Abstract
The period of sustained financial austerity since 2009 has led to a shift in competition policy within the English National Health Service. Policymakers have directed their attention away from the preexisting priority to support quicker access to routine and planned hospital care and have focused instead on improving emergency, cancer, and general practitioner services. This has prompted the development of a new policy framework and, in particular, a desire to create collaborative health systems focused on specific populations. In addition, previous policy initiatives to engage the leadership of general practitioners in planning services have been revisited. The overall effect has been to shift emphasis away from competitive markets and back toward a planning approach.