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‘Managing the cracks’: Management development for health care interfaces
Author(s) -
Hunter David J.
Publication year - 1990
Publication title -
the international journal of health planning and management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.672
H-Index - 41
eISSN - 1099-1751
pISSN - 0749-6753
DOI - 10.1002/hpm.4740050103
Subject(s) - realm , health care , accountability , public relations , business , purchasing , action (physics) , interface (matter) , private sector , public sector , process management , knowledge management , marketing , political science , economics , computer science , economic growth , bubble , maximum bubble pressure method , parallel computing , physics , quantum mechanics , law
The realm of public policy (including health policy) is, in many ways, more complex than that of decision‐making within the corporate organisations found in the private sector. The range of stakeholders is generally wider; many of the ways of influencing action are more subtle and indirect; and, arrangements for representation, accountability and consultation are correspondingly more elaborate. A future of this complexity in healthcare systems is the presence of numerous organisational and managerial interfaces. The paper considers three key sectors and the interfaces between them: primary health care, hospital care, and community care. Proposals for reforming the British National Health Service and community care services are destined to multiply the interfaces to be managed since they are predicated upon a split between purchasing services and providing them. The intention is to encourage a plurality of providers who will compete for contracts. The paper argues that the challenge posed by interface management is probably greater than any other in healthcare management. The requisite skills for successful interface management are reviewed. The paper concludes that these network skills are in short supply and that those responsible for management development in the NHS must tackle this lacuna as a matter of some urgency.