The National Health Service and How it Provides Service to the Public - Literature review Example

This paper analyses the performance of the National Health Service and makes recommendations on how it can improve on service delivery. It reviews literature on the quality of service offered by the National Health Service and proposes new ways of service delivery. With regards to this, the paper will define performance management, how it is measured and then proceeds to the current health status of Britons before delving into the challenges being faced and how best to fix them. Introduction The British National Health Service before the internal market reforms of the 1990s was a snarl-up of vicious incentives which made it very inefficient.

Increased efficiency was achieved through the introduction of market incentives which in turn stimulated innovation in primary practice care. The improvement in service delivery followed because the medical practitioners had devised better ways of delivering quality service to the patients (Enthoven, 2000). This paper will review literature on all the attempts made by the government to ensure that the citizens get quality healthcare and enumerate the reasons why some of them flopped as others succeeded.

The current performance level of the British National Health Service will also be carefully analysed. . This restricted the free flow of performance of the system because the government retained most of the control powers. The other reason for the dismal performance was because the experiment itself was based on an inadequate comprehension of both professional and managerial motivations. The importance of decentralisation in large corporations in terms international development cannot be overemphasised at this level.

This is not limited to the private sector as the public sector has equally benefitted from this. The self governing trusts were introduced in the British National Health Service in the 1990s to serve as a paradigm case for the decentralisation of the public sector (Arrowsmith & Sisson, 2002). The progressive introduction of activity based funding in the National Health Service has been done progressively since the year 2003 under the name payment by results. This is representative of a major shift from the previous funding arrangements that were based on annual block payments for large bundles of services to what is being practiced at the moment (Sussex, & Farrar, 2009).

The results from an interview done by Sussex and Farra (2009) indicated that there is a high degree of solidarity among the employees of National Health Service and the competition among the NHS hospitals was greatly curtailed. The problem however is that the payment by results initiative was introduced against a background of many other efficiency incentives. The managers did not detect any further specific boost effect of the initiative which was a major cause of concern for the policy makers.

The fact that no impact on care quality was reported raises concerns on the appropriateness of the initiative itself. Perverse Bureaucratic