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Divergence of NHS choice policy in the UK: what difference has patient choice policy in England made?

Sanderson, Marie, Allen, Pauline, Peckham, Stephen, Hughes, David, Brown, Menna, Kelly, Grace, Baldie, Debbie, Mays, Nicholas, Linyard, Alison, Duguid, Anne and others. (2013) Divergence of NHS choice policy in the UK: what difference has patient choice policy in England made? Journal of Health Services Research and Policy, 18 (4). pp. 202-208. ISSN 1355-8196. (doi:10.1177/1355819613492716) (The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided)

The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided. (Contact us about this Publication)
Official URL
http://dx.doi.org/10.1177/1355819613492716

Abstract

Objectives To examine the types of choices available to patients in the English NHS when being referred for acute hospital care in the light of the divergence of patient choice policy in the four countries of the UK. Methods Case studies of eight local health economies in England, Scotland, Northern Ireland and Wales (two in each country); 125 semi-structured interviews with staff in acute services providers, purchasers and general practitioners (GPs). Results GPs and providers in England both had a clear understanding of the choice of provider policy and the right of patients to choose a provider. Other referral choices potentially available to patients in all four countries were date and time of appointment, site and specialist. In practice, the availability of these choices differed between and within countries and was shaped by factors beyond choice policy, such as the number of providers in an area. There were similarities between the four countries in the way choices were offered to patients, namely lack of clarity about the options available, limited discussion of choices between referrers and patients, and tension between offering choice and managing waiting lists. Conclusions There are challenges in implementing pro-choice policy in health care systems where it has not traditionally existed. Differences between England and the other countries of the UK were limited in the way choice was offered to patients. A cultural shift is needed to ensure that patients are fully informed by GPs of the choices available to them.

Item Type: Article
DOI/Identification number: 10.1177/1355819613492716
Additional information: Published online before print July 31 2013.
Uncontrolled keywords: Cross-country comparisons; health systems reform; patient choice of provider
Subjects: R Medicine > R Medicine (General) > R729 Types of medical practice
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Centre for Health Services Studies
Depositing User: Stephen Peckham
Date Deposited: 03 Sep 2013 13:15 UTC
Last Modified: 10 Jun 2019 15:25 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/35067 (The current URI for this page, for reference purposes)
Peckham, Stephen: https://orcid.org/0000-0002-7002-2614
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