Uses of Performance Metrics in Clinical and Managerial Networks

It has been widely argued that strategic change in organizations is best supported by encouraging networks, rather than imposing change bureaucratically. In the NHS, the government has been encouraging clinicians and managers to work together in networks to improve performance. This article shows that this kind of networking is difficult to realize. The author explains where the main problems lie: clinical managerial conflict; top-down approaches to the implementation of benchmarking initiatives; and the inadequacy of the evidence base for comparison.