To examine whether longer-term contracts for health services will shift attention away from concern for finance and activity levels and towards the achievement of better quality services.
Analysis of 288 contracts from the British National Health Service (NHS) and 12 semi-structured interviews with staff from provider (NHS hospital trusts) and purchaser (health authorities) organisations.
No relationship was found between the duration of a contract and the duration of service specifications or quality frameworks.
The annual contracting cycle is concerned largely with ensuring that all parties stay within activity targets and financial constraints, and this is unlikely to be affected by a shift to longer-term contracts.
The setting of standards and initiatives to improve quality is largely independent of the contracting process and the duration of contracts, and relies on relationships rather than contracts.
It is optimistic to expect longer-term contracts automatically to produce a greater focus on quality and the incentives needed to ensure that improvements in quality are delivered.
However, this may not matter as issues of quality are being addressed more appropriately in the British NHS through a variety of other routes.
Mots-clés Pascal : Budget, Hôpital, Gestion hospitalière, Royaume Uni, Contrat, Qualité, Soin, Organisation hospitalière, Financement
Mots-clés Pascal anglais : Budget, Hospital, Hospital management, United Kingdom, Contract, Quality, Care, Hospital organization, Financing
Notice produite par :
ORS Auvergne - Observatoire Régional de la Santé d'Auvergne
Code Inist : 002B30A11. Création : 14/12/1999.