ABSTRACT
Introduction Measuring the outcome of healthcare is not new but it is increasingly important. There are three main drivers: ●● Concerns about quality of care – beginning with the Bristol Royal Infirmary Inquiry and the Shipman
affair, but continuing more recently with the Mid-Staffordshire Inquiry. ●● Financial constraints – universally, the funding to pay for healthcare is being outstripped by demand,
and doubly so since the recession, with real-terms reduction or flat cash settlements for the NHS. This is shifting the focus away from paying for activity and towards productivity, paying for outcomes and ‘value’ – benefit or outcome of care per unit cost. Commissioners of care are increasingly looking towards outcome-based commissioning.
