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Increasing competition in NHS is hampering commissioning

BMJ 2011; 343 doi: http://dx.doi.org/10.1136/bmj.d6021 (Published 22 September 2011) Cite this as: BMJ 2011;343:d6021
  1. Zosia Kmietowicz
  1. 1London

The government needs to rethink some of its key policies if England’s new clinical commissioning groups are to be better at providing integrated care than their primary care trust predecessors, a new report warns.

Pro-market policies with an emphasis on increased activity and more services, rather than collaboration and care in the community, have impeded the commissioning of integrated care, says the report from the health policy think tanks the Nuffield Trust and the King’s Fund.

It acknowledges that commissioning has the power to improve outcomes and reduce costs, but primary care trusts have struggled to introduce better services, especially for patients who need urgent care, …

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