scholarly journals Patient Choice for Older People in English NHS Primary Care: Theory and Practice

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Andrew J. E. Harding ◽  
Frances Sanders ◽  
Antonieta Medina Lara ◽  
Edwin R. van Teijlingen ◽  
Cate Wood ◽  
...  
Keyword(s):  
Primary Care ◽  
Older People ◽  
Theory And Practice ◽  
Patient Choice ◽  
Healthcare Provision ◽  
Care Theory ◽  
Conceptual Paper ◽  
Individual Choices ◽  
English National Health ◽  
English National Health Service

In the English National Health Service (NHS), patients are now expected to choose the time and place of treatment and even choose the actual treatment. However, the theory on which patient choice is based and the implementation of patient choice are controversial. There is evidence to indicate that attitudes and abilities to make choices are relatively sophisticated and not as straightforward as policy developments suggest. In addition, and surprisingly, there is little research on whether making individual choices about care is regarded as a priority by the largest NHS patient group and the single largest group for most GPs—older people. This conceptual paper examines the theory of patient choice concerning accessing and engaging with healthcare provision and reviews existing evidence on older people and patient choice in primary care.

Choice of providers and mutual healthcare purchasers: can the English National Health Service learn from the Dutch reforms?

2010 ◽  
Vol 5 (3) ◽  
pp. 343-363 ◽  
Author(s):  
Gwyn Bevan ◽  
Wynand P. M. M. van de Ven
Keyword(s):  
National Health Service ◽  
Health Service ◽  
The Netherlands ◽  
National Health ◽  
Thought Experiment ◽  
Internal Market ◽  
Patient Choice ◽  
Market Model ◽  
English National Health ◽  
English National Health Service

AbstractIn the 1990s, countries experimented with two models of health care reforms based on choice of provider and insurer. The governments of the UK, Italy, Sweden and New Zealand introduced relatively quickly ‘internal market’ models into their single-payer systems, to transform hierarchies into markets by separating ‘purchasers’ from ‘providers’, and enabling ‘purchasers’ to contract selectively with competing public and private providers so that ‘money followed the patient’. This model has largely been abandoned where it has been tried. England, however, has implemented a modified ‘internal market’ model emphasising patient choice, which has so far had disappointing results. In the Netherlands, it took nearly 20 years to implement successfully the model in which enrollees choose among multiple insurers; but these insurers have so far only realised in part their potential to contract selectively with competing providers. The paper discusses the difficulties of implementing these different models and what England and the Netherlands can learn from each other. This includes exploration, as a thought experiment, of how choice of purchaser might be introduced into the English National Health Service based on lessons from the Netherlands.

scholarly journals Cooperation or competition? Proposed changes in healthcare provision in England

2011 ◽  
Vol 35 (12) ◽  
pp. 441-443 ◽  
Author(s):  
Laurence Mynors-Wallis
Keyword(s):  
National Health Service ◽  
Social Care ◽  
Integrated Services ◽  
Healthcare Provision ◽  
Health And Social Care ◽  
Market Driven ◽  
The Uk ◽  
English National Health ◽  
Targeted Approach ◽  
English National Health Service

SummaryThe Health and Social Care Bill currently going through the UK Parliament seeks to further increase cooperation in the English National Health Service (NHS). The proposals are controversial in significant part because the benefits of competition in healthcare are uncertain. Will patients benefit from innovation and choice brought about by new providers of care or will the vulnerable be faced by geographically variable, fragmented and non-integrated services? Will there be financial savings to reinvest in patient care or will there be increased administration driven by the transaction costs of market driven care? This editorial advocates a cautious targeted approach for the implementation of competition in those areas where current NHS provision is poor rather than whole scale potentially disruptive change.

Activity based financing in England: the need for continual refinement of payment by results

2007 ◽  
Vol 2 (4) ◽  
pp. 419-427 ◽  
Author(s):  
ANDREW STREET ◽  
ALAN MAYNARD
Keyword(s):  
Primary Care ◽  
Quality Of Care ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Day Surgery ◽  
Hospital Funding ◽  
English National Health ◽  
English National Health Service

AbstractThe English National Health Service is introducing activity based tariff systems or Payment by Results (PbR) as the basis for hospital funding. The funding arrangements provide incentives for increasing activity, particularly day surgery, and, uniquely, are based on costing data from all hospitals. But prices should not be based on average costs and the potential of PbR to improve the quality of care is yet to be exploited. Without refinement, PbR threatens to undermine expenditure control, to divert resources away from primary care, and to distort needs based funding.

scholarly journals Free to Choose? Reform, Choice, and Consideration Sets in the English National Health Service

2016 ◽  
Vol 106 (11) ◽  
pp. 3521-3557 ◽  
Author(s):  
Martin Gaynor ◽  
Carol Propper ◽  
Stephan Seiler
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Patient Choice ◽  
Consideration Sets ◽  
Demand Model ◽  
Elasticity Of Demand ◽  
English National Health ◽  
Modest Reduction ◽  
English National Health Service

Choice in public services is controversial. We exploit a reform in the English National Health Service to assess the effect of removing constraints on patient choice. We estimate a demand model that explicitly captures the removal of the choice constraints imposed on patients. We find that, post-removal, patients became more responsive to clinical quality. This led to a modest reduction in mortality and a substantial increase in patient welfare. The elasticity of demand faced by hospitals increased substantially post-reform and we find evidence that hospitals responded to the enhanced incentives by improving quality. This suggests greater choice can raise quality. (JEL D12, I11, I18)

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