Learning about competition from the UK's National Health Service

"Hospital competition is an important and significant driver of quality and outcomes improvement. That’s true both for a nationalized health system like the NHS and the private system in the United States."

Learning about competition from the UK's National Health Service
A Frakt
Journal of the American Medical Association
8th July 2015

Read more here.

The NHS: Busting the myths

"The NHS Confederation is publishing a series of myth busters, which challenge common misconceptions and enrich the debates on topical, sometimes controversial, issues regarding our health and care." These are the first three:

• Primary care in the NHS 
• Competition in the NHS 
• NHS Managers

Putting the consumer at the heart of UK healthcare

"The responsibility to allocate healthcare funding should be shifted from politicians and health sector bureaucrats to individual patients. Funding should closely follow patients, so that patients would allocate funding through the choices they made."

A patient approach: Putting the consumer at the heart of UK healthcare
K Niemietz
IEA Discussion Paper No. 64
Institute of Economic Affairs
August 2015

Read more here.

Procurement and competition rules: Can the NHS be exempted?

"An incoming government could make broader changes to policy and the system architecture of the NHS that would ensure that commissioners and public sector providers were rarely subject to these rules in practice."

Procurement and competition rules: Can the NHS be exempted?
B Collins
The King's Fund
March 2015

Read more here.

Mergers in the NHS

"The introduction of competition into the provision of NHS-funded hospital care in England has meant that the work of NHS providers and commissioners has become increasingly exposed to competition regulation."

Mergers in the NHS: Lessons from the decision to block the proposed merger of hospitals in Bournemouth and Poole
E Spencelayh, J Dixon
December 2014

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Public sector commissioning of local mental health services from the third sector

"If commissioners are to lead the transformation of mental health services then there needs to be sufficient investment in their capacity and expertise to ensure that they have the tools and time to undertake this role."

Public sector commissioning of local mental health services from the third sector
J Rees, R Miller, H Buckingham
Third Sector Research Centre: working paper 122
May 2014

Read more here.

How collaborative are quality improvement collaborative

“Individual organizations should assess the costs and benefits of collaboration as a means of attaining quality improvement.”

How collaborative are quality improvement collaborative: a qualitative study in stroke care
P Carter, P Ozieranski, S McNicol. M Power, M Dixon-Woods
Implementation Science, 2014, 9:32

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NHS procurement, patient choice and competition

"This briefing has been produced for peers ahead of a debate that is taking place in the House of Lords on Wed 24 April, following a motion by Lord Hunt of King's Heath to annul the revised regulations. It may also be of interest to other individuals interested and engaged in discussions surrounding the implementation of the Health and Social Care Act."

Parliamentary Briefing: NHS procurement, patient choice and competition: response to draft regulations
Nuffield Trust
April 2013

Read more here.

Hospital quality competition under fixed prices

"The literature shows that more competition increases quality when providers are profit maximisers and marginal cost of treatment is constant."

Hospital quality competition under fixed prices: CHE Research Paper 80
H Gravelle, R Santos, L Siciliani, R Goudie
University of York
November 2012

Read more here.

Competitive integration in the NHS

"Greater integration in healthcare will result in better outcomes for patients and a more seamless patient experience."

All together now: competitive integration in the NHS
H Featherstone, D Skelton, D Prior
Policy Exchange
October 2012

Read more here.

Mental health and the market

"Understanding how the market in mental health works is critical – both for the development of future national policy, as well as for the implementation of existing policy relating to competition and choice."

Mental health and the market
NHS Confederation
October 2012

Read more here.

Choice and competition in public services: learning from history

"This report identifies 11 general rules that current reformers should be aware of when introducing market mechanisms."

Choice and competition in public services: learning from historyT Gash, T Roos
Institute for Government
August 2012

Read more here.

Delivering public services through markets

"Evidence from international and national research suggests that, under certain conditions, competition can deliver higher quality services and improve effi ciency while maintaining equity."

Delivering public services through markets: principles for achieving value for money
National Audit Office
June 2012

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Does competition improve public hospitals' efficiency?

"Our results suggest that competition between public providers prompted public hospitals to improve their productivity by decreasing their pre-surgery, overall and post-surgery length of stay."

Does competition improve public hospitals' efficiency? Evidence from a quasi-experiment in the English National Health Service
Z Cooper, S Gibbons, S Jones, A McGuire
Centre for Economic Performance
February 2012

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Competition in the NHS

"The NHS is far from being a competition-free zone, but the extent of competition remains confined to a minority of the services provided to NHS patients."

Competition in the NHS
Office of Health Economics Commission
January 2012

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Merger mania and hospital outcomes in the English NHS

"Given that mergers reduce the scope for competition between hospitals the findings suggest that further merger activity may not be the appropriate way of dealing with poorly performing hospitals."

Can governments do it better? Merger mania and hospital outcomes in the English NHS
M Gaynor, M Laudicella, C Propper
The Centre for Market and Public Organisation
January 2012

Read more here.

The quest for efficiency in the English NHS

"A competitive, flexible approach to health care delivery will promote innovation, making it possible to learn from health care providers that adopt diferent approaches to delivery."

Competition, integration and incentives: the quest for efficiency in the English NHS
AM Garber
The Nuffield Trust
December 2011

Read more here.

Competition in healthcare

This research scan examines empirical research about the impact of competition in healthcare.


Competition in healthcare
The Health Foundation
April 2011

Read more here.

Can competition and integration co-exist in a reformed NHS?

"This paper discusses evidence and examples of the relationship between competition of
different types and integration of service delivery."

Can competition and integration co-exist in a reformed NHS?
L Hawkins
The King's Fund
July 2011

Read more here.

When and how provider competition can improve health care delivery

"The extent to which competition among providers can increase health care quality and control costs may depend on the clinical setting. The strongest impact may be in out-of-hospital care."

When and how provider competition can improve health care delivery
P Dash, D Meredith
McKinsey Quarterly
Source: Healthcare Payor and Provider Practice
November 2010

Read more here. (This paper is free, but registration is required to read the full text.)