League tables ‘obscuring’ trust performance

Government’s trust league tables are “actively obscuring” patients’ understanding of their local services and should be scrapped, a think-tank has recommended.

The league tables  are “management tools masquerading as public information” which could encourage providers to do “things that improve a league position without improving care,” the Nuffield Trust said in a blog.

The league tables, updated quarterly and most recently last month, were first published in September by then health secretary Wes Streeting. He hailed them as a key plank of a “new era of transparency and accountability” for the NHS.

Mr Streeting stressed the public value, adding “patients and taxpayers have to know how their local NHS services are doing compared to the rest of the country”.

The tables rank 205 NHS trusts across approximately 30 indicators covering waiting times, cancer access, urgent and emergency care, and financial balance.

But Nuffield Trust CEO Thea Stein argues that while the National Oversight Framework has merit as an internal performance management tool, it “fails” as a guide to the public on the care quality organisations are providing.

She writes in a blog today that after nine months of the league tables, the evidence suggests they “are actively obscuring the picture [about the quality of local services for patients] rather than illuminating it”.

“What patients need is clear, relevant, easy-to-understand information about the services they are using and, where it applies, the ability to make a timely, informed choice. The league tables do not provide that… As a public-facing product, they should go.”

She also said they had created “exactly the conditions in which gaming behaviour tends to emerge”.

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Source: HSJ, 3 July 2026