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This paper seeks to describe an application of the Public Sector Scorecard (PSS) to Sheffield's Stop Smoking Service.

The paper uses the PSS, an integrated service improvement and performance measurement framework for the public and voluntary sectors. The PSS shares the key advantages of the Balanced Scorecard in ensuring that performance measures reflect all aspects of an organisation's performance and have clear links to the organisation's strategy. In addition its structure and methodology, with more emphasis on service user involvement, working across organisational boundaries, process mapping, service improvement, and risk management, provide many additional benefits to organisations in the public and voluntary sectors. The study incorporated service user workshops with over 100 service users and a series of meetings with a reference group containing staff, service users and other key stakeholders.

The paper concludes that the PSS has many benefits both in improving a public health service and in aligning its strategy, processes and performance measures both with one another and with the requirements and expectations of service users and other key stakeholders.

The paper will be of use to anyone interested in integrating strategy, service improvement, and performance measurement whether in public health or in other public or voluntary organisations.

The authors examined the cardiac care pathway with the aim of identifying factors that impact on diagnosis and treatment of coronary heart disease in British Pakistani women.

This is an exploratory qualitative study. In depth interviews and focus groups with an opportunistic sample of Pakistani women and a purposive sample of clinicians working at different points along the care pathway were conducted. The authors used a pathways to care approach to illustrate how their individual and cumulative effect may contribute to differential receipt of treatment, including revascularisation, and health inequalities.

Four major issues were identified: complex life circumstances; “atypical” presentation and symptomatology; problems related to investigative testing; and poor communication. Mapping these barriers onto the Pathways to Care Model provided valuable insight into their impact on patients' progression through the different stages of the care pathway.

Adopting a care pathway approach demonstrated how individual factors have an impact at several points along the care pathway. It indicated where further, more detailed enquiry is merited and where intervention studies might usefully be directed to improve care.

Examining the whole care pathway identified areas of service improvement that merit a co‐ordinated response.

The framework provided by the Pathways to Care Model offered insight into the causes of the previously observed attenuation in women's progress along the cardiac diagnosis and treatment pathway and is an important first step to addressing this health inequality in a holistic way.

The Public Sector Scorecard (PSS) is an integrated performance management framework incorporating strategy mapping, service improvement, and measurement and evaluation. It adapts and extends the balanced scorecard to suit the culture and values of the public and voluntary sectors. The purpose of this paper is to assess, with the aid of two case studies across organisational boundaries, how the PSS addresses a number of critical success factors for performance management and improvement in the public and third sectors.

The research takes a case study approach assessing the use of the PSS for the UK Ethnic Minority Employment Task Force, and for Sheffield Let’s Change4Life, a £10 million programme addressing obesity in children and families.

This paper concludes that the PSS is an effective framework to help organisations improve outcomes for service users and stakeholders without increasing overall cost, and develop measures of performance that help them improve and assure quality without motivating staff to achieve arbitrary targets at the expense of poor service to the public. Key to this is its emphasis on developing a performance management culture based on improvement, innovation and learning rather than a top-down blame culture.

There have been many research papers describing the problems and pitfalls of public sector performance management, but few which offer a solution. A particular innovation is how the theory of planned behaviour was integrated with a performance management framework for a behaviour change programme addressing childhood obesity.