Using patient referrals to analyse hospital competition

This week the Health Foundation hosted a panel discussion which looked back on the Competition & Markets Authority (CMA) review of the planned merger between Ashford & St Peter’s Hospitals NHS Foundation Trust (ASP) and Royal Surrey County Hospital NHS Foundation Trust (RSC). The CMA, Monitor and the two Trusts reflected on the case and…

Agency price caps: one year on

Almost a year has passed since the Government’s plans for agency price caps were first reported. At the time, I asked whether staffing agencies were really ripping off the NHS, and whether capping agency rates was likely to save the NHS money. Christopher Cook, from BBC Newsnight, asked similar questions as did others. NHS Improvement, however, has now said that…

When is competitive tendering good for services?

HSJ has reported that an increase in competitive tendering of NHS contracts may be a result of the new Public Contracts regulations that come into force in April. There is an interesting contrast between a requirement for more competitive tendering, and the poor outcome experienced with the recent tender for older people’s services in Cambridgeshire. That said,…

Competition risks for GP federations and super practices

The trend towards delivering GP services at increased scale seems to have gathered pace over the past few months. In January, HSJ tracked how GP federations and other large scale GP practices have been forming across England. It identified 268 ‘at scale’ GP organisations operating across 171 CCGs, with a further 20 in the process of…

Reflections on the Ashford / Royal Surrey merger decision

Readers with an ongoing interest in the competition in healthcare are no doubt aware of the recent decision by the Competition & Market Authority (CMA) to clear the planned merger between Ashford & St Peter’s Hospitals NHS Foundation Trust and Royal Surrey County Hospital NHS Foundation Trust. Aldwych Partners, where I am one of the founding partners, is very…

Community Pharmacy: entry controls and industry concentration

Community pharmacies are at the centre of much interesting work in terms of delivering more care to NHS patients, and taking some of the strain off other parts of the healthcare system. Pharmacy Voice has been established to represent the sector, and there are numerous initiatives at an industry and provider level. Lloyds Pharmacy, for example,…

Is Monitor’s draft tariff a recipe for longer waiting times?

Last week Monitor released its audit of 2014-15 reference costs for Acute Trusts. Nearly half of the 75 acute trusts it audited had “materially inaccurate” reference costs. Monitor’s report points out that providers with inaccurate cost information will find it difficult to make well-informed management and operational decisions about their services. Similarly, without accurate cost information, Monitor…

What’s the point of transparency?

Jeremy Hunt’s speech today talked about the role of intelligent transparency as a means of improving NHS services. Transparency, of course, isn’t an end in itself. From a patient’s perspective, knowing you are getting a poor quality service doesn’t make things better. Transparency is only useful if it results in service improvement. There are at least…

When does an alliance become a merger?

Today’s announcement of an alliance between three Acute Trusts in the West Midlands (Walsall, Sandwell & West Birmingham and Dudley) raises at least two interesting questions from a competition perspective.   First, is the alliance a merger that is subject to review by the Competition & Markets Authority (CMA)? Second, if the alliance isn’t a merger,…

Does coordinated action against staffing agencies breach competition law?

In the last few days I have written about using competition rules to address ‘egregious’ pricing by agencies that supply temporary staff to the NHS, and the possibility that capping agency payments may not be effective in reducing labour costs for the NHS. I thought it was worth completing the trifecta by considering whether the NHS’s plans…