The use of standard contracts in the English National Health Service: A case study analysis

► Economic and socio-legal theories predict that contracting for health care is problematic. ► In health care it is impossible to specify in detail all eventualities and relational contracting is significant. ► We investigated implementation of a new detailed contract introduced in England in 2007. ► As predicted by theory we found that contracting in England depended on personal and hierarchical relationships. ► Financial risk was allocated via informal agreements and hierarchical intervention prevented disputes escalating.