Mark Exworthy

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This article examines the context within which coterminosity (the coincidence of geographical boundaries between two or more organisations) is currently being re-defined, given the development of purchasing in health and social care agencies in the British welfare system. It explores the current trends within purchasing and especially the notion of(More)
Like health equity, the social determinants of health (SDH) are becoming a key focus for policy-makers in many low and middle income countries. Yet despite accumulating evidence on the causes and manifestations of SDH, there is relatively little understanding about how public policy can address such complex and intractable issues. This paper aims to raise(More)
This paper reports from an ethnographic study of hospital planning in England undertaken between 2006 and 2009. We explored how a policy to centralise hospital services was espoused in national policy documents, how this shifted over time and how it was translated in practice. We found that policy texts defined hospital planning as a clinical issue and(More)
OBJECTIVES To test the feasibility of deriving comparative indicators in all the practices within a primary care group. DESIGN A retrospective audit using practice computer systems and random note review. SETTING A primary care group in southern England. SUBJECTS All 18 general practices in a primary care group. MAIN OUTCOME MEASURES Twenty six(More)
It is estimated that over 50,000 individuals from the UK each year elect to fund their own treatment abroad. Such treatments commonly include cosmetic and dental surgery; cardio, orthopaedic and bariatric surgery; IVF treatment; and organ and tissue transplantation. The UK has also experienced inward flows of patients who travel to receive treatment and pay(More)
The development of health policy is recognized as complex; however, there has been little development of the role of agency in this process. Kingdon developed the concept of policy entrepreneur (PE) within his ‘windows’ model. He argued inter-related ‘policy streams' must coincide for important issues to become addressed. The conjoining of these streams may(More)
Foundation trusts (FTs) have been a central part of the government's National Health Service (NHS) reforms in England since 2004. They illustrate the government's claim to decentralization, by granting greater autonomy to high performing organizations. The number of FTs has grown steadily, reaching 131 in September 2010, over 50% of eligible trusts. Despite(More)
US health policy is beginning to address health-care disparities, mainly in terms of racial/ethnic groups and access to care for vulnerable groups. Though not widespread, policies are engaging a wide range of organizations, including federal, state and local government, insurers, providers and philanthropic foundations. It initially seems strange that US(More)
GOAL Assess the progress and pitfalls of current United Kingdom (U.K.) policies to reduce health inequalities. OBJECTIVES (1) Describe the context enabling health inequalities to get onto the policy agenda in the United Kingdom. (2) Categorize and assess selected current U.K. policies that may affect health inequalities. (3) Apply the "policy windows"(More)
OBJECTIVES To investigate reactions to the use of evidence-based cardiovascular and stroke performance indicators within one primary care group. DESIGN Qualitative analysis of semi-structured interviews. SETTING Fifteen practices from a primary care group in southern England. PARTICIPANTS Fifty two primary health care professionals including 29(More)