Service-level agreements at the Huddersfield NHS Trust.

Service-level agreements (SLAs) have been claimed to be an excellent vehicle for organisational improvement where there is a substantial degree of departmental autonomy. Such a situation is likely to exist in NHS trust hospitals because of the differentiated nature of the work performed by each department, with varying degrees of specialisation and professionalism, access to patients, use of technology and differing cost bases but also an interdependence of the direct services to the support services. It is proposed that SLAs can be used to promote improved integration between departments, quality assurance and provide a framework for cost transfer charging. The article describes and analyses SLAs from an overview of the idea to the particular implementation to date at the Huddersfield NHS Trust. SLAs have been negotiated between the Directorate of Clinical Support and its customers, and these are supported by computerised measurement and reporting tools.