Reforms to public services have extended consumer choice by allowing for the entry of private providers. The aim is to generate competitive pressure to improve quality when consumers choose between providers. However, for many services new entrants could also affect whether a consumer demands...

This report examines trends in the organisation of general practitioner (GP) practices in England between 2004 and 2010, and the relationship between practice size and two indicators of the quality of care: Quality and Outcomes Framework (QOF) scores; emergency in patient admissions for...

There is widespread and unexplained variation in the outcomes of similar patients across place and providers in all developed health systems. This paper provides new evidence on the role senior doctors play in determining patient outcomes. I exploit within-hospital quasi-random assignment of...

A common reform used to increase consumer choice and competition in public services has been to allow private providers to compete with public incumbents. However, there remains a concern that not all consumers are able to benefit equally from wider choice. We consider the case of publicly...

The emergency department (ED) is a complex node of healthcare delivery that is facing market and regulatory pressure across developed economies to reduce wait times. In this paper we study how ED doctors respond to such incentives, by focussing on a landmark policy in England that imposed strong...

The emergency department (ED) is a complex node of healthcare delivery that is facing market and regulatory pressure across developed economies to reduce wait times. In this paper we study how ED doctors respond to such incentives, by focussing on a landmark policy in England that imposed strong...

In this report, we examine the career progression of nurses and other staff groups within the NHS Agenda for Change (AfC) pay framework in England over the decade between 2012 and 2021. We document differences in progression across pay bands between staff groups and within groups of nurses to...

In this report, we use administrative payroll data from the Electronic Staff Record, combined with local earnings data from the Annual Survey of Hours and Earnings for the period between 2014 and 2019, to examine the correlation between leaving rates for certain NHS staff groups and measures of...