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Evaluating the impact of health reforms

This book provides an in-depth analysis of the NHS reforms ushered in by UK Coalition Government under the 2012 Health and Social Care Act, arguably the most extensive reforms ever introduced in the NHS.

Contributions from leading researchers from the UK, the US and New Zealand examine the reforms in the contexts of national health policy, commissioning and service provision, governance and others. Collectively, the chapters presents a broader assessment of the trajectory of health reforms in the context of marketisation, the rise of health consumerism and the revelation of medical scandals.

This is essential reading for those studying the NHS, those who work in it, and those who seek to gain a better understanding of this key public service.

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The tendency of governments to recycle policy from previous periods presents analysts with the opportunity of assessing their likelihood of success in new time periods. This article presents a theoretical and empirical contribution toward this goal. Its theoretical contribution utilises the work of Pawson and Archer by exploring how context from previous and current periods can be compared and separated from generic policy mechanisms that underpin reforms in order to be able to show how outcomes from the past might be reproduced or transformed in current policy. Its empirical contribution applies this framework to the case of GP fundholding from the 1990s and practice-based commissioning of the 2000s, to show how the latter policy both addresses the difficulties of its predecessor but also makes significant errors that jeopardise its potential for success.

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This chapter introduces the prevalence of NHS reforms since its inception and the lack of discussion and evaluation of these reforms following their implementation. The chapter offers a brief summary of the Coalition government health reforms, and introduces the concept of ‘reform fatigue.’ The authors state that in the remainder of the book, four themes will be used to explain the significance of Coalition health reforms in their analysis. The first theme is the re-organisation within fiscal constraints. The second is centralisation and localism. The third is marketization, and the fourth is health care quality and patient safety. The authors give further descriptions of these themes. The chapter concludes by offering an overview of the organisation of the remainder of the book.

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Quality and safety are defined and measured in different ways by academics, commentators and agencies, while the relationships between them are viewed in different ways. Raleigh and Foot write that while the definitions of quality vary in different settings, some themes – safety, effectiveness and patient experience – are common to most quality frameworks and are regarded as the three pillars of quality in healthcare. This chapter examines these three pillars, and, after a brief review of earlier periods, it focuses on reforms in England under the Coalition government. It then explores the impact of reforms on quality and safety, providing a wider comparative perspective.

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This book provides an in-depth analysis of the NHS reforms ushered in by UK Coalition Government under the 2012 Health and Social Care Act, arguably the most extensive reforms ever introduced in the NHS. Contributions from leading researchers from the UK, the US and New Zealand examine the reforms in the contexts of national health policy, commissioning and service provision, governance and others. Collectively, the chapters presents a broader assessment of the trajectory of health reforms in the context of marketisation, the rise of health consumerism and the revelation of medical scandals. This is essential reading for those studying the NHS, those who work in it, and those who seek to gain a better understanding of this key public service.

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This book provides an in-depth analysis of the NHS reforms ushered in by UK Coalition Government under the 2012 Health and Social Care Act, arguably the most extensive reforms ever introduced in the NHS. Contributions from leading researchers from the UK, the US and New Zealand examine the reforms in the contexts of national health policy, commissioning and service provision, governance and others. Collectively, the chapters presents a broader assessment of the trajectory of health reforms in the context of marketisation, the rise of health consumerism and the revelation of medical scandals. This is essential reading for those studying the NHS, those who work in it, and those who seek to gain a better understanding of this key public service.

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This book provides an in-depth analysis of the NHS reforms ushered in by UK Coalition Government under the 2012 Health and Social Care Act, arguably the most extensive reforms ever introduced in the NHS. Contributions from leading researchers from the UK, the US and New Zealand examine the reforms in the contexts of national health policy, commissioning and service provision, governance and others. Collectively, the chapters presents a broader assessment of the trajectory of health reforms in the context of marketisation, the rise of health consumerism and the revelation of medical scandals. This is essential reading for those studying the NHS, those who work in it, and those who seek to gain a better understanding of this key public service.

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This book provides an in-depth analysis of the NHS reforms ushered in by UK Coalition Government under the 2012 Health and Social Care Act, arguably the most extensive reforms ever introduced in the NHS. Contributions from leading researchers from the UK, the US and New Zealand examine the reforms in the contexts of national health policy, commissioning and service provision, governance and others. Collectively, the chapters presents a broader assessment of the trajectory of health reforms in the context of marketisation, the rise of health consumerism and the revelation of medical scandals. This is essential reading for those studying the NHS, those who work in it, and those who seek to gain a better understanding of this key public service.

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This book provides an in-depth analysis of the NHS reforms ushered in by UK Coalition Government under the 2012 Health and Social Care Act, arguably the most extensive reforms ever introduced in the NHS. Contributions from leading researchers from the UK, the US and New Zealand examine the reforms in the contexts of national health policy, commissioning and service provision, governance and others. Collectively, the chapters presents a broader assessment of the trajectory of health reforms in the context of marketisation, the rise of health consumerism and the revelation of medical scandals. This is essential reading for those studying the NHS, those who work in it, and those who seek to gain a better understanding of this key public service.

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What’s the evidence?

NHS reform continues to be a topical yet contentious issue in the UK. Reforming healthcare: What’s the evidence? is the first major critical overview of the research published on healthcare reform in England from 1990 onwards by a team of leading UK health policy academics. It explores work considering the Conservative internal market of the 1990s and New Labour’s healthcare reorganizations, including its attempts at performance management and the reintroduction of market-based reform from 2004 to 2010. It then considers the implications of this research for current debates about healthcare reorganization in England, and internationally. As the most up-to-date summary of what research says works in English healthcare reform, this essential review is aimed at anyone interested in the wide-ranging debates about health reorganization, but especially students and academics interested in social policy, public management and health policy.

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