1. Indicators and targets have been effective in improving performance in a number of areas of health and social care in Scotland. However, current thinking suggests that our present system can be improved upon in terms of its effectiveness in improving services.
2. Principles, which should underlie the development of guidelines and targets, have been identified. An important first principle is to understand why indicators and targets are being used. This review has assumed that the guiding principle for the use of such indicators should be the Scottish Government's purpose of allowing all of Scotland to flourish through achieving sustainable, inclusive growth. Other characteristics of effective indicators include the fact that they are pragmatic, coproduced and subject to continuing review. They should also reflect the performance across the whole system they are trying to measure.
3. The present system of targets and indicators is fragmented and many of the indicators do not lend themselves to effective improvement interventions. A different approach to targets and indicators is necessary.
4. Current indicators have been grouped according to their impact on different stages of the life course. If the aim is to improve healthy life expectancy and wellbeing of individuals, then different indicators have impact on different aspects of the life course.
5. Improving early life, social and economic circumstances of people living with deprivation as well as improving health and social services are all interventions which interact to increase healthy life expectancy. If an effective group of indicators, which would assist continuing improvement, are to be developed, we need to see the drivers of wellbeing as part of a complex system.
6. It is recommended that we move to a system of indicators and targets which allow improvements across a whole system of care to be tracked. It is important that frontline staff, managers accountable for performance and the people who use services coproduce the activities which they can then use to drive improvement.
7. Scottish public services are effective and efficient. A new approach to improving those services can deliver further success in comparison to many other systems.
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