(Staff exit) The reconfiguration of the clinic's physical layout to facilitate student supervision also resulted in the clinic functioning more efficiently for other staff.
It will also help to determine whether the service is being used as policymakers intended, that is, to deal with immediate and unexpected health problems and indicate whether the service could be optimised to better manage demands for healthcare, for example, through changes in staffing structures, service reconfiguration or examining ways to improve access.
Implementation costs (such as set-up costs, staff training costs, service reconfiguration costs, costs for dual running of usual care and RM services) were not included in the model but are often a consideration for the health organisations.
We did not consider costs associated with staff retraining and service reconfiguration required to change practice away from the standard of transurethral resection, but these are likely to be small if the cost effective strategy of vaporisation followed by holmium resection in the case of failure or relapse is adopted as sufficient capacity already exists.
(iii) Following analysis, engagement with service commissioners led to successful negotiation of a business plan for service reconfiguration with increased staffing levels for Unit A and further development of local community rehabilitation services.
To date however, there has been very limited published research data objectively evaluating the impact of service reconfiguration on clinical services and staff in the UK NHS.
For example, the introduction of "hot weeks" in gynaecology emergency (one week blocks where consultant gynaecologists are on call for emergency gynaecology from 8 am to 5 pm from Monday to Friday, with all their elective work cancelled) in parallel with the reconfiguration, improved the availability senior medical staff.
As the Namibia example suggests, policy-makers and facility managers can use the WISN method to estimate health worker requirements for a range of needs and scenarios, including making staff adjustments in response to implementation of new services, decentralization, or reconfiguration of primary care services.
(Interview 4, Participant 4) Fragmentation and access to diagnostic services: Primary care staff expressed difficulties accessing diagnostic services due to ongoing service reconfigurations and the involvement of multiple agencies.
The aim of this project was to investigate the impact of the reconfiguration of gynaecological services on the key performance indicators of the Trust (clinical outcomes, patient experience, staff satisfaction, teaching and training, research and development and value for money).
