A recent commentary published in the Lancet by Allyson Pollock and colleagues concluded that there is no evidence that competition for patients in the NHS saves lives or improves quality of care, Improvements in area such as survival following acute myocardial infarction are likely to be due to the development of cardiac networks that encourage collaboration between hospitals and the wider provision of services such as percutaneous coronary interventions (PCI). The article was widely quoted in the media, including in the Independent and Pulse.
NHS budgets are under considerable pressure. It is therefore unsurprising that many NHS Integrated Care Boards (ICBs) In England will aim to prioritise price in contract awards, But this approach is a significant threat to community-centred healthcare. While competitive tendering is a legally required, an excessive focus on costs in awarding NHS contracts risks overshadowing key factors such as established community trust, local expertise, and the long-term impact on continuity of care. This shift towards cheaper, often external, commercial providers threatens to cut the links between communities and their local health services. The argument that competitive tendering is solely about legal compliance, and not cost, is undermined by the very nature of such tendering, which by design encourages the lowest bid. This approach risks eroding the social fabric of local healthcare provision, where established relationships and understanding of specific community needs are essential. Establishe...
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