Linda Marks1, David J Hunter. 1. Wolfson Research Institute, School for Health, Durham University Queen's Campus, Thornaby, Stockton on Tees TS17 6BH, UK. linda.marks@durham.ac.uk
Abstract
OBJECTIVES: The objective of this study was to identify factors influencing the capacity of NHS managers to 'manage for health'. STUDY DESIGN: Semi-structured interviews (32) were carried out over the telephone or face to face with national stakeholders (15) and NHS senior managers (17) from four Strategic Health Authorities (SHAs) and five Primary Care Trusts (PCTs) in England. Interviews were transcribed and a qualitative analysis carried out. RESULTS: The current system of targets and incentives prioritised access to acute services, public health skills were too thinly spread, baseline data were inadequate, decision-making for public health investment was fragmented and evidence for effective interventions was scanty. Health improvement targets should be plausible, longer term and locally owned, but key factors in creating a proactive public health organisation were a strong public health ethos, and effective management and leadership skills. Strengthening the NHS's role in managing for health was welcomed, but enthusiasm was tempered by concurrent NHS policy initiatives and incentives pulling in opposing directions. CONCLUSIONS: Key NHS policy initiatives have been developed in isolation from each other. While their combined effect remains unpredictable, they may serve to threaten the welcome shift towards managing for health improvement.
OBJECTIVES: The objective of this study was to identify factors influencing the capacity of NHS managers to 'manage for health'. STUDY DESIGN: Semi-structured interviews (32) were carried out over the telephone or face to face with national stakeholders (15) and NHS senior managers (17) from four Strategic Health Authorities (SHAs) and five Primary Care Trusts (PCTs) in England. Interviews were transcribed and a qualitative analysis carried out. RESULTS: The current system of targets and incentives prioritised access to acute services, public health skills were too thinly spread, baseline data were inadequate, decision-making for public health investment was fragmented and evidence for effective interventions was scanty. Health improvement targets should be plausible, longer term and locally owned, but key factors in creating a proactive public health organisation were a strong public health ethos, and effective management and leadership skills. Strengthening the NHS's role in managing for health was welcomed, but enthusiasm was tempered by concurrent NHS policy initiatives and incentives pulling in opposing directions. CONCLUSIONS: Key NHS policy initiatives have been developed in isolation from each other. While their combined effect remains unpredictable, they may serve to threaten the welcome shift towards managing for health improvement.
Authors: Lindsay Prior; Joanne Wilson; Michael Donnelly; Andrew W Murphy; Susan M Smith; Mary Byrne; Molly Byrne; Margaret E Cupples Journal: Health Expect Date: 2011-12-12 Impact factor: 3.377
Authors: Daniel Turner; Sarah Salway; Ghazala Mir; George T H Ellison; John Skinner; Lynne Carter; Bushara Bostan Journal: BMC Public Health Date: 2013-03-26 Impact factor: 3.295
Authors: David C Taylor-Robinson; Beth Milton; Ffion Lloyd-Williams; Martin O'Flaherty; Simon Capewell Journal: BMC Public Health Date: 2008-12-18 Impact factor: 3.295