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Priorities, protocols and outcomes: contracting for your caseload
Author(s) -
MEIKLE MARGARET S
Publication year - 1995
Publication title -
international journal of language and communication disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.101
H-Index - 67
eISSN - 1460-6984
pISSN - 1368-2822
DOI - 10.1111/j.1460-6984.1995.tb01648.x
Subject(s) - negotiation , business , order (exchange) , currency , charter , quality (philosophy) , health care , process (computing) , operations management , psychology , actuarial science , finance , computer science , economics , political science , economic growth , philosophy , epistemology , monetary economics , law , operating system
The process of negotiating for speech and language therapy services has changed considerably in the last four years. It is no longer possible to rely on the service being purchased just because it is there. Purchasers have become much more sophisticated in determining their requirements, and cost, quantity and quality have many elements. As in many districts throughout the country, Portsmouth found itself apparently with a demand that outstripped the supply of resources available. In meeting our purchaser's requirements under the Patient's Charter (DoH, 1992) that we see people for the first time within six weeks, a subsequent waiting list and waiting time for treatment built up to unacceptable levels. In order to try and respond to clinical need, the following measures were developed: (1) Priority Rating Scales — all patients seen for an initial appointment and assessment were given a priority rating; (2) Each disorder was approached according to defined clinical protocols; (3) Each episode of care was measured against established goals and outcomes were recorded by use of a light pen data recorder. This paper will briefly outline the development of each of the three areas above and discuss the benefits and advantages already perceived. The paper also highlights the use of the above tools in contract negotiation in an endeavour to ensure that there is more meaningful currency between the purchaser and ourselves as providers. In an environment within the public sector, where there is minimal new financial growth, purchasers of healthcare are keen to ensure that there is a clear return for their investment. There is a requirement on all providers to clarify their capacity within existing resources and to be more detailed about identifying shortfalls in provision. It is necessary for all professional managers to take the lead in these areas in order to ensure their service maintains a high profile during the agreeing of contracts.