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In the last post on GP Balanced Scorecards in the NHS, I lamented that the GP Practice balanced scorecard from Southwark PCT provided a very limited view of the GPs practices in their area. In fact i was concerned that NHS balanced scorecards rarely pass the basic tests of a proper Balanced Scorecard.  They tend to be operational scorecards, are rarely balanced.

In this one we look at a similar “GP Balanced Scorecard” from Hertfordshire.  To access it you will have to visit this page and then download the excel spreadsheet that contains the scorecard.

Although this so called “balanced scorecard” contains ostensibly the same data the first impression is that it is better presented.  It is much clearer.  You can’t do a comparison directly across GP Practices but you can see a better explanation of the perfoemance of each practice vs their peers.

More improtantly there are far better explanations of the measures that are being used.  This also reveals the problem with this data.  It is curious that the example I am looking at is dated Nov 2010.  What is immediately apparent is that the data is quite historic and probably only updated once a year.  At least half the data is from the National GP patient survey conducted between 1st July 2009 and 30th June 2010.  Given it is now April 2011, this data is almost 18 months out of date.   Even at the time it was produced the data was between 6 and 18 months out of date.  Even the screening programme figures date to 2009/10.

So while this is a reasonably good, comprehensive picture of some of the interaction and services between the patients and the surgery, it is only of use perhaps once a year.

So here is the important question.  To whom is this useful?  Remember that a Balanced Scorecard and its Strategy Map is designed for a management team.  So, which management team would make decisions on the basis of this information, especially if it is only updated once every year?

Looking carefully at the spreadsheet there is the slighest clue that this is not used for any decision making at all.  In fact on the excel tab it is labeled “Public version”.  Now this is interesting given that there is no such indication on the originating page where it is described as the “GP balanced scorecard”.  Well it clearly is not.  It is the public’s limited (not balanced) scorecard of the GP ‘s practices.  Could I use it to choose my GP?  probably not, though it might suggest one to avoid (asuming they have not changed).

So what we do not have is any clue as to what the PCT uses to manage the GP practices on a month to month basis and what they are looking for and managing or seeking to change or influence.  Neither do we have any clue what the actual senior partners at the GP practices are using to manage their practice (apart from aiming to hit these dated targets).