Effect of diverging policy across the NHS

Arturo Alvarez-Rosete, Jennifer Dixon, Gwyn Bevan, Nicholas Mays

Arturo Alvarez-Rosete, Jennifer Dixon and colleagues look at the effect of diverging NHS policy since devolution in 1998.

Publication:  BMJ
Reference:  BMJ 2005; 331: 946-950

Since 1998, the elected political bodies in Scotland, Wales and Northern Ireland have been able to use their varying powers to shape NHS policy.

As a result, in England, the emphasis has been on national targets to improve performance (particularly reducing waiting times), increasing capacity, and sharper market-style incentives. In Scotland, the 1990s quasi-market has been abolished and steps taken to build a professionally led, integrated system based on concepts such as managed clinical networks.

In Wales, the focus has been on improving the public health through partnership working between the local NHS, local government, and communities, and in Northern Ireland, developments have been stalled by political uncertainty.

But what is the effect of these differences in emphasis of policy? How has devolution affected the ability to collect and compare NHS data across the four UK countries? And has this resulted in significant differences in performance?

Read full article on the BMJ website