ABSTRACT
This chapter describes the development of performance indicators nationally
in the UK. It begins with an outline of the historical development of PIs, from
the early days of monitoring in health and social care to the emergence of more
well-defined indicators during the 1980s. This history is predominantly one of
regulation, with indicators being used as mechanisms of control of local
authorities by central government. The content of these indicator systems is
described as a prelude to later chapters where the development of PIs for local
social care practice is discussed. Some criticisms of these indicators are also
outlined. The discussion then moves on to the use of PIs in terms of other
stakeholders: local authorities and the consumer. The historical review
concludes with an outline of the use of PIs during the 1990s: in central
government; as part of the community care reforms; and as an aid to service
review by the public. Finally, the rationale and use of indicators as part of the
government’s recent modernisation agenda for health and social care is
described. In order to consolidate these historical issues, the discussion then
moves on to look at conceptual work on PIs with a review of definitions,
models and descriptions. The chapter closes with a discussion of the actual use
of PIs, focusing on techniques of analysis and some conventions commonly
used.
