The English NHS has introduced a system of budgets for general practices covering hospital expenditure for the patients on their lists. We model individual expenditure using diagnostic information from previous hospital spells, plus a large set of attributed variables measuring population,...

We examine whether a hospitals quality is affected by the quality provided by other hospitals in the same market. We first set out a theoretical model with regulated prices which specifies conditions on demand and cost functions which determine whether a hospital will have higher quality when...

We examine how public sector third-party purchasers and hospitals negotiate quality targets when a fixed proportion of hospital revenue is required to be linked to quality. We develop a bargaining model linking the number of quality targets to purchaser and hospital characteristics. Using data...

Hospital bed blocking occurs when hospital patients are ready to be discharged to a nursing home but no place is available, so that hospital care acts as a more costly substitute for long-term care. We investigate the extent to which higher supply of nursing home beds or lower prices can reduce...

We investigate the impact of area general practitioner (GP) supply on individual health in England. If no allowance is made for the endogeneity of GP supply, the effect is positive but not statistically significant. When GP supply is instrumented by age related capitation the effect is markedly...

Since 2003, 25% of UK general practitioners’ income has been determined by the quality of their care. The 65 clinical quality indicators in this scheme (the Quality and Outcomes Framework) are in the form of ratios, with financial reward increasing linearly with the ratio between a lower and...

Long waiting times for inpatient treatment in the UK National Health Service have long been a source of great popular and political concern, and therefore a target for policy initiatives. One such is the London Patient Choice Project, under which patients at risk of breaching inpatient waiting...

There is increased emphasis on the measurement of performance in the NHS. Following the White Paper, additional high level indicators for measuring primary care performance at Health Authority level have been proposed by the NHS Executive. These include measures based on prescribing and on...

In recent years there have been marked changes in organisational structures and budgetary arrangements in the English NHS, potentially altering the relationships between purchasers (primary care organisations (PCOs) and general practices) and providers. Using data on elective hospital admissions...

The White Paper Our Health, Our Care, Our Say noted concerns about geographical equity of access to GPs (Department of Health, 2006, page 63), listed the 30 PCTs with the lowest number of GPs per head of need adjusted population, and set out policy initiatives to attract additional providers of...