Service-line management

Service-line management is a system in which a hospital trust is divided into specialist clinical areas that are then managed, by clinicians, as distinct operational units.

Service-line management enables clinicians and managers to plan service activities, set objectives and targets, monitor financial and operational activity and manage performance. Service-line reporting provides the necessary data on financial performance, activity, quality and staffing.

Service-line management: Can it improve quality and efficiency? presents the findings from a series of interviews with staff at seven NHS trusts that are using SLM or SLR, revealing how they are implementing this approach and identifying what helps and what hinders this way of working.

The paper outlines a number of important issues for trusts to consider when introducing SLM.

• The role of the board – including the need for both clear and consistent executive support for using SLM and for executives to be willing to relinquish control over decisions and budgets.
• Clinical engagement – especially the need to provide support and training to enable clinicians to take on leadership and management roles and to develop shared and realistic goals.
• Data – including identifying and evaluating existing sources of data and the need to accept that the time needed to implement SLM, the value of the information obtained, and the ease of data collection will vary between service lines because of external and clinical factors.
• Resources – including the challenge of finding the time and resources to dedicate to the introduction of SLR and SLM and the need for well-resourced and suitably skilled financial and informatics support.

The paper concludes that implementing SLR and SLM well is challenging, but it works best when it is part of the overall management approach of the trust and its day-to-day way of working.

Read Lara Sonola's blog on service-line management and its effect on the NHS