Creative use of existing clinical and health outcomes data to assess NHS performance in England: Part 2—more challenging aspects of monitoring

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Abstract
There have been recent calls for better data on NHS outputs and outcomes in England.1–4 However, this will require new data collection that could take several years. In the meantime, creative and informed use of existing data, with clear admission of the known shortcomings, may give some indication of how outcomes are changing.5 The main challenges are to measure health validly and to judge how much any improvements are due to NHS interventions.