Annex A > Chapter 5 - Regional, District and Trust Management > Management structures throughout the period in question > Targets
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Targets
138 Targets, typically financial or clinical, were set for the services by the RHAs and imposed on the hospitals through the DHAs. The B&WDHA was subject to targets set by the SWRHA and was constrained by the policies of the RHA in what it could or could not do.
139 Dr Pitman explained that the Region held the budget for any significant development of a major Region-wide service, and the District would not embark on such a development without specific support from the Region. There would have to be discussions with the Regional Finance Officer on cost and expected levels of service. [163] She said:
`It would have been a regional team of officers, the Regional Finance Officer and probably the RMO and others who were involved, like the Service Planning Officer, who decided at what level they should be encouraging the District, and Districts at that time were encouraging their units to hit those targets or guidelines.' [164]
140 If the targets set for operations were not met, the Region was involved further. It addressed the matter in reviews to discuss ways in which the targets were to be met in future.
141 Policy flowed down from the DHSS to Region to District to the hospitals that provided the service. For example, in 1984 there was a view at Ministerial level that it would benefit patients to be treated locally and not travel across regional boundaries, and also that a greater case throughput led to more experience which in turn led to greater expertise and therefore better outcomes. It was at the April 1984 meeting between the SWRHA and the DoH, that a desire to increase the cardiac surgery caseload, for both adult and paediatric cases, to 600 per annum at the BRI was expressed on behalf of the Minister. [165]
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Footnotes
[165] UBHT 0102 0434; minutes of meeting April 1984 and T56 p.32 Miss Hawkins