The Health service journal
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A survey of acute trusts and health authorities suggests that expenditure in the private sector has more than doubled since the signing of the concordat in October 2000. But it still represents less than 1 per cent of total acute spending. ⋯ More than three-quarters of respondents cited prices in the independent sector as a barrier to greater collaboration. There is little evidence of NHS organisations and those in the independent sector forming partnerships for long-term service planning.
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The differences between the English and Scottish health systems are becoming increasingly wide. The star-grading system in England has led to a winners and losers model, whereas Scotland has gone for a more collective approach. England has emphasised partnership with the private sector, Scotland with the voluntary sector and councils. Both systems will rely increasingly on staff involvement.
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A study of bed occupancy in 21 hospitals over the past two years showed an average of 29 per cent of patients no longer needed acute care. Two-thirds of this group had been in hospital for more than 28 days. About a fifth of this group were under 65. The main reasons for delayed discharges were waits for social services assessment or home-care packages.