Door slams shut on targets and opens on a world of outcomes

In their pre-emptive strike against health minister Lord Darzi's next stage review - to be unveiled on Monday - the Conservatives fleshed out their plan to scrap the loathed target culture and replace it with a focus on outcomes.

On the Today programme on Tuesday shadow health secretary Andrew Lansley was at great pains not to use the T-word - in a swerve worthy of a premier league footballer he quickly replaced the word "targeting" with "focused on".

In reality a highly selective group of targets is likely to remain no matter who is in power. But it is clear from across the political spectrum that the days of process-focused targets are broadly coming to an end, giving way to quality and outcomes. If there was a time when process targets were the electricity to jolt the NHS into providing a better service, it is now passing.

In the new world it will be data, much of it provided by patients themselves, which will be the engine of service improvements. Measures of a range of outcomes will allow patients - with the right advice and support - to make informed choices between trusts and clinical teams. NHS medical director Sir Bruce Keogh is clearly determined to push this data into the public domain.

Long term goals (the Conservatives cite getting five-year survival rates for cancer in excess of EU averages by 2015, for example) are of course laudable, but the timescales are so long that an NHS depending on these alone would struggle to use them to drive improvement. Patient reported outcome measures are much more timely and valuable in pushing change and promoting excellence.

Next week we will see how Lord Darzi plans to move the service towards outcomes and quality. Enjoy the spectacle of the politicians doing what you have been suggesting for years.