This report focuses on the 16 TPPs in England which pursued the objective of reducing acute hospital emergency admissions and/or length of stay to at least the end of the second 'live' year, March 1998. The analysis of hospital episode statistics was undertaken in order to establish whether the action ...
The overall aim of the third year of the national evaluation of TPPs, spanning October 1997 to September 1998, was to identify the ingredients of successful devolved purchasing based in primary care by in-depth study of twelve first wave TPPs. The analysis presented here considers eleven of the case studies ...
Total purchasing was the first major 'internal market' policy initiative to be extensively evaluated by the Department of Health and Scottish Office. This report draws together the main evidence from the evaluation in order to inform the development of the new primary care organisations in the NHS, which came into ...
This report summarises the hospital activity analysis for two types of first-wave total purchasing pilots (TPPs), 'commissioner' TPPs and 'co-purchaser' TPPs. The main objective of the analysis was to compare changes in hospital activity, in the areas for which TPPs had objectives, with those of comparators. The authors conclude that: ...
This working paper from the second year of TPPs makes the following key findings: larger TPPs are becoming high achievers; a group of TPPs (43 per cent) improved their performance over two years, about a quarter remained at the same level and about a third dropped out; a greater proportion ...
This report describes the evaluation of total purchasing and extended purchasing sites with an interest in mental health services. A consistent objective of these sites was the improvement of communication and information flows between primary and secondary care. The priority was the development of services for people with common mental ...
The evaluation of the Total Purchasing Pilots (TPPs) provides important lessons for the development of the new primary care organisations envisaged in the English, Welsh and Scottish NHS white papers. Despite originating in a very different context, total purchasing was essentially about groups of practices working together to develop services ...
This report aims to describe the ways in which the structure, role and impact of TPPs may be instructive to PCGs. Practical illustrations are used to demonstrate how particular changes in services were achieved in the context of local conditions, providing useful examples for PCGs. English PCGs are the main ...
Many of the potential pitfalls of increasing purchaser plurality in the NHS are relevant in planning and developing general practitioner led locality commissioning. However, this involvement in commissioning or purchasing maternity care may actually provide the 'bite' necessary to move reluctant provider trusts more quickly towards services which meet the ...
Considerable management challenges must be faced in order to ensure the successful operation of primary care groups (PCGs). The insights to be gained from those involved in total purchasing pilots (TPPs) are likely to prove valuable in informing the development of PCGs, and workshops were held to capture some of ...