TY - JOUR
T1 - Managing poorly performing clinicians
T2 - Health care providers' willingness to pay for independent help
AU - Watson, Verity
AU - Sussex, Jon
AU - Ryan, Mandy
AU - Tetteh, Ebenezer
PY - 2012/3
Y1 - 2012/3
N2 - Objective: To determine the willingness to pay (WTP) of senior managers in the UK National Health Service (NHS) for services to help manage performance concerns with doctors, dentists and pharmacists. Methods: A discrete choice experiment (DCE) was used to elicit senior managers' preferences for a support service to help manage clinical performance concerns. The DCE was based on: a literature review; interviews with support service providers and clinical professional bodies; and discussion groups with managers. From the DCE responses, we estimate marginal WTP for aspects of support services. Results: 451 NHS managers completed the DCE questionnaire. NHS managers are willing to pay for: advice, 'facilitation', and behavioural, health, clinical and organisational assessments. Telephone advice with written confirmation was valued most highly. NHS managers were willing to pay £161.56 (CI: £160.81-£162.32) per year per whole time equivalent doctor, dentist or pharmacist, for support to help manage clinical performance concerns. Marginal WTP varied across respondent subgroups but was always positive. Conclusions: Health care managers valued help in managing the clinicians' performance, and were willing to pay for it from their organisations' limited funds. Their WTP exceeds the current cost of a UK body providing similar support. Establishing a central body to provide such services across a health care system, with the associated economies of scale including cumulative experience, is an option that policy makers should consider seriously.
AB - Objective: To determine the willingness to pay (WTP) of senior managers in the UK National Health Service (NHS) for services to help manage performance concerns with doctors, dentists and pharmacists. Methods: A discrete choice experiment (DCE) was used to elicit senior managers' preferences for a support service to help manage clinical performance concerns. The DCE was based on: a literature review; interviews with support service providers and clinical professional bodies; and discussion groups with managers. From the DCE responses, we estimate marginal WTP for aspects of support services. Results: 451 NHS managers completed the DCE questionnaire. NHS managers are willing to pay for: advice, 'facilitation', and behavioural, health, clinical and organisational assessments. Telephone advice with written confirmation was valued most highly. NHS managers were willing to pay £161.56 (CI: £160.81-£162.32) per year per whole time equivalent doctor, dentist or pharmacist, for support to help manage clinical performance concerns. Marginal WTP varied across respondent subgroups but was always positive. Conclusions: Health care managers valued help in managing the clinicians' performance, and were willing to pay for it from their organisations' limited funds. Their WTP exceeds the current cost of a UK body providing similar support. Establishing a central body to provide such services across a health care system, with the associated economies of scale including cumulative experience, is an option that policy makers should consider seriously.
KW - Discrete choice experiment
KW - Health care quality assurance
KW - Health economics
UR - http://www.scopus.com/inward/record.url?scp=84857443346&partnerID=8YFLogxK
U2 - 10.1016/j.healthpol.2011.12.006
DO - 10.1016/j.healthpol.2011.12.006
M3 - Article
C2 - 22251755
AN - SCOPUS:84857443346
SN - 0168-8510
VL - 104
SP - 260
EP - 271
JO - Health Policy
JF - Health Policy
IS - 3
ER -