Efficiency, effectiveness and efficacy: towards a framework for high-performance in healthcare commissioning

Abstract

This article reports on research to identify the key characteristics of highperforming healthcare commissioning organizations of the future. Previous assessments have focused on efficiency and effectiveness, but have paid no attention to the role of efficacy which this research suggests is crucial. In order for healthcare organizations to become high-performing they must be able to re-construct the criteria of performance for the healthcare system deployed by the government and other key stakeholders. Although this study focuses on English healthcare organizations, this article suggests that the importance of efficacy similarly applies in other sectors and other geographical locations given the dominance of notions of performance worldwide.

Additional information

Notes on contributors

Helen Dickinson

Helen Dickinson heads the health and social care partnership programme at the Health Services Management Centre (HSMC), University of Birmingham.

Edward Peck

Edward Peck is Professor of Public Services Development, University of Birmingham.

Joan Durose

Joan Durose is a senior fellow, HSMC, University of Birmingham.

Elizabeth Wade

Elizabeth Wade is a senior policy manager for the NHS Confederation, London.