TY - JOUR

T1 - Managing capacity and demand in a resource constrained environment

T2 - lessons for the NHS?

AU - Laing, A.W.

AU - Shiroyama, C.

PY - 1995

Y1 - 1995

N2 - The purchaser-provider split within the NHS which emerged out of the government's 1990 White Paper, Working for Patients, together with the introduction of the Patients Charter, has imposed new, tighter performance measures on provider units. The internal market has placed clear contractual guarantees on providers in terms of service/care provided. The Patients Charter has set, with little reference to local conditions, required timescales for treatment, i.e. waiting time guarantees for patients. The government is committed to reducing these guaranteed waiting times further. Both these factors have forced provider units to look far more closely at the way they operate, and the way they provide services. The impact of these performance measures has been magnified by the tight budgetary constraints within which provider units are currently expected to operate. Consequently the option of increasing service provision through expanding facilities and staff has effectively been precluded in the majority of instances. Thus provider units have been forced into reappraising the manner in which service provision is structured and the services delivered. While this restructuring of service provision has been most obvious in those services where the internal market has had the more immediate effect - for example, direct access services such as physiotherapy - increasingly, performance measure pressures have forced providers to examine the processes by which they deliver both in-patient and out-patient care. Analyses the difficulties encountered by an NHS Trust in Scotland in managing capacity and demand in a specialist out-patient clinic.

AB - The purchaser-provider split within the NHS which emerged out of the government's 1990 White Paper, Working for Patients, together with the introduction of the Patients Charter, has imposed new, tighter performance measures on provider units. The internal market has placed clear contractual guarantees on providers in terms of service/care provided. The Patients Charter has set, with little reference to local conditions, required timescales for treatment, i.e. waiting time guarantees for patients. The government is committed to reducing these guaranteed waiting times further. Both these factors have forced provider units to look far more closely at the way they operate, and the way they provide services. The impact of these performance measures has been magnified by the tight budgetary constraints within which provider units are currently expected to operate. Consequently the option of increasing service provision through expanding facilities and staff has effectively been precluded in the majority of instances. Thus provider units have been forced into reappraising the manner in which service provision is structured and the services delivered. While this restructuring of service provision has been most obvious in those services where the internal market has had the more immediate effect - for example, direct access services such as physiotherapy - increasingly, performance measure pressures have forced providers to examine the processes by which they deliver both in-patient and out-patient care. Analyses the difficulties encountered by an NHS Trust in Scotland in managing capacity and demand in a specialist out-patient clinic.

KW - article

KW - health care organization

KW - health care policy

KW - health service

KW - health services research

KW - hospital admission

KW - hospital management

KW - management

KW - methodology

KW - national health service

KW - organization and management

KW - orthopedics

KW - outpatient department

KW - patient advocacy

KW - patient referral

KW - standard

KW - system analysis

KW - United Kingdom

KW - utilization review

KW - Ancillary Services, Hospital

KW - Appointments and Schedules

KW - Great Britain

KW - Health Care Rationing

KW - Health Care Reform

KW - Health Services Needs and Demand

KW - Health Services Research

KW - Management Audit

KW - Orthopedics

KW - Outpatient Clinics, Hospital

KW - Patient Advocacy

KW - Referral and Consultation

KW - Scotland

KW - State Medicine

KW - Systems Analysis

KW - Waiting Lists

U2 - 10.1108/02689239510096811

DO - 10.1108/02689239510096811

M3 - Journal article

VL - 9

SP - 51

EP - 67

JO - Journal of Management in Medicine

JF - Journal of Management in Medicine

SN - 0268-9235

IS - 5

ER -