ABSTRACT
This chapter argues that the form service evaluation takes can have a major impact upon service development. It also argues that systems of evaluation have the potential of mistaking efficiency for quality. The UK government's concern over expenditure of the public sector generally, and the health and social services in particular, became focused around what has become known as the '3 E's' - economy, efficiency and effectiveness. A major criticism of health and social care services was that they were judged to be inefficient in terms of providing an optimal level of services for a given amount of resources. However, recent experience in the UK has been dominated by outcome evaluation. One example of this is the evaluation of accident and emergency units in the UK against citizens charter stipulations. The chapter also shows that current forms of evaluation which are based primarily on outcome are problematic because they do not fully incorporate realisation of organisational goals.
