Table 1 Organisational decision-making levels

the national or regional level, where the healthcare budget is decided…includes decisions regarding increases or reductions in spending, or financing of particular programmes.

local level (regional or hospital), where resources are allocated to different functions and local authorities make decisions about local priorities.

the care level, where healthcare professionals make decisions about who, how, when, where and how to care for patients.

…represents the key constraint within which further divisions of funds between regions and local health providers.

…choices may involve the priorities attached to treatment services versus preventative medicine; particular patient groups, or certain hospital services.

…the question of professional prerogative can be limited by constraints from above.