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Performance and Assurance

Service performance has been impacted significantly over the past two years following the global pandemic, including needing to wait longer to access services and the change in complexity resulting from this. Focusing on performance as a whole across all organisations within the system will be a key enabler for the effective delivery of our Integrated Care System priorities. Integrated performance management and monitoring is essential to enable transformation of services and evidence-based interventions that will improve outcomes across all focus areas

There remains the need to respond to the requirements of the NHS Long Term Plan and the annual NHS Operational Plan and we need to understand the current position with regards to how organisations in our system are performing, the areas of challenge, actions in place to address these and to be assured that health outcomes are improving. 

The National System Oversight Framework aims to achieve and promote delivery of the metrics under the 5 domains, including:

  • quality of care, access and outcomes
  • preventing ill health and reducing inequalities
  • leadership and capability
  • finance and use of resources
  • people.


The Framework encompasses the aims of the Operational Plan within these domains. There is now a national dashboard, that shows current performance and ranking information to enable benchmarking. A local dashboard is being developed to support this and to provide supplementary background information. This will help to drive the programmes of work that are needed to improve performance within agreed timescales and through co-designed action plans.  

Meeting the needs of the population and population health is key to performance management and links closely with the Joint Strategic Needs Assessment and also the Health Inequalities Strategy.        

Key areas of activity include: 

  • develop a single oversight framework for the system, that:

- includes high quality and up-to-date information from all organisations, to improve healthcare and population health and to tackle inequalities in outcomes, experience and access. 
- includes broader health metrics, with a focus on outcome measures to transform and improve population health
- is open and transparent to enable joint ownership of issues, mutual accountability and collaborative working. 

  • ensure a robust monitoring and tracking system for performance, that:

- enables early detection of challenged areas, monitoring of progress and understanding of impact to reduce variation and inequalities across the system
- includes granular information to ensure that inequalities are able to be highlighted down to small geographic locations across the system, to support in service provision and targeting interventions.  

  • embed a mature assurance process rooted in principles of mutual accountability and equal partnership to collaboratively tackle challenged areas and achieve the ICS aims
  • increase partnership working, including on effective performance improvement strategies, with routes to share good practice within the system.