31 January 2019

Does hospital competition reduce rates of patient harm in the English NHS?

Does hospital competition reduce rates of patient harm in the English NHS?
Competition and Markets Authority 31 January 2019
  • Previous hospital mergers have reduced the number of distinct organisations offering publicly funded and provided care in the NHS, reducing choice and between-hospital competition in some areas. 
  • This paper tests the impact of variation in concentration on a new quality indicator: the prevalence of patient harm from falls, pressure ulcers, blood clots and urinary tract infections. Analysis finds a significant inverse relationship between concentration and quality. Specifically, estimates imply that a hypothetical merger to monopoly would, on average, be associated with a significant increase in harm rates. 
  • In addition to the direct effect on patients’ well-being, even small gains to health from competition would likely give rise to large savings for the taxpayer because of reduced treatment costs.