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Inter-Organisational Purchasing Networks: Evolution Of Consortia Based Purchasing Amongst GP Fundholders

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Abstract

In the last few years there have been considerable changes in the National Health Service Arguably the most significant of these has been the introduction of competition into health care, that is the split of the health service into purchasers and providers of care. Central to this development has been the introduction of General Practice Fundholding, whereby practices are able to purchase health care for their patients directly from competing suppliers Those practices which have become fundholders have faced considerable challenges in developing their purchasing function given the complexities of contracting within the context of the NHS Internal Market Although one of the original aims of GP Fundholding was to facilitate locally responsive purchasing, such have been the complexities of contracting that many fundholding practices have attempted to reduce the managerial demands of purchasing through membership of purchasing consortia. Based on an in-depth study of GP Fundholders across Scotland, this paper explores the development of consortia based purchasing. Specifically this paper seeks to address three issues central to the evolution of inter-organisational purchasing networks Firstly the patterns of organisational structure and evolving operational dynamics of such consortia Secondly the impact of such networks on the process and pattern of organisational purchasing Thirdly the managerial implications of purchasing through such inter-organisational networks for the participating organisations These issues will be addressed within the context of evolving perspectives on inter-organisational networks and the dynamics of purchasing centres This examination should serve to throw further light on both the dynamics of health care purchasing and contribute to the understanding of the evolution of inter-organisational purchasing networks In particular it will address whether such patterns of purchaser development has impacted on the evolution of locally responsive purchasing.

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