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Managing activity and expenditure in the new NHS market

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  • Russell Mannion
  • Andrew Street

Abstract

The English National Health Service is introducing ‘Payment by Results’ so that hospitals are paid according to the activity they undertake. This should encourage hospitals to increase activity but perhaps to unaffordable levels. Drawing on interviews with NHS staff and documentary evidence, the authors examine local strategies to manage activity and NHS expenditure. These alone cannot be relied upon to control expenditure, and payments themselves should be modified.

Suggested Citation

  • Russell Mannion & Andrew Street, 2009. "Managing activity and expenditure in the new NHS market," Public Money & Management, Taylor & Francis Journals, vol. 29(1), pages 27-34, January.
    • Handle: RePEc:taf:pubmmg:v:29:y:2009:i:1:p:27-34
    DOI: 10.1080/09540960802617335
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    References listed on IDEAS

    as
    1. Diane Dawson & Maria Goddard, 1999. "Long‐term contracts in the NHS: a solution in search of a problem?," Health Economics, John Wiley & Sons, Ltd., vol. 8(8), pages 709-720, December.
    2. Propper, Carol & Croxson, Bronwyn & Shearer, Arran, 2002. "Waiting times for hospital admissions: the impact of GP fundholding," Journal of Health Economics, Elsevier, vol. 21(2), pages 227-252, March.
    3. Maria Goddard & Russell Mannion, 1998. "From competition to co‐operation: new economic relationships in the National Health Service," Health Economics, John Wiley & Sons, Ltd., vol. 7(2), pages 105-119, March.
    4. Wyke, Sally & Mays, Nicholas & Street, Andrew & Bevan, Gwyn & McLeod, Hugh & Goodwin, Nick, 2003. "Should general practitioners purchase health care for their patients? The total purchasing experiment in Britain," Health Policy, Elsevier, vol. 65(3), pages 243-259, September.
    5. Ellis, Randall P. & McGuire, Thomas G., 1990. "Optimal payment systems for health services," Journal of Health Economics, Elsevier, vol. 9(4), pages 375-396, December.
    6. A. Street & D. Dawson, 2002. "Costing hospital activity: the experience with healthcare resource groups in England," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 3(1), pages 3-9, March.
    7. Russell Mannion & Andrew Street, 2006. "Payment by results and demand management: learning from the South Yorkshire laboratory," Working Papers 014cherp, Centre for Health Economics, University of York.
    8. Ellis, Randall P., 1998. "Creaming, skimping and dumping: provider competition on the intensive and extensive margins1," Journal of Health Economics, Elsevier, vol. 17(5), pages 537-555, October.
    9. Dusheiko, Mark & Gravelle, Hugh & Jacobs, Rowena & Smith, Peter, 2006. "The effect of financial incentives on gatekeeping doctors: Evidence from a natural experiment," Journal of Health Economics, Elsevier, vol. 25(3), pages 449-478, May.
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    Cited by:

    1. Jacobs, Rowena & Mannion, Russell & Davies, Huw T.O. & Harrison, Stephen & Konteh, Fred & Walshe, Kieran, 2013. "The relationship between organizational culture and performance in acute hospitals," Social Science & Medicine, Elsevier, vol. 76(C), pages 115-125.

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