Reforms to the English national health service (NHS) are using patient choice and provider competition to drive improvements in performance. In completing the design of the reforms, the government faces the challenge of ensuring that commissioners can negotiate on equal terms with providers, and that appropriate arrangements are put in place for market management and regulation. Politicians als...

The article by Brenna and Spandonaro on interregional mobility for acute hospital care in Italy raises important issues concerning social and territorial equity in a healthcare system. Based on Regions and private providers’ strategic behavior, the hypothesis adopted to explain patient cross-border mobility (CBM), demonstrated by statistical analysis, may be further explored using qualitative m...

The paper by Gilbert et al. should be on the table of every politician and National Health Service (NHS) manager in the run up to the general election, when the NHS is at the hustings. They have raised profound moral dilemmas of the internal and external market in their present form, such as the practicalities of distributive justice and the enhancement of autonomy – to which are added the pres...

Recent changes in the English National Health Service (NHS) have introduced new complexities into the accountability arrangements for healthcare services. This commentary describes how the new organizational structures have challenged the traditional centralized accountability structures by creating a more dispersed system of governance for local health-care commissioners. It sets the context o...

BACKGROUND Bevacizumab is used extensively in the treatment of cancer, including advanced ovarian cancer, for which results of the International Collaborative Ovarian Neoplasm (ICON) 7 trial have been recently reported. The National Institute for Health and Care Excellence's (NICE's) recent decision not to recommend bevacizumab for advanced ovarian cancer was not based on evidence related to th...

BACKGROUND Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), in its most severe clinical presentation, can result in patients becoming housebound and bedbound so unable to access most available specialist services. This presents particular clinical risks and treatment needs for which the National Institute for Health and Care Excellence (NICE) advises specialist medical care and moni...

recent disclosures of failures of care in the national health service (nhs) in england have led to debates about compassion deficits disallowing health professionals to provide high quality responsive care. while the link between high quality care and compassion is often taken for granted, it is less obvious how compassion – often originating in the individual’s emotional response – can become ...

Molecular Haematology, Division of Cancer Studies, King’s College London, London, United Kingdom; Department of Haematological Medicine, King’s College Hospital National Health Service (NHS) Foundation Trust, London, United Kingdom; Division of Health and Social Care, King’s College London, London, United Kingdom; National Institute for Health Research (NIHR) Biomedical Research Centre, Guy’s a...