Benchmarking In Health (part I)

The papers in this special issue cover a range of topics and issues on benchmarking in health. The papers cover a wide range of perspectives, from practitioners and academics, covering theoretical and practical aspects of benchmarking. Benchmarking has become an increasingly widespread practice in managing health care provision. The label of benchmarking covers a diverse range of practices. The diversity of practices is explored in this special issue. The papers in this special issue emphasise the growing application and significance of benchmarking and examine the possibility of its use to better understand and improve health service performance. Internationally, many schemes have been devised to assist health care practitioners and managers to improve services and cost efficiency. Governments have introduced new cost and information systems and managerial practices, including benchmarking, in seeking to control the fiscal burden of health care provision. Benchmarking has been employed in various guises from external cost comparisons through to improvement of healthcare procedures. This special issue draws together evidence of various attempts to better understand best practice(s). Benchmarking is not a passive process and is likely to alter behaviour in areas being benchmarked. This is a powerful tool if correctly targeted at appropriate “benchmarks” but can equally be dysfunctional where ill-conceived benchmarking practices are adopted. Benchmarking initiatives can be controversial and may be seen by some in health care as another way of merely justifying cost-cutting behaviour and there may be examples where this is the case. However, there is scope for benchmarking clinical as well as financial metrics/outcomes. The following summary of each of the papers provides an overview of the range of issues covered. Northcott, D. and Llewellyn, S., “Benchmarking in UK health: a gap between policy and practice?” In their paper Northcott and Llewellyn note that benchmarking is one of the private sector-grown managerialist tools whose application and significance is rapidly increasing in the UK public sector. Despite its prevalence, the nature (competitive or comparative), the process (based on indicators or ideas) and the outcomes (standards or best practice) of benchmarking in public services remain unclear. Their paper aims to inform the debate on the merits (or demerits) of relative performance evaluation through an examination of current UK National Health Service (NHS) benchmarking policy and practice. Specifically, recent literature and government pronouncements are drawn on to explore whether benchmarking is being used dynamically, to disseminate best practice in healthcare, or whether it is primarily a government tool to enforce static competitive performance standards. The findings reveal that benchmarking requirements, imposed by government policy, are articulated in terms of comparative ideas-benchmarking with the