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 aims to describe the experience and adequacy of budgetary and risk management arrangements of all first wave Total Purchasing Pilots (TPPs) in 1996/97. The results of a postal questionnaire sent to every TPP manager were analysed. The authors conclude that TPPs have taken seriously the management of expenditure ...
Total purchasing is potentially the most significant development in NHS purchasing of health services since the introduction of general practitioner fundholding in 1991. It offers fundholding practices the opportunity to purchase all of the health care not included in fundholding for patients on their lists. The study of 53 total ...
Variations in health care in the NHS are a persistent and ubiquitous problem. But which variations are acceptable or warranted – for example, variations driven by clinical need and informed patient choice – and which are not? The important question is how to promote ‘good’ variation and minimise ‘bad’ variation. ...