Clinical directors’ views of centralisation and commissioning of cleft services in the UK

BMC Oral Health

Andrea Waylen³  Andrew Ness²  Jonathan Sandy¹  Julia K Scott⁴  Aidan Searle³ 

[1] School of Oral and Dental Sciences, Faculty of Medicine and Dentistry, University of Bristol, Lower Maudlin St, Bristol BS1 2LY, UK;Bristol Nutrition Biomedical Research Unit, UHBristol Education Centre, Lower Maudlin Street, Bristol BS1 2LY, UK;School of Oral and Dental Science, Lifecourse Epidemiology and Population Oral Health, University of Bristol, Lower Maudlin Street, Bristol BS1 2LY, UK;Department of Orthodontics, Derriford Hospital, Plymouth PL6 8DH, UK

关键词: Clinical directors;    Commissioning;    Centralisation;    Specialist services;   

Others  :  1118152
DOI  :  10.1186/1472-6831-15-12

 received in 2014-09-25, accepted in 2015-01-15,  发布年份 2015

【 摘 要 】

Background

To determine the views of Clinical Directors working in the United Kingdom (U.K.) Cleft Service with regard to centralisation, commissioning and impact on cleft service provision.

Methods

In-depth qualitative interviews were conducted with 11 Clinical Directors representing regional cleft services. Interviews were transcribed verbatim, a coding frame was developed by two researchers and transcripts were coded using a thematic, ‘interpretive’ approach.

Results

Clinical Directors perceived the commissioning of cleft services in the U.K. to be dependent upon historical agreements and individual negotiation despite service centralisation. Furthermore, Clinical Directors perceived unfairness in the commissioning and funding of cleft services and reported inconsistencies in funding models and service costs that have implications for delivering an equitable cleft service with an effective Multidisciplinary Team.

Conclusions

National Health Service (NHS) commissioning bodies can learn lessons from the centralisation of cleft care. Clinical Directors’ accounts of their relationships with specialist commissioning bodies and their perspectives of funding cleft services may serve to increase parity and improve the commissioning of cleft services in the U.K.

【 授权许可】

   
2015 Searle et al.; licensee BioMed Central.

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