Just after the 2010 UK election, when I was still seconded to the Department of Health, the new English health secretary, Andrew Lansley, came to meet the department’s doctors to set out his vision for the NHS. This led to the Health and Social Care Act 2012, now widely regarded as a costly and needless disruption lacking electoral mandate. Ironically, a different mandate was part of this visio...

BACKGROUND The cause of adverse weekend clinical outcomes remains unknown. In 2013, the "NHS Services, Seven Days a Week" project was initiated to improve access to services across the seven-day week. Three years on, we sought to analyse the impact of such changes across the English NHS. METHODS Aggregated trust-level data on crude mortality rates, Summary Hospital-Level Mortality Indicator (...

BACKGROUND This paper examines NHS secondary care contracting in England and Wales in a period which saw increasing policy divergence between the two systems. At face value, England was making greater use of market levers and utilising harder-edged service contracts incorporating financial penalties and incentives, while Wales was retreating from the 1990 s internal market and emphasising coope...

Patient-reported outcome measures (PROMs) are now routinely collected in the English National Health Service (NHS) and used to compare and reward hospital performance within a high-powered pay-for-performance scheme. However, PROMs are prone to missing data. For example, hospitals often fail to administer the pre-operative questionnaire at hospital admission, or patients may refuse to participa...