Trends in health services management.
This paper describes how the NHS in the United Kingdom needs to continue to adapt and evolve in response to six major pressures, and how the corresponding challenge facing managers in the NHS is how to cope, adapt and tackle those pressures. The foundation was laid in 1984 with the introduction of general management from central government down to the sub-units of the nine District Health Authorities in Wales. This signalled a change in the service from one merely administered to one which was actively managed. The NHS manager must now concentrate on a number of fronts, notably planning, performance objectives, policy management, resource allocation and positive management of change. The Corporate Management Programme for Wales published in 1988 reinforces fundamental management principles and describes an agenda of management initiatives and objectives for the NHS in Wales over the next five years. The Programme has initiated the process of Corporate Planning. The future trend in health services management is interwoven with the programme of reform of the NHS introduced by the Government's White Paper 'Working for Patients' published in 1989. Initiatives introduced in Wales which will assist this programme of reform are described.