Current Issues in Health Service Management

1
Current Issues in Health Service Management
What are the measure and policies adopted
United Kingdom

• Chan Yuk King, Irene
• Lui Ching Man, Man
• Wan Sau Ying, Irony
• Wong Shun Tim, Ray
• Leung Chi Kit, Jackson
• Chan Wai Fung, Anita

2
Main Challenge of UK Health Care System

• Allocation of Resources
• 2003-2004
• 12 NHS trust 4 primary care trusts overspend
  more than 5m.
• 106 NHS bodies failed to balance their books

3
Political-led NHS I

• The NHS was setup by the Attlee Labour government
  in 1948
• Principle From Cradle to Grave
• All citizens would have access to the health care
  they needed regardless of income

4
Political-led NHS I

• Vote-catching-reluctant to change the payment
  system
• The financing of the NHS through taxation, with
  Parliament voting on money to cover costs, proved
  to be an immediate problem

5
Political-led NHS I
Allocation of Resource
tax-funding monopoly
6
Political-led NHS II

• Reform of the NHS
• Patient-led NHS
• Redefine the NHS as the facilitator not provider
• Allocation of resources
• Money follow patients
• Payment by result
• Primary Care Trust (PCTs)
• Private Finance Initiative (PFI)
• Public-private Partnership (PPP)
• Local Improvement Finance Trust (LIFT)
• Foundation Hospital Trusts

7
NHS Funding
8
Overcentralisation I

• In 1990s
• Central government and the NHS
• Command-and control model
• Market fragmentation model
• Result in hierarchic

9
Overcentralisation II

• Introduce the internal market model
• Separation of the roles of provider and purchaser
• Competition
• Shape services around patients needs

10
Disempowered patients I

• Services vs Patients
• Too hierarchical and paternalistic
• patients do not have their own records
• The complaints system is discredited in the NHS
• Patients have few rights of redress when things
  go wrong

11
Disempowered patients II

• Information to empower patients
• Expert Patient Programme
• NHS Direct online
• NHS Direct information
• Strengthening patients choice
• Pateint Choice
• GPs who willl not the fundholders within the
  PCT

12
Disempowered patients II (contd)

• Patient advocacy services
• Supporting Doctors, Protecting Patients
• Doctors - as a condition of contract
• Annual appraisal and clinical audit
• Establish of the National Clinical Assessment
  Authority
• Protection for patients
• NHS-wide patient advocacy and Liasion Service
  (PALS)

13
Improving health Reducing Inequality I

• Wide gap between health needs and health services
• Disadvantage in all forms
• Poverty
• Lack of educational attainment
• Unemployment
• Discrimination and social exclusion

14
Improving health Reducing Inequality II

• Particular emphasis on health inequalities at
  ministerial level in 1997
• In 2004, DoH stated that different needs and
  equalities should be taken into account
• Geographic region
• Socio-economic group
• Gender and age
• Faith and ethnicity
• Disability
• Race
• Sexual orientation

15
Improving health Reducing Inequality II (contd)

• Setting a national inequalities target
• The White Paper-Saving Lives Our Healthier
  Nations
• Reducing inequalities in access to NHS services
• The inverse care Law
• Ensuring a healthy start in life
• A new sexual health and HIV strategy
• Screening programme for women and children
• Teenage pregnancy strategy

16
Improving health Reducing Inequality II (contd)

• Reducing smoking
• White Paper-Smoking Kills
• Improving diet and nutrition
• Tackling drugs and alcohol-related crime
• New partnerships to tackle inequality
• NHS
• Governments National Strategic Partnership

17
Aging Population I

• People over 65 account for 2/3 of hospital
  patients
• 40 of all emergency admissions

18
(No Transcript)
19
Aging Population II

• Assuring standards of care
• NSF ensure that ageism is not tolerated ,with the
  elimination of any arbitrary policies based on
  age alone
• Extending access to services
• NHS retirement health check
• Promoting independence in old age
• Ensuring fairness in funding
• Establish of the Royal Commission on Long-Term
  Care
• Nursing homes is fully funded by the NHS

20
Standard of Health Care I

• Different healthcare provider
• 1. NHS Foundation Trusts
• 2. Prviate health care providers
• 3. Voluntary health care providers

21
Standard of Health Care II

• Monitor the Standard for Better Health
• Healthcare Commission (HC) of all health care
  organization
• Commission for Social Care Inspection (CSCI)
• Standard Based System
• National Service Frameworks (NSFs)
• National Institute for Clinical Excellence (NICE)

22
Standard of Health Care II

• PCTs working with Local Authorities (LAs), NHS
  partners and other organization
• Contribute to the achievement of national
  priorities and targets

23
Conclusion

• As the cost containment of the UK Health services
  system
• Health services system is undergoing a series of
  reform for its improvement