Key points

  • In February 2019 the Competition and Markets Authority (CMA) published a working paper on the impact of hospital competition on rates of patient harm in the English NHS
  • We examine the central conclusion of the CMA paper – that the research provides ‘further empirical evidence that competition ultimately benefits patients’ – finding that this cannot be substantiated from the analysis
  • We outline how more rigorous well-designed research is needed to measure the impact of competition on the quality of care

Encouraging competition for clinical care as a means to improve performance in the NHS has been a major feature of policy over the past 30 years. The policy is contentious and hotly debated, yet might have benefits. Good empirical evidence on the impact of competition in the NHS is crucial to guide future policy, and for national bodies such as the Competition and Markets Authority (CMA) to regulate effectively. Informed and evidence-based coverage of findings reported in the press on the NHS’s competition strategy is also critical.

In February 2019 the CMA published a working paper on the impact of hospital competition on rates of patient harm in the English NHS entitled Does hospital competition reduce rates of patient harm in the English NHS?

In this paper we first look in more detail at the CMA working paper to examine whether the claim that it provides ‘further empirical evidence that competition ultimately benefits patients’ can be made with any confidence. We conclude it cannot.Secondly we outline how further investigation might be improved in future. We do this by examining the approach taken in the CMA working paper, which is an approach shared across many similar studies on this topic.

Cite this publication

Dixon J, Beckert W, Alderwick H, Thorlby R, Black N, 'Hospital mergers increase death and harm'? Not so fast… Health Foundation; 2019 (https://www.health.org.uk/publications/hospital-mergers-increase-death-and-harm-not-so-fast)

Further reading

Briefing

The measurement maze

November 2019
Briefing

Our briefing suggests there's potential to make better use of quality measurement to improve quality...

Collection

General Election 2019

Collection

Our views and analysis on health and social care from the 2019 General Election.

You might also like...

Press release

Plan for Digital Health and Social Care contains important ambitions, but tackling workforce and capacity pressures will be the key to realising the vision

Press release

Health Foundation response to the publication of the government’s Plan for Digital Health and Social...

Event

Webinar: What should the COVID-19 inquiry focus on?

Event

In this webinar, we looked at the key questions for the inquiry and explore ways in which it could...

Watch video

Event

Webinar: What does the future look like for the general practice workforce?

Event

In this webinar, we will explore the REAL Centre’s upcoming report on updated NHS workforce supply...

Register
Kjell-bubble-diagramArtboard 101 copy

Get social

Better use of tech and data offers significant potential to drive faster improvement in health and care. Will the G… https://t.co/y10GKFdvaU

Follow us on Twitter
Kjell-bubble-diagramArtboard 101

Work with us

We look for talented and passionate individuals as everyone at the Health Foundation has an important role to play.

View current vacancies
Artboard 101 copy 2

The Q community

Q is an initiative connecting people with improvement expertise across the UK.

Find out more