Chapter 8: Hospital productivity in England’s National Health Service
The National Health Service in England is one of the largest connected sets of public sector organizations in Europe, and on a par with the provincially run and more mixed health systems in large countries such as China and India. The vast bulk of NHS activivites (69 per cent of the output index in 2007–08) is made up of hospital and community health services (Peñaloza et al., 2010, p. 6). Most trusts operate just one or two hospitals, and hospital sizes vary from smaller ‘district general hospitals’ for a single city or area, through to large, multi- specialism hospitals in regional metropolitan areas and in Central London. In this chapter we explore in detail what influences seem to shape the overall productivity of the acute hospital trusts in England. We begin by setting the scene, looking at successive governments’ attempts to boost the efficiency of NHS hospitals by introducing elements of competition to attract patients between hospitals, interspersed with other periods where policy stressed more the integration of services and the stabilization of hospital budgets in a more predictable fashion.
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