Facing up to New Realism: The case of using the Target Cost Management approach in healthcare delivery Management
Ganye, Kwah Driscole
Thesis or dissertation
University of Exeter
This study emerged out of the difficulties to identify the type of management model(s) used by the NHS to manage it care delivery portfolios. Amidst a period of persistent negative returns on care delivery output, questionable quality issues, shrinking resources, public outcry about hospital performances and management distress, this study set up to identify and examine three aspects within operations management and strategy related to the healthcare in general and NHS healthcare delivery management system in particular. The first is to determine the type of strategic management model deployed by the NHS. Being the principal healthcare deliverer in the UK, the study initially assumes that the NHS deployed a robust cost management model which is hypothetically holistic and runs through the entire care delivery value chain. Investigation presented in this thesis shows that such a model is not in use within the NHS management framework. This vacuum led to the proposal that Target Cost Management (TCM) model could be adopted by the NHS. The main reason for this is that the TCM system will fits well within the NHS benchmarking operation and care delivery requirements. The second aspect of the study seeks to understand what the TCM model is all about plus the reasons why it is being considered as a more superior system than other costing methods. When compared with the popular cost–plus or the traditional costing system, TCM is identified as being ex–ante, price based, dynamic and strategic, meeting modern cost management needs while others are more ex–post and cost – based and considered outdated. Seeking whether TCM could be applied in the NHS, a case study is designed to test the hypothesis thereby justifying such proposition since there is limited implementation of this phenomenon of interest in other studies.
MASTER OF PHILOSOPHY IN MANAGEMENT