Measuring NHS output growth

We report estimates of output growth for the National Health Service in England over the period 2003/4 to 2006/7. Our output index is virtually comprehensive, capturing as far as possible all the activities undertaken for NHS patients by both NHS and non-NHS providers across all care settings. We assess the quality of output by measuring the waiting times and survival status of every single patient treated in hospital, and we allow for improved disease management in primary care. We propose and apply a method that avoids the traditional requirement for consistent definition of output categories over time in construction of output indices. Use of our approach is critical: it would be not otherwise be possible to calculate output growth for the NHS over the years we consider in any meaningful way. After correcting for significant improvements in data collection in the early period, output growth for the NHS between 2003/4 to 2006/7 averages 5.1% per year, of which 1% is due to improvements in the quality of care.