Health Manpower Management

John A. Piper; Barry Muir; Allister Stewart; John Willetts

1997 Health Manpower Management

doi: 10.1108/09552069710175436pmid: 10184781

Effective strategic analysis of existing and potential services requires a framework which is relevant and understandable to both clinicians and senior managers. Our work with NHS trusts has developed a framework based on analysis of services into four principal service streams ‐ emergency general hospital, non‐emergency general hospital, specialist general hospital and tertiary. Relating service streams to clinical specialties provides a matrix which can provide a basis for an initial analysis of the current and prospective clinical services portfolio, allowing drilling down into the detail and back up to the overall picture. Portfolio effectiveness is assessed by considering overall viability consisting of three interrelated elements ‐ clinical, market and financial viability. The inter‐relationship of service streams, clinical specialties and viability allows the trust board and key clinicians to share insights into the current and potential systemic linkages between these three elements and to develop a vision of future strategic direction.

Jane Hemsley‐Brown

1997 Health Manpower Management

doi: 10.1108/09552069710175445pmid: 10173519

Discusses the interpretation of nursing statistics, the problem of counting how many nurses there are in the workforce, and the need to be aware of how statistics are compiled when presenting numerical data to support arguments relating to nursing and the nursing workforce. Argues that NHS workforce statistics provide considerable evidence for claiming that there is a significant decline in the number of nursing staff doing the work of nursing in the NHS. Explains that although there was an increase in the number of qualified nurses working in the NHS throughout the 1980s (over a ten‐year period the number of qualified nurses increased by 22 per cent), the increase in qualified nursing staff has not compensated for the loss of student learners in the workforce. Emphasizes that during the last three years for which figures are available, however, these gains have been wiped out, and the number of qualified nurses has declined to pre‐Project 2000 levels.

Aminah Jatoi; Rosemary Jaromin; Debera Grzybek; Phuong L. Nguyen

1997 Health Manpower Management

doi: 10.1108/09552069710175454pmid: 10173520

Personnel costs comprise the largest clinical laboratory expense. Yet standards to judge the productivity of personnel have not been established. A survey of the authors’ own personnel was conducted to derive productivity standards in the Clinical Hematology Laboratory at the Massachusetts General Hospital, Boston, Massachusetts, USA. Technologists were asked how many white blood cell differentials they could perform in an eight‐hour shift. Differential productivity was tracked before and after the survey. Of the respondents, 100 per cent failed to meet their own expectations of productivity. Nine technologists were tracked both before and after the survey was mailed and manifested a significant increase in productivity. These results suggest that technologists are objective in their assessment of their own productivity, that their opinions might be a resource for establishing productivity standards within the laboratory, and that such surveys may serve as motivational tools to augment productivity.

Clare Kelliher

1997 Health Manpower Management

doi: 10.1108/09552069710175463pmid: 10173521

Seeks to evaluate the policy of competitive tendering for ancillary services in the National Health Service, by reference to a number of case studies of catering services. Argues that the success of the policy was dependent on certain assumptions being met about the extent of competitive pressure and the potential for savings, largely labour cost savings, to be made. Shows by case studies that these conditions frequently did not occur and hence the policy was flawed. Furthermore, even where these conditions did occur, the evidence shows that a range of other factors influenced the extent to which labour cost savings could be made.

John Hindle

1997 Health Manpower Management

doi: 10.1108/09552069710175472pmid: 10173522

Presents a background to process understanding which offers potential benefits to the NHS. Considers the various business processes found in health care organizations, noting that the management of cross‐functional processes is an area in which improvements can be made. Outlines the kind of problems which can result from mismanagement of such processes and the potential benefits of process improvement.

John Hindle

1997 Health Manpower Management

doi: 10.1108/09552069710175481pmid: 10173523

Notes the importance of continuous improvement as a concept to guide management and that this concept requires numerous components to make it work. Picks out the role of information management as a key area, citing factors such as the creation of an “information culture” as being of major importance. Looks at the path followed by some Trusts in pursuit of this “information culture” wherein staff gained an improved insight into the use of information as a management tool.

Hugh Flanagan

1997 Health Manpower Management

doi: 10.1108/09552069710175490pmid: 10173524

Management of the NHS is necessary and vital to effective delivery of health services. It is not a process that can be avoided, whoever does it. New Labour needs effective managers in the NHS if they are to bring about the changes they want to see. Manager bashing, which New Labour is showing signs of continuing, is counter productive and encourages a climate of threat for managers which subsequently translates into bad management practice with its inevitable consequences for service quality and productivity. The NHS badly needs a positive long‐term strategy of serious investment in individual and organizational development. It is a question of balanced investment between the long‐term management capability of the NHS and immediate patient care. The major issues of rationing, priorities and the balance between health and health services will always be part of the difficult national and local management task. Some move by politicians in the direction of open recognition of these difficulties and the burden they place on the skill, will and courage of managers could go a long way to building a caring management culture.