A bed too far: The implementation of freedom of choice policy in the NHS

Freedom of hospital choice has become a popular policy among the European public health services to ensure better patient rights, reduce waiting times and improve efficiency and quality in public hospitals. The English National Health Service has recently adopted this policy. This organisation needs to introduce important reforms in order to implement this policy, in particular in the information that it provides to patients. This paper presents the Andalusian Health Service (SAS) initiative in the disclosure of information, based on patient surveys, so it can be understood by patients. Andalusia implemented a freedom of choice policy 10 years ago. This paper also studies how SAS hospitals are scored by patients and how the quality of hospitals may affect their choice. Regression analyses indicate that two hospital dimensions, a ‘human dimension’ and a ‘facilities dimension’, significantly explain how patients assess the quality of the Andalusian hospitals. Nonetheless, these two dimensions do not explain the reputation of the hospitals, a main aspect when choosing a hospital, to the same extent. The lessons provided by looking at the SAS experience may give an insightful knowledge on whether patients in England will finally opt for the best hospitals.