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英文原文
Budget management
Introduction
The NHS reforms have had far reaching implications for clinicians of all grades and specialties. Among other changes, it has been deliberate government policy that senior clinicians should have more direct management and budgetary responsibility within their own clinical areas. Trust hospitals have developed a directorate based management structure and devolved budgets to clinical directors. AE departments have either become directorates in their own right or associate directorates within larger directorates. AE consultants who take on clinical directorship responsibilities will have more direct control of spending within their own department. At first this may seem intimidating, but the advantages of having control outweigh the disadvantages of more administrative activity.
This article aims to give some guidelines to help make the task less daunting, as well as some tips based on personal experience. I do not intend to cover fund raising activity or the organization of postgraduate education and its funding. Brief mention will be made of business planning at the end. And we have outlined what management budgeting is and how it differs from traditional budgetary control systems in health authorities; considered what it aims to achieve; and discussed the participation of clinicians in the management budgeting process and its likely impact on their methods of working.
What is a budget?
Traditional budgetary control systems are based primarily on a structure of what are normally termed functional or departmental budgets. In this structure budgets are held by those people responsible for providing a service.
There is normally no participation of clinical staff in this budgetary control structure other than the possibility that the budget holders for pathology and radiology might be the consultants in charge. This seems strange given the considerable influence that clinicians have over the use of hospital resources.
In any system of b
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