Journal article 1461 views
The use of standard contracts in the English NHS: a case study analysis
Christina Petsoulas,
Pauline Allen,
David Hughes,
Peter Vincent-Jones,
Jennifer Roberts
Social Science & Medicine,, Volume: 73, Issue: 2, Pages: 185 - 92
Swansea University Author: David Hughes
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DOI (Published version): 10.1016/j.socscimed.2011.05.021
Abstract
<p>The use of contracts is vital to market transactions. The introduction of market reforms in health care in the UK and other developed countries twenty years ago meant greater use of contracts. In the UK, health care contracting was widely researched in the 1990s. Yet, despite the changing p...
Published in: | Social Science & Medicine, |
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Elsevier
2011
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http://www.sciencedirect.com/science/article/pii/S027795361100298X |
URI: | https://cronfa.swan.ac.uk/Record/cronfa6726 |
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2011-10-01T00:00:00.0000000 v2 6726 2012-01-23 The use of standard contracts in the English NHS: a case study analysis f1fbd458e3c75d8b597c0ac8036f2b88 David Hughes David Hughes true false 2012-01-23 FGMHL <p>The use of contracts is vital to market transactions. The introduction of market reforms in health care in the UK and other developed countries twenty years ago meant greater use of contracts. In the UK, health care contracting was widely researched in the 1990s. Yet, despite the changing policy context, the subject has attracted less interest in recent years. This paper seeks to fill a gap by reporting findings from a study of contracting in the English National Health Service (NHS) after the introduction of the national standard contract in 2007. By using economic and socio-legal theories and two case studies we examine the way in which the new contract was implemented in practice and the extent to which implementation conformed to policy intentions and to our theoretical predictions. Data were collected using non-participant observation of 36 contracting meetings, 24 semi-structured interviews, and analysis of documents. We found that despite efforts to introduce a more detailed ('complete') contract, in practice, purchasers and providers often reverted to a more relational style of contracting. Frequently reliance on the NHS hierarchy proved to be indispensable; in particular, formal dispute resolution was avoided and financial risk was re-allocated in compromises that sometimes ignored contractual provisions. Serious data deficiencies and shortages of skilled personnel still caused major difficulties. We conclude that contracting for health care continues to raise serious problems, which may be exacerbated by the impending transfer of responsibility to groups of general practitioners (GPs) who generally lack experience and expertise in large-scale, secondary care contracting.</p> Journal Article Social Science & Medicine, 73 2 185 92 Elsevier 31 12 2011 2011-12-31 10.1016/j.socscimed.2011.05.021 http://www.sciencedirect.com/science/article/pii/S027795361100298X COLLEGE NANME Medicine, Health and Life Science - Faculty COLLEGE CODE FGMHL Swansea University 2011-10-01T00:00:00.0000000 2012-01-23T12:31:41.9670000 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Public Health Christina Petsoulas 1 Pauline Allen 2 David Hughes 3 Peter Vincent-Jones 4 Jennifer Roberts 5 |
title |
The use of standard contracts in the English NHS: a case study analysis |
spellingShingle |
The use of standard contracts in the English NHS: a case study analysis David Hughes |
title_short |
The use of standard contracts in the English NHS: a case study analysis |
title_full |
The use of standard contracts in the English NHS: a case study analysis |
title_fullStr |
The use of standard contracts in the English NHS: a case study analysis |
title_full_unstemmed |
The use of standard contracts in the English NHS: a case study analysis |
title_sort |
The use of standard contracts in the English NHS: a case study analysis |
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f1fbd458e3c75d8b597c0ac8036f2b88 |
author_id_fullname_str_mv |
f1fbd458e3c75d8b597c0ac8036f2b88_***_David Hughes |
author |
David Hughes |
author2 |
Christina Petsoulas Pauline Allen David Hughes Peter Vincent-Jones Jennifer Roberts |
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Social Science & Medicine, |
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73 |
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Swansea University |
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10.1016/j.socscimed.2011.05.021 |
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Elsevier |
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Faculty of Medicine, Health and Life Sciences |
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Faculty of Medicine, Health and Life Sciences |
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School of Health and Social Care - Public Health{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Public Health |
url |
http://www.sciencedirect.com/science/article/pii/S027795361100298X |
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description |
<p>The use of contracts is vital to market transactions. The introduction of market reforms in health care in the UK and other developed countries twenty years ago meant greater use of contracts. In the UK, health care contracting was widely researched in the 1990s. Yet, despite the changing policy context, the subject has attracted less interest in recent years. This paper seeks to fill a gap by reporting findings from a study of contracting in the English National Health Service (NHS) after the introduction of the national standard contract in 2007. By using economic and socio-legal theories and two case studies we examine the way in which the new contract was implemented in practice and the extent to which implementation conformed to policy intentions and to our theoretical predictions. Data were collected using non-participant observation of 36 contracting meetings, 24 semi-structured interviews, and analysis of documents. We found that despite efforts to introduce a more detailed ('complete') contract, in practice, purchasers and providers often reverted to a more relational style of contracting. Frequently reliance on the NHS hierarchy proved to be indispensable; in particular, formal dispute resolution was avoided and financial risk was re-allocated in compromises that sometimes ignored contractual provisions. Serious data deficiencies and shortages of skilled personnel still caused major difficulties. We conclude that contracting for health care continues to raise serious problems, which may be exacerbated by the impending transfer of responsibility to groups of general practitioners (GPs) who generally lack experience and expertise in large-scale, secondary care contracting.</p> |
published_date |
2011-12-31T03:08:17Z |
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1763749812844363776 |
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11.021648 |