Specialty location decisions in the reformed NHS: a case study.
A soft systems approach, largely based on soft systems methodology, was used to steer a study (completed in 1996) of the National Health Service contracting process. It led to action research projects on a number of related issues. One such area that emerged very strongly concerns service rationalization and service planning, and in particular the location of 'small' specialties. A Trust-based study involving patient flow modelling demonstrates the form these problems can take within the internal market and highlights the challenge they make to the contracting process or the new primary care group based commissioning process if they are to be resolved in a rational manner.
Hindle
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T
Management School, Lancaster University, UK.
Roberts
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E
Worthington
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D
D002391:Catchment Area, Health; D003284:Contract Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D019981:Health Care Sector; D006297:Health Services Accessibility; D006302:Health Services Research; D006280:Health Workforce; D006779:Hospitals, Public / Q000458:organization & administration / Q000706:statistics & numerical data*; D008511:Medicine / Q000458:organization & administration; D015233:Models, Statistical; D019982:Organizational Case Studies; D011365:Professional Practice Location; D013038:Specialization; D013222:State Medicine / Q000191:economics / Q000458:organization & administration*; D013597:Systems Analysis; D006113:United Kingdom