Performance Assessment and Wicked Issues

Blackman, Tim (2015). Performance Assessment and Wicked Issues. [Data Collection]. Colchester, Essex: UK Data Archive. 10.5255/UKDA-SN-851743

Performance assessment is an established feature of local government and the National Health Service in the UK, but has only recently been extended to health inequalities, a 'shared priority' across these sectors. Whether performance assessment can work with a 'wicked issue' of this nature, where causation and accountabilities are complex, is a central question for the research.

The study is comparing work on tackling health inequalities in localities across England, Wales and Scotland. Since devolution these countries have diverged in their approaches to both health policy and performance management, so there are opportunities to explore these differences and their implications. The study is based on two phases of interviews with key stakeholders, enabling an analysis to be undertaken of the discourses that are in play and how these differ across countries, localities, sectors, professional roles and time. For example, are targets influencing how upstream or downstream the public health approaches are, and what is the balance between national and local priorities? The interviews are being supplemented by statistical and performance management data from the localities to look at the 'fit' between the local discourses and evidence about health inequalities.

Data description (abstract)

This study aimed to investigate the inequalities in the National Health Service' (NHS) policies and practices at local levels across England, Scotland and Wales using a total of 195 semi-structured face-to-face interviews. The interviews were conducted with 195 public sector professionals in the NHS (mostly in senior management positions) in several case study localities across the three countries in two phases (2006 and 2008). All interviews were transcribed. The time gap between the two study phases of 2006 and 2008 allowed for analysis of the changes over time as new approaches to performance assessment developed and political changes occurred.

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