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Do hospitals respond to greater autonomy? Evidence from the English NHS

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Author Info

  • Rossella Verzulli

    (Centre for Health Economics, University of York, UK)

  • Rowena Jacobs

    (Centre for Health Economics, University of York, UK)

  • Maria Goddard

    (Centre for Health Economics, University of York, UK)

Abstract

Foundation Trusts (FTs) were introduced in the English NHS in 2004/5 and gave NHS Trusts the opportunity to become independent not-for-profit public benefit corporations. Whilst remaining in the public sector, FTs were granted greater autonomy than non-FTs. The reform was intended to create incentives for providers to deliver higher quality services in the most efficient way. This paper examines the impact of the FT policy on hospital performance, as proxied by measures of financial management, quality of care and staff satisfaction. Results suggest that generally FTs perform better than non-FTs. However, these differences appear to be long-standing rather than the effect of the FT policy per se and we find some evidence of a convergence in hospital performance between FTs and non-FTs.

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File URL: http://www.york.ac.uk/media/che/documents/papers/researchpapers/RP64_Foundation_Trusts.pdf
File Function: First version, 2011
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Bibliographic Info

Paper provided by Centre for Health Economics, University of York in its series Working Papers with number 064cherp.

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Length: 32 pages
Date of creation: Jul 2011
Date of revision:
Handle: RePEc:chy:respap:64cherp

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Related research

Keywords: Foundation Trusts; hospital reform; performance indicators;

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References

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  1. Giorgia Marini & Marisa Miraldo & Rowena Jacobs & Maria Goddard, 2008. "Giving greater financial independence to hospitals-does it make a difference? The case of English NHS Trusts," Health Economics, John Wiley & Sons, Ltd., vol. 17(6), pages 751-775.
  2. Russell Mannion & Maria Goddard & Michael Kuhn & Angela Bate, 2005. "Decentralisation Strategies and Provider Incentives in Healthcare: Evidence from the English National Health Service," Applied Health Economics and Health Policy, Springer Healthcare | Adis, vol. 4(1), pages 47-54.
  3. Propper, Carol & Sutton, Matt & Whitnall, Carolyn & Windmeijer, Frank, 2010. "Incentives and targets in hospital care: Evidence from a natural experiment," Journal of Public Economics, Elsevier, vol. 94(3-4), pages 318-335, April.
  4. Rowena Jacobs & Diane Dawson, 2003. "Hospital efficiency targets," Health Economics, John Wiley & Sons, Ltd., vol. 12(8), pages 669-684.
  5. Sascha O. Becker & Andrea Ichino, 2002. "Estimation of average treatment effects based on propensity scores," Stata Journal, StataCorp LP, vol. 2(4), pages 358-377, November.
  6. Allen, Pauline, 2006. "New localism in the English National Health Service: What is it for?," Health Policy, Elsevier, vol. 79(2-3), pages 244-252, December.
  7. George France & Francesco Taroni & Andrea Donatini, 2005. "The Italian health-care system," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages S187-S202.
  8. Sofia Dimakou & David Parkin & Nancy Devlin & John Appleby, 2009. "Identifying the impact of government targets on waiting times in the NHS," Health Care Management Science, Springer, vol. 12(1), pages 1-10, March.
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