A recent study led by the Leverhulme Centre for Demographic Science’s Associate Professor Charles Rahal provides the most comprehensive analysis to date on how charities and voluntary organisations contribute to service delivery for the UK's National Health Service (NHS).
In collaboration with John Mohan from the Third Sector Research Centre at the University of Birmingham, the study used a dataset of over 25,000 procurement datasets which contain information on £445 billion worth of transactions across over 1.9 million rows of data between 2012 and 2020.
The study found that non-profit organisations were involved in about 1% of all NHS procurement by both value and volume, indicating that their participation remains limited despite the recent Health and Social Care Act of 2012 which aimed to expand markets for NHS procurement and encourage competition.
Associate Professor Charles Rahal said, ‘Through the harmonisation and analysis of a vast number of heterogenous procurement datasets, we have gained a clearer understanding of the role of charitable enterprises in the delivery of public health services. Our findings stress the need for more targeted policies to fully leverage the potential of non-profits in delivering healthcare.’
The study found that non-profit organisations provided a wide range of services, categorised using both International Classification of Non-Profit Organisations (ICNPO) and Standard Industrial Classification (SIC) codes. Notably, the ‘Social Services’ sector saw more frequent payments, but the highest cumulative values were, perhaps unsurprisingly, delivered by the ‘Health’ sector.
The research also highlighted how contracts were distributed across various types and sizes of non-profits, with Community Interest Companies (CICs) often receiving high-value contracts alongside smaller grassroots organisations.
Charles Rahal adds, ‘By using ‘Big Data’ techniques to leverage procurement records made public through the Coalition government's transparency agenda, this study demonstrates the value of large, non-standard public administration records for the analysis of public policy and public service delivery. We hope that our work acts as a guide for future data harmonisation efforts as the NHS – at the macro, meso, and micro levels – perseveres to become increasingly efficient.’
This work began in 2015 and has received funding over the years from the Economic and Social Research Council (ES/M010392/1, ES/M010392/1), the British Academy, and the Leverhulme Trust (Grant RC-2018-003). The code library which powers this work – termed NHSSpend – can be found on GitHub. An open-source version of the study is also available. Please cite the study and code library as follows:
Rahal, C., and Mohan, J. (2024), ‘The role of the third sector in public health service provision: evidence from 25,338 heterogeneous procurement datasets’, Journal of the Royal Statistical Society Series A: Statistics in Society, 2024; 10.1093/jrsssa/qnae092.
Rahal, C., Knowles, I., Barnard, S., and Mohan, J., (2021), ‘Introducing NHSSpend: Data and code to parse, harmonize and reconcile NHS procurement data, Zenodo; 10.5281/zenodo.5054679‘
