Total purchasing was the first major 'internal market' policy initiative to be extensively evaluated by the Department of Health and Scottish Office. This report draws together the main evidence from the evaluation in order to inform the development of the new primary care organisations in the NHS, which came into ...
This report summarises the hospital activity analysis for two types of first-wave total purchasing pilots (TPPs), 'commissioner' TPPs and 'co-purchaser' TPPs. The main objective of the analysis was to compare changes in hospital activity, in the areas for which TPPs had objectives, with those of comparators. The authors conclude that: ...
This working paper from the second year of TPPs makes the following key findings: larger TPPs are becoming high achievers; a group of TPPs (43 per cent) improved their performance over two years, about a quarter remained at the same level and about a third dropped out; a greater proportion ...
The NHS (Primary Care) Act 1997 made possible local contracts for general practice services and spawned Personal Medical Services (PMS) pilots. These are intended to make primary care services more sensitive to local needs and are therefore particularly useful in London where long-term infrastructural problems have proved intractable. The King's ...
This report describes the evaluation of total purchasing and extended purchasing sites with an interest in mental health services. A consistent objective of these sites was the improvement of communication and information flows between primary and secondary care. The priority was the development of services for people with common mental ...
The evaluation of the Total Purchasing Pilots (TPPs) provides important lessons for the development of the new primary care organisations envisaged in the English, Welsh and Scottish NHS white papers. Despite originating in a very different context, total purchasing was essentially about groups of practices working together to develop services ...
This report aims to describe the ways in which the structure, role and impact of TPPs may be instructive to PCGs. Practical illustrations are used to demonstrate how particular changes in services were achieved in the context of local conditions, providing useful examples for PCGs. English PCGs are the main ...
This publication is a comprehensive review of health care and policy issues. It includes a detailed description of health events in the last twelve months, as well as discussion of key policy issues. Specific areas dealt with in this issue include: influencing the diffusion of new medical technologies; the future ...