This would appear to be a weakness in the standards as currently agreed, and Scotland should consider whether patient-reported 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 patient-reported measures in accountability and contracting frameworks (OECD, 2015) 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 whole-system approach to targets and system performance relative to targets, considering the inputs and drivers behind successfully, or unsuccessfully, met targets.