Chapter 10 THE UNITED KINGDOM Chapter 10: Overview • Country Description • Brief History of the Healthcare System • Description of the Healthcare System • Evaluation of the Healthcare System • Emerging Challenges • Conclusion Country Description • History • Government or Political System • Macroeconomics • Major Industries, Ports and Airports, and Infrastructure and Transportation Development Demographics • Age Distribution of the Population • Education Levels of the Population • Major Religious Groups Brief History of the Healthcare System • Pre-World War II – Hospitals – General practice – Payment • Private • Government Brief History of the Healthcare System • Post-World War II – Emergence of the modern system – Development of the Ministry of Health Description of the Healthcare System • Delivery at the local level • Connecting for Health Description of the Healthcare System • Primary Care – Community based – Practice-based Commissioning • Others Care Description of the Healthcare System • Secondary Care – NHS Acute Trusts – NHS Foundation Trusts Description of the Healthcare System • Secondary Care – Employment of professional staff • Long-term care • Private sector Description of the Healthcare System • Facilities – GP surgeries – Hospitals Description of the Healthcare System • Workforce – Medical education • Technology and equipment Evaluation of the Healthcare System • Cost – Funding – NHS Plan Evaluation of the Healthcare System • General Medical Services contract – Payment for results • Primary Medical Services Evaluation of the Healthcare System • Quality – Population health measures • Access • Innovation Current and Emerging Issues and Challenges • Increase in private sector participation • Waiting times • Utilization review • Increasing costs and budget restraints Current and Emerging Issues and Challenges • Growing and aging population is increasing demand • Significant pressure on the government to erase a budget deficit • Budget restraint is for NHS trusts and foundation trusts • Passage of the Health and Care Act of 2016 lays the groundwork for improvement Conclusion • Continues as a fairly stable health system • Political upheaval and budget pressure affecting the health system’s stability • System is designed for primary, public health, and tertiary care • Health outcomes some of the best in the world • Aging population remains a major challenge This Section Reserved for Instructors Suggested Discussion or Research Questions General Question Categories • • • • • • • • • Structure and Evaluation Healthcare Services and Systems Global Burden of Disease Cultural Influences Medical Travel and Tourism and Off Shoring Health Communication, Marketing, Social Marketing Data and Measurement Policy, Strategy, and the Regulatory Environment Global Health Leadership International Best Practices Discussion or Research Questions • Some experts state the National Health System (NHS) in the United Kingdom is ‘not fit for the future’ and unless it undergoes radical change. Many think it may be forced to abandon free healthcare for all. Do you believe this statement? Why or why not? • What types of organizations are responsible for the delivery of care in the National Health Services? • Delivery of care is divided into primary and secondary systems. Who is responsible for funding and providing care within each of the systems? Discussion or Research Questions • Describe the role of the private sector in the national healthcare delivery system. • How are primary care services reimbursed and describe the pay-for-performance component of the reimbursement system? Suggested Topic Areas To Use When Facilitating Discussions, Projects, or Case Studies • Engagement of stakeholders • Effectively working in and managing teams • Learning how to get in front of the problem or identify opportunities • Learning to communicate effectively • Assessment of solutions that fit the country • Embracing systems thinking • Recognize and embrace diversity • Sustaining the mission of health as well as health care Links to Suggested Images • https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialca re/healthcaresystem/articles/expenditureonhealthcareintheuk/2015-03-26 • http://evidencenetwork.ca/archives/24206 • http://www.commonwealthfund.org/publications/fundreports/2014/jun/mirror-mirror • https://www.avert.org/professionals/hiv-around-world/western-centraleurope-north-america/uk
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