Strategic control for a United Kingdom regional health authority: a conceptual framework

After a brief review of the nature of strategic planning, and the problem of defining health service objectives, the paper concentrates on the question of decision making and "strategic control," in the context of a regional health authority, a system at the level of the organization. The purpose of monitoring is defined in detail. A critical review of concepts of control in various disciplines considers their suitability to the health authority context. An integration of feedforward and feedback control loops is developed in order to meet the specific characteristics of a system in which "environment" can be viewed as the "input," and to provide the adaptive, learning capability which is required by the situation of insufficient data, ignorance of underlying mechanisms, and continuing change.