Autonomy and performance in the public sector: the experience of English NHS hospitals

Rossella Verzulli, Rowena Jacobs () and Maria Goddard
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Rowena Jacobs: University of York

The European Journal of Health Economics, 2018, vol. 19, issue 4, No 11, 607-626

Abstract: Abstract Since 2004, English NHS hospitals have been given the opportunity to acquire a more autonomous status known as a Foundation Trust (FT), whereby regulations and restrictions over financial, management, and organizational matters were reduced in order to create incentives to deliver higher-quality services in the most efficient way. Using difference-in-difference models, we test whether achieving greater autonomy (FT status) improved hospital performance, as proxied by measures of financial management, quality of care, and staff satisfaction. Results provide little evidence that the FT policy per se has made any difference to the performance of hospitals in most of these domains. Our findings have implications for health policy and inform the trend towards granting greater autonomy to public-sector organizations.

Keywords: Foundation Trusts; Hospital reform; Autonomy; Hospital performance; Treatment effects; Policy evaluation (search for similar items in EconPapers)
JEL-codes: I11 I18 (search for similar items in EconPapers)
Date: 2018
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Citations: View citations in EconPapers (1)

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DOI: 10.1007/s10198-017-0906-6

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