Health management challenges: the case of hospital from Behind-os-Montes and Alto Douro and East Kent hospitals university NHS foundation trust

It is imperative that healthcare systems, regardless of their source of funding, are sustainable, provide quality care and develop towards their customers’ expectations. This study aims at a comparative analysis between two hospital centres, one belonging to the Portuguese National Health Service and the other to the British National Health Service, in order to identify which strategies have been adopted by their hospital management to reduce health costs without prejudice to the quality of the services provided. To this end, semi-structure interviews were conducted with the financial directors of both hospitals. The questions presented focus on changes in terms of financing, the relationship between costs and quality, improving efficiency by cutting costs, strategies for reducing waste and operating vectors for improving efficiency. In the Portuguese case, his perspective focuses on the management and organisation of services from a perspective intrinsic to the organisation, characterised by restructuring and innovation, based on close and cooperative interrelations between sectors and hierarchies. In the British testimony, we verify a perspective more focused on the outside of the organisation, placing its focus on an inter-relational triangulation between population, organisations and professionals. The focus on health professionals, technology, reorganisation of services and waste stands out as being four fundamental pillars of action for an efficient cost reduction, without impairing quality, considered as areas of intervention relevant to the development of future studies. We also highlight the managers’ concern in cost reduction without prejudice to quality and in promoting services adjusted to the needs of the users.