Key elements of market-based incentives in the NHS to date have included competition among providers, choice for patients, and national prices (tariffs). On the basis of the available international evidence the Nuffield Trust considers that all these areas need further development in synergy with one another.
Key challenges facing the new economic regulator include the establishment of a correct tariff rate, making a decision about what forms of competition should be encouraged, and tackling the barriers to entry, exit and expansion faced by providers. We also believe it is important to recognise that an effective economic regulator will be a very powerful force influencing the pattern and cost of health care across England. Our response urges the Government to consider how accountability and public engagement are to be managed.