This paper explores whether NHS hospitals in England managed their earnings upward before applying to the government for foundation trust (FT) status—a scheme that allowed them greater financial freedom and management autonomy—in order present an overly positive picture increase chances a successful application. The shows FTs adjusted discretionary accruals up two years FT status. practice was ...

Reforms to the English national health service (NHS) are using patient choice and provider competition to drive improvements in performance. In completing the design of the reforms, the government faces the challenge of ensuring that commissioners can negotiate on equal terms with providers, and that appropriate arrangements are put in place for market management and regulation. Politicians als...

OBJECTIVES Delivering treat-to-target strategies in rheumatoid arthritis (RA) involves commitments from both providers and payers for healthcare. We have summarised the perspectives of payers from England, where the National Health Service (NHS) provides universal care that is without cost for patients. METHODS We reviewed the literature - including that from the NHS and National Institute fo...

AIM To explore interpretations of "appropriate" and "inappropriate" elective referral from primary to secondary surgical care among senior clinical and non-clinical managers in five purposively sampled primary care trusts (PCTs) and their main associated acute hospitals in the English National Health Service (NHS). METHODS Semi-structured face-to-face interviews were undertaken with senior ma...