Implementing quality : a study of the adoption and implementation of quality standards in the contracting process in a general practitioner multifund.
The increase in managerialism in the 1980s and the 1990 NHS reforms have had major implications for the regulation of providers.
Purchasers of health care in the UK are now expected to specify three factors in their contracts : volume, cost and quality.
This paper focuses on one of these : i.e. the quality standards purchasers now include within their health service contracts.
The case study is of a general practitioner multifund and the analysis focuses on how quality standards are derived and adopted in outpatient contracts.
The data were derived from in-depth face-to face interviews with the key participants in the contracting process.
The evidence shows that the standards were derived and adopted with very little participation from the providers.
The impact of the quality standards on hospitals consultants'behaviour was negligible, there was very little monitoring of the standards by the multifund, and providers accepted standards which they knew they could not meet.
It is concluded that this non-participatory method of developing the quality standards is likely to mean that their impact on service delivery will be limited.
Mots-clés Pascal : Protection sociale, Qualité, Méthodologie, Evaluation, Royaume Uni, Europe, Monde, Hôpital, Médecin généraliste, Médecin, Personnel sanitaire, Travailleur social, Coopération, Gouvernement, Coopération internationale, Santé publique, Système santé, Europe Ouest, Aspect politique, Géographie, Politique internationale, Politique sanitaire
Mots-clés Pascal anglais : Welfare aids, Quality, Methodology, Evaluation, United Kingdom, Europe, World, Hospital, General practitioner, Physician, Health staff, Social worker, Cooperation, Government, International cooperation, Public health, Health system, Western Europe, Political aspect, Geography, International policy, Health policy
Notice produite par :
ORS Auvergne - Observatoire Régional de la Santé d'Auvergne
Code Inist : 002B30A11. Création : 21/07/1998.