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NHS Outcomes Framework Indicators

The NHS Outcomes Framework provides national level accountability for the outcomes the NHS delivers; it drives transparency, quality improvement and outcome measurement throughout the NHS.

It also sets out the national outcome goals that the Secretary of State uses to monitor the progress of NHS England. It does not set out how these outcomes should be delivered, it is for NHS England to determine how best to deliver improvements by working with Clinical Commissioning Groups to make use of the tools at their disposal.

The NHS Outcomes Framework uses the ONS mid-year population estimates for England as its subject population, and where standardisation is required, the European Standard Population is generally used. All indicators are reported at England level, and are broken down, where possible, by a combination of Age, Lower tier local authority, Upper tier local authority, Region, Religion, Ethnicity, Deprivation decile, Sexual orientation, Gender and Condition.


The framework was developed in December 2010, following public consultation, and is updated on an annual basis to ensure that the most appropriate measures are included. Work is ongoing to improve the framework as a whole by refining existing indicators and developing new indicators in areas currently not covered.

Indicators in the NHS Outcomes Framework are grouped around five domains, which set out the high-level national outcomes that the NHS should be aiming to improve. For each domain, there are a small number of overarching indicators followed by a number of improvement areas. They focus on improving health and reducing health inequalities:

  • Domain 1 - Preventing people from dying prematurely
    This domain captures how successful the NHS is in reducing the number of avoidable deaths.
  • Domain 2 - Enhancing quality of life for people with long-term conditions
    This domain captures how successfully the NHS is supporting people with long-term conditions to live as normal a life as possible.
  • Domain 3 - Helping people to recover from episodes of ill health or following injury
    This domain captures how people recover from ill health or injury and wherever possible how it can be prevented.
  • Domain 4 - Ensuring that people have a positive experience of care
    This domain looks at the importance of providing a positive experience of care for patients, service users and carers.
  • Domain 5 - Treating and caring for people in a safe environment and protecting them from avoidable harm
    This domain explores patient safety and its importance in terms of quality of care to deliver better health outcomes.

Mid-2013 ONS Population Estimates

The Office for National Statistics (ONS) has made us aware of an error affecting the calculation of their mid-2013 population estimates. The estimates of the foreign armed forces special population, which are included within the mid-year population estimates, are incorrect for certain local authorities, counties and regions. The national level population estimates are unaffected. As the error relates to a special population, it only affects the18-59 age range and affects males more than females. Forest Heath is the local authority with the most significant impact with the published population estimate being 3.3% higher than the correct value. The impact on other local authorities is much smaller.

Overall, the population estimates for 45 local authorities, 10 counties/metropolitan counties and seven regions are affected by the error.

For further information please see the ONS Quality and Methodology information:

ONS will release revised mid-2013 population estimates in June 2015, after which we will update all affected indicators. A full list of affected indicators is contained within the Commentary.

Our commitment to continuous improvement

Like all indicators managed by the Health and Social Care Information Centre, the NHS Outcomes Framework Indicators will be subject to continuous review, using our Indicator Assurance Process.

We welcome further comments and suggestions for improvement on the NHS Outcomes Framework Indicators, please send to

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