Regulation, `donated labour' and the NHS reforms

The main objective of this exploratory study was to assess the effects of the NHS reforms on the motivations and performance of doctors and nurses at the University College London Hospital (UCLH) and, in particular, the extent to which the extrinsic incentives inherent in a
more rigorous management regime undermined or enhanced the intrinsic incentives on
which clinical activity and performance in the NHS had depended formerly.
The research was based primarily on interviews with 46 doctors and 48 nurses employed by
UCLH and their psychometric profiles supplemented with information from interviews with
Clinical Directors and General Managers, on data recording clinical activity extracted from
the Hospital Episodes Statistics (HES) database and on financial data provided by the UCLH
Accounts Department. Clinical activity was measured by the number of Finished Consultants
Episodes (FCEs) per annum. An incomplete measure of labour productivity was given by
FCEs per consultant.