ABSTRACT
Over the last 10-15 years the funding structures and format have been refined, but they still follow the same basic pattern for acute hospitals. More recently, however, those same funding streams have been increasingly used to force delivery of quality targets, such as improved waiting times and better outcomes. Thus the role of the medical manager in the acute setting has changed over the last 20 years from one that was largely to do with being accountable for financial delivery to one where the manager is held to account not only for meeting financial targets, but also for patient safety, clinical outcomes, delivery of national targets, meeting statutory obligations and ensuring ongoing compliance with the various regulatory frameworks that now govern work in the NHS and healthcare in general.
