHS Trusts. It discusses the relationship between institutions and organisations, particularly how organisational systems react in the light of the societal steering media trying to control them