J Fam Plann Reprod Health Care 2006: 32(1) Background The National Health Service (NHS) in England is going through another reorganisation, in the spirit of creating a ‘patient-led NHS’. Practice-based commissioning (PBC) refers to devolution of commissioning responsibilities from primary care trusts (PCTs) to individual or groups of primary care professionals; this may be a group of general pr...

BACKGROUND The UK National Institute for Health and Clinical Excellence (NICE) has published guidance for employers on promoting mental wellbeing. A national audit in 2011 found wide variation between English National Health Service (NHS) trusts (organizations providing health care) in the implementation of this guidance, but it is not known whether fuller compliance with the guidance results i...

Variation in the provision of health care has long been a policy concern. We adapt the framework for productivity measurement used in the National Accounts, making it applicable for sub-national comparisons using cross-sectional data. We assess the productivity of the National Health Service (NHS) across regions of England, termed Strategic Health Authorities (SHAs). Productivity is calculated ...

background in recent years, accreditation of private hospitals followed by decentralisation of the italian national health service (nhs) into 21 regional health systems has provided a good empirical ground for investigating the tiebout principle of “voting with their feet”. we examine the infra-regional trade-off between greater patient choice (due to an increase in hospital services supply) an...

Personal health budgets (PHBs) were piloted in the National Health Service (NHS) in England between 2009 and 2012 and were found to have greater positive effects on quality of life and psychological well-being for those with mental health problems than commissioned service, as well as reducing their use of unplanned care. The government intends to extend PHBs in England for long-term conditions...

Healthcare-associated infections are a major concern to patients and the public as a result of both high rates of infection across the National Health Service (NHS), and media coverage of outbreaks at individual hospitals. The government has put in place a range of policies designed to reduce healthcare-associated infections in NHS organisations in England (with a similar priority being given i...

NHS Direct is a 24-h patient-led telephone advice service, based in England and Wales, which aims to help callers to self-manage problems and reduce unnecessary demands on other National Health Service (NHS) provision (Munro et al., 2000a). NHS Direct is the world’s largest health care telephone advice service (Munro, 2002) and is leading the current international trend towards telemedicine and...

INTRODUCTION NHS Direct, a leading telephone healthcare provider worldwide, provided 24/7 health care advice and information to the public in England and Wales (1998-2014). The fundamental aim of this service was to increase accessibility, however, research has suggested a disparity in the utilisation of this service related to ethnicity. This research presents the first national study to deter...

This commentary explores some of the issues raised by Gilbert et al.short communication, Morality and Markets in the NHS. The increasing role of market mechanisms and the changing types of healthcare providers together with the use of choice and competition to drive improvements in quality in the National Health Service (NHS), all have important ethical implications. In order for the NHS to con...