this would appear to be a weakness in the standards as currently agreed and scotland should consider whether patientreported measures including patient satisfaction and experience should be included several oecd health systems in the nordic countries and in canada for example are increasingly using patientreported measures in accountability and contracting frameworks oecd in an effort to make services more responsive to patient needs and preferences the inclusion of this target helps underline the need to see a wholesystem approach to targets and system performance relative to targets considering the inputs and drivers behind successfully or unsuccessfully met targets