Non‐price competition in NHS secondary care contracting: empirical results
Journal of Health Organization and Management
ISSN: 1477-7266
Article publication date: 5 September 2008
Abstract
Purpose
The purpose of this paper is, for English acute NHS hospitals, to investigate how they operate their governance systems in the area of secondary care contracting and identify the key determinants of relationship building within the contacting/commissioning of secondary care focusing upon non‐price competitive behaviour.
Design/methodology/approach
A survey instrument was designed and mailed to a sample of all acute NHS hospitals in England of whom 35 per cent responded. This survey was then analysed using logit techniques.
Findings
The analysis suggests that: those NHS Trusts offering volume discounts, non‐price competitive incentives or having a strong belief in performance being by “payment by results” criteria are significantly more likely to offer augmented services to secondary care purchasers over and above contractual minima; those NHS Trusts strongly believing in the importance of non‐price factors (such as contract augmentation or quality) in the contracting process are more likely to offer customisation of generic services; and those NHS Trusts using cost‐sharing agreements to realign contracts when negotiating contracts or who strongly believe in the importance of service augmentation in strengthening relationships, or that increased hospital efficiency is the most important aspect of recent NHS reform are more likely to utilise default measures to help realign contracts.
Originality/value
This paper fills a gap in the area of non‐price competition in English NHS acute secondary care contracting.
Keywords
Citation
Gray, K. and Bailey, M.F. (2008), "Non‐price competition in NHS secondary care contracting: empirical results", Journal of Health Organization and Management, Vol. 22 No. 5, pp. 480-495. https://doi.org/10.1108/14777260810898705
Publisher
:Emerald Group Publishing Limited
Copyright © 2008, Emerald Group Publishing Limited