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 ...
While most GP practices participating in total purchasing have some experience of contracting with health care providers, the extension of their responsibilities has, in many cases, taken them into entirely new areas and posed a set of challenges for primary care-based purchasing. This paper concentrates on a central element of ...
In a previous working paper the results of a survey of the contracting arrangements of the 53 first wave total purchasing pilot (TPP) projects during 1996-97 were given. This working paper reports the results of a follow-up survey carried out for the 1997-98 contracting round. The survey was designed to ...
This report is an in-depth, comparative study of the UK plans and US experience of competition in the supply of hospital services. It shows how both competition and regulation policies have been used to contain escalating costs in the US. American experience raises concerns about the impact of competition on ...
This report reviews the performance of health services in Sweden, Holland, West Germany, Canada and USA. The main aim has been to identify the countries' studies, to draw parallels with the UK, and to establish the lessons, if any, from abroad. Chapter one traces the origins of the Prime Minister's ...
This research report attempts to clarify key issues in British nursing for health policy makers. It is specifically aimed at a non-nursing audience, in the hope that it will illuminate important aspects of workforce planning, management and health care delivery for NHS managers and other people concerned with British health ...
The briefing paper provides a constructive analysis of the White Paper (Working for Patients). It argues that the White Paper outlines an ambitious and high risk strategy. The paper identifies main themes underlying the White Paper proposals: new institutional arrangements for the health services; the management of clinical activity; responsiveness ...
This report examines the present state of the 1987 expenditure plans in the light of the most up to date information available. It discusses the different ways in which public expenditure can be measured, followed by an examination of expenditure on Hospital and Community Health Services during the 1980's. The ...