The NHS recently took a significant move forward in being open and transparent about results, with the decision to publish data on outcomes for individual surgeons.. Last week, data on all but six vascular surgeons across the country was made available.
Heart surgeons have been doing this since 2005. According to Cardiac Surgeon Professor Ben Bridgewater, there have been big improvements in quality as a result: ‘the mortality rates in cardiac surgery today are about a third of what they were ten years ago’. Not all of this will be down to the publication of data, of course, but a third reduction in mortality rates is a big deal.
League tables have been used in education for years, to help parents vote with their feet and make the best choice for their child. They provide an open way for parents to see how well the school is doing and demand change if necessary. But there have always been complaints that they are over-simplistic and lead to people gaming the system. In 2001 Wales scrapped league tables in schools as a result.
But then a few years ago, interesting research from the University of Bristol showed that Wales was performing poorly on educational achievement and educational inequality because it had lost the accountability measure of the league tables. Without the same pressure on poor-performing schools to improve, and because poor kids are more likely to go to bad schools as richer parents have the option of moving away from poor schools, disadvantaged children were badly affected. The researchers concluded that bringing back league tables would be the most cost-effective way to improve the performance of schools. A few years later Wales brought back a modified version of the league table.
This research on education and the NHS’s recent move leads me to wonder how the charitable sector could benefit from greater transparency. NPC is a big fan of shared measurement approaches, where organisations working in the same sector measure outcomes in the same way. It reduces costs to charities, by saving time and resources, and helps them compare their results to those of their peers.
We’re working on shared measurement approaches in the criminal justice and youth employability sectors. But when we talk about shared measurement, we come across people who are reluctant to try it because they worry it will lead to benchmarking. Charities are nervous about what will happen if it becomes easy to compare outcomes, in the same way that schools and surgeons were nervous. But charities could be missing a trick to improve outcomes for the people they are trying to help. League tables help schools realise where they are not performing as well as others. The spotlight of a league table means that people focus on improvements they can make, no matter how small, so they can climb up the league table. Small changes can add up to be big changes. Sometimes as big as a third fewer people dying.