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Specialist Health Services within the New NHS

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Abstract

Problems have long been associated with the provision of specialist health services, including securing equity in access, ensuring adequate provision and the financial viability of providers, developing new services and avoiding unnecessary service duplication. However, the introduction of the internal market within the NHS has raised additional concerns. Providers of specialist services are experiencing problems in contracting with multiple purchasers, and purchasers have been faced with unpredictable high-cost extra-contractual referrals (ECRs). The change towards capitation funding is moving funds away from districts with specialist providers and the reorganisation of health services within London and other major cities threatens the very existence of some hospitals providing specialist services (Tomlinson, 1992; Thompson, 1993). Reports by specialist committees have highlighted actual and potential problems for specialist services within the new contracting environment and have drawn attention to the need for appropriate contractual arrangements (CSAG, 1993; BPA, 1993).

Keywords

Specialist Service Tertiary Referral Specialist Provider Specialist Health Service Multiple Purchaser 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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© Penelope Mullen 1997

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