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Competition between hospitals improves care, says research

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Hospitals perform better when senior staff have clinical backgrounds and there is competition from nearby health trusts, according to research.

Strong NHS management was linked to the number of neighbouring trusts competing for patients and effective communication with nurses and medical staff, the London School of Economics found.

Its Centre for Economic Performance studied nearly two-thirds of England’s acute hospitals, and reported political importance of the surrounding area also played a role.

“All else equal, hospitals located in marginal [electoral] constituencies are much less likely to be closed than hospitals in safe seats,” it said, which allowed comparison between “near-identical” areas with few or many hospitals.

The study suggested improved “managerial quality” could be due to the government’s “quasi-market” reforms creating competition for top jobs or patient numbers.

Researchers said patient outcomes also improved with better management, noting: “A one-standard deviation improvement in management is associated with a fall in the death rate from heart attacks from 17% to 16%.”

According to the research sample, this figure translates into roughly 400 fewer fatal heart attacks every year.

The study concluded: “Whatever the exact mechanism, having more local rivals does appear to have advantages for management and patient care.”

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