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Regulation of the NHS in England

Professor Gwyn Bevan
Professor of Management Science

Date: 11 November 2003
: 1:00pm - 2:30pm
: CARR Seminar Room, H615


In 1997, the New Labour government laid out its policies to replace what was seen as outright competition of the 'internal market' with a 'third way' that offered a more collaborative approach. The policy implemented for NHS organisations in England, emphasised two instruments of regulation: clinical governance and performance (star) ratings. Clinical governance is a system of steps and processes to ensure that patients receive care of high quality. Each organization was, from 2001, subject to reviews of clinical governance by the Commission for Health Improvement (CHI). Performance (star) ratings are typically based on three elements: key targets, a wider set of indicators (in the "balanced scorecard"); and results of CHI's reviews of clinical governance. These were first published by the Department of Health in 2001 (for acute and specialist hospitals). In 2002, CHI took over responsibility for the development and production of ratings, and published these for all types of NHS hospitals, ambulances and Primary Care Trusts in 2003. From April 2004, CHI will be replaced by a new inspectorate with wider powers: the Commission for Healthcare Audit and Inspection (CHAI). New government policies being introduced from 2003-04 emphasise patient choice and payment by results (funding providers for service volumes at standard costs). The objective of this seminar is to consider regulatory issues raised by performance ratings and these new policies.