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abpi unit one > 1.2.7 NHS in the devolved nations > Flashcards

1.2.7 NHS in the devolved nations Flashcards

1
Q

1.2.7.1 WALES
Wales does not have the purchaser provider split (the internal market where parts of the English NHS buy services from other parts) Instead what do the Welsh NHS operate through?

A

Integrated health boards.

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2
Q

Healthcare and social care in Wales were established as what type of sectors?

A

Distinct sectors.

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3
Q

How is healthcare in Wales funded?

A

Healthcare in Wales is almost entirely publicly funded

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4
Q

Who plans and commissions healthcare in Wales?

A

Healthcare in Wales is planned and commissioned by the NHS.

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5
Q

How is social care in Wales funded?

A

Social care is publicly and privately funded.

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6
Q

What is social care in Wales provided through?

A

Social Care is provided through multiple public, private and voluntary providers.

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7
Q

When did the reorganisation of NHS Wales come into effect?

A

The reorganisation of NHS Wales came into effect on 1st October 2009.

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8
Q

What did the reorganisation of NHS Wales create?

A

The reorganisation of NHS Wales created a single local health organisation that are responsible for delivering all healthcare services within a geographical area, rather than the Trust and Local Health Board system that existed previously.

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9
Q

The NHS now delivers services through Local Health Boards and NHS Trusts. How many Local Health Board and NHS Trusts are there?

A

There are 7 Local Health Boards and 3 NHS Trusts.

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10
Q

There are currently 3 NHS Trusts in Wales with an all wales focus, what are these?

A

The Welsh ambulance Services Trust for emergency services.
The Velindre NHS Trust offering specialist services in cancer care and a range of national support services.
The New Public Health Wales.

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11
Q

In the Welsh Government’s draft budget 2019-2020, the Health and social Services Main Expenditure Group (MEG) was how much?

A

£8,347million, a 5.4% increase in real terms from the 2018-19 supplementary budget.

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12
Q

What does the Health and Social Service MEG contain the core revenue and capital funding for?

A

The Health and social services MEG contains the core revenue and capital funding for NHS Wales, as well as funding to support public health, social care and supporting children.

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13
Q

How much additional revenue funding does the Welsh Government plan to invest in health and social care in 2019-2020?

A

The Welsh Government plans to invest more than £500m additional revenue funding in health and social care in 2019-2020.

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14
Q

In 2017-18 how many health boards failed to meet the first financial duty and also failed to have a three-year integrated-term plans approved?

A

4 health boards.

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15
Q

Patients in Wales would receive primary and secondary care via what?

A

Health Boards

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16
Q

When was ‘a revolution from within: transforming health and care in Wales’ published? and what did it highlight?

A

Was published in 2018 and highlighted that the current pattern of health and social care provision was not fit for further

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17
Q

What demonstrated the need for change?

A

The need for change is demonstrated by the fact that spending on health and care is outpacing the growth of the country’s wealth and currently health and care consume a growing proportion of the welsh governments budget.

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18
Q

The report proposed that the vision of one system of seamless health and care for Wales should aim to delivery against how many mutually supportive goals? what are these known as?

A

Four mutually supportive goals known as the quadruple Aim.

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19
Q

What are the 4 goals of the quadruple aim?

A

a) improve population health and wellbeing through a focus on prevention.
b) improve the experience and quality of care for individuals and families.
c) enrich the wellbeing capability and engagement of the health and social care workforce
d) increase the value achieved from funding of health and care through improvement, innovation, use fo best practice and eliminating waste.

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20
Q

“A healthier Wales: Our Plan for Health and Social Care” = this plan is in response to what/

A

The Parliamentary Review Report.

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21
Q

What does the plan set out a long term future vision for?

A

a ‘whole system approach to health and social care’ which is focused on health and wellbeing and on preventing illness.

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22
Q

To achieve the future vision, what will they do?

A
  • The will develop new models of seamless local health and social care which will scale from local to national level.
  • A national Transformation Programme will ensure that change happens quickly and with purpose across wales.
  • it will provide targeted funding and resources to accelerate progress through a dedicated £100m Transformation fund.
  • A new national executive function linked to a regional focus for integrated local health and social care delivery.
    This will include a shared planning approach at national, regional and local levels, supported by levers for change and quality statements.
  • increased investment in digital technologies as a key enabler of change.
  • support and invest in the development of the health, social care and third sector workforce including unpaid carers and volunterrs.
  • co-ordination of research, innovation and improvement activity.
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23
Q

What does the NHS Wales Planning Framework2019-22 set out?

A

The Framework sets out the principles that underpin the 2019-22 Integrated Medium Term Plans (IMTPs) as well as providing the necessary guidance to empower NHS organisations to produce approvable plans

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24
Q

What must the IMTPs continue to demonstrate?

A

IMTPs must continue to demonstrate a truly integrated planning approach.

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25
Q

A truly integrated planning approach must link population need to what? and must set out what?

A

This approach must link population need to quality, service models, capacity requirements, workforce development and capital and should set out how health boards and trusts will work together and with their partners to continuously improve services for the people they serve.

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26
Q

What are expected to have a strong role to play, brining together a range of stakeholders inc, social care, health, the third sector and the independent sector?

A

Regional Partnership Boards (RPBs)

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27
Q

Are prescriptions free in wales?

A

Yes!

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28
Q

What is the AWMSG?

A

The All Wales Medicines Strategy Group established as a statutory advisory Welsh Assembly sponsored public body under the 1977 NHS Act, to provide advice on medicines managements and prescribing to Welsh Government in an effective, efficient and transparent manner.

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29
Q

When was the AWMSG established

A

2002

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30
Q

What medicines is there mandatory funding for?

A

All positive NICE and AWMSG guidance three months after a decision has been made, making all NICE AWMSG approved medicines routinely available.

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31
Q

What is the WPAS?

A

Wales Patient Access Schemes are proposed by pharma companies and agreed with the Welsh Government with input from the Patient Access Scheme Wales Group PASWG within the AWMSG Health Technology Assessment process.

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32
Q

What happens if a WPAS is considered feasible?

A

The company will be invited to include the WPAS alongside its submission for medicines appraisal by the AWMSG.

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33
Q

For requests that are received for healthcare that falls outside of the routinely funded range of services and include requests for treatment and medicines that are not routinely available within NHS Wales - these are referred to as what?

A

Individual Patient Funding Requestions (IPFR)

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34
Q

1.2.7.2 SCOTLAND

Who is responsible for the National Health Service in Scotland?

A

The National Health Service in Scotland is a devolved matter and therefore rests with the Scottish Government.

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35
Q

Legislation about the NHS is made by who?

A

The Scottish Parliament.

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36
Q

Who had ministerial responsibility in the Scottish Cabinet for the NHS in Scotland?

A

The Cabinet Secretary for Health and Wellbeing.

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37
Q

Who decides what resources are to be devoted to the NHS in the context of devolved public expenditure?

A

The Scottish Government.

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38
Q

What was the total Scottish Government health budge in 2017/18?

A

£13.1 billion.

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39
Q

What does Scotland, like Wales, focus on, unlike England? What is it building towards?

A

Scotland, like Wales focuses on integration and collaboration rather than as in England competition and choice.
There is no tariff for hospital services (except for cross boundary flow activity)
Scotland is building towards integrated health and social care.

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40
Q

Where has a lowest life expectancy in Western Europe and the lowest of the UK countries?

A

Scotland!

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41
Q

What did a report publish in 2018 by Audit Scotland highlight?

A

Audit Scotland published in October 18 a report which highlighted that NHS Scotland is not in a financially sustainable position and performance against the 8 key national performance targets continues to decline.

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42
Q

How many board met all of the key national targets?

A

No boards.

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43
Q

How many boards met the 62-day target for cancer referrals?

A

3.

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44
Q

What was the only target met nationally in 2017/18?

A

For drug and alcohol patients to be seen within 3 weeks.

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45
Q

How many NHS Boards are there covering the whole of Scotland?

A

14 NHS Boards.

46
Q

How many national or special NHS boards provide national services

A

7 national or special NHS boards provide national services.

47
Q

What do the Healthcare Improvement body - Healthcare Improvement Scotland provide?

A

The healthcare improvement body, healthcare improvement Scotland provides scrutiny and public assurance of health services.

48
Q

NHS Boards in Scotland are all purpose organisations -what do they do?

A

The plan, commission and delivery NHS services and take overall responsibility for the health of their populations.
They therefore plan and commission hospital and community health services inc. services provided by GPs, dentists, community pharmacists and opticians who are independent contractors.

49
Q

Practice Question: Regional NHS boards are responsible for:

A

Commissioning, general practice and community services.

50
Q

Practice Question: Scotland uses what to deliver services?

A

Scotland uses NHS Boards to delivery services.

51
Q

In 2011 following on from the launch of the Quality Strategy, the Scottish Government announced its ambitious plan for what?

A

For integrated health and social care and set out the 2020 Vision and Strategic Narrative for achieving sustainable quality in the delivery of health and social care across Scotland.

52
Q

What did the Public Bodies (Joint Working) (Scotland) Act, 2014 intend to ensure?

A

It intended to ensure that health and social care services are well integrated so that people receive the care they need at the right time and in the right setting with force on community based preventative care.

53
Q

What is a key priority of health and social care for the Scottish Government?

A

Integration of health and social care.

54
Q

Integration is not the goal in itself, what is the main objective?

A

The main objective is to improve health, wellbeing and quality care - integration is need as necessary because the belief is if services are planned and delivered together rather than each pursuing its own strategy independent the resulting improved efficiency will help Scotland to mange the predicted increases in demand as people live for longer with multiple health conditions and ensure sustainable health and social care services.

55
Q

What is the 2020 vision?

A

To return people to their home or community asap.

56
Q

When was the health and social care delivery plan published, what does it set out and what is the aim?

A

The delivery plan published in 2016 sets out their programme to further enhance health and social care services.
The aim is for people of Scotland to live longer, healthier lives at home or in a homely setting and have a health and social care system that:

  • is integrated
  • focuses on prevention, anticipation and supported self management.
  • will make day case treatment the norm, where hospital treatment is required and cannot be provided in a community setting.
  • focuses on care being provided to the highest standards of quality and safety, whatever the setting with the person at the centre of all decisions and ensures people get back into their home or community environment as soon as appropriate with minimal risk of re-admission.
57
Q

The plan focuses on 3 areas often referred to as the triple aim: What are these 3 areas/

A

1) Better Care: improve the quality of care for people by targeting investment at improving serviced which will be organised and delivered to provide the best most effective support of all.
2) Better Health: Improve everyone health and wellbeing by promoting and supporting healthier lives from the earliest years, reducing health inequalities and adopting an approach based on anticipation, prevention and self management.
3) Better Value: Increase the value from and financial sustainability of care by making the most effective use of the resources available to us and the e most efficient and consistent delivery ensuring that the balance of resource is spent where it achieves the most and focusing on prevention and early intervention.

58
Q

Practice Question: The Scottish Gov 2020’s Vision includes what?

A

The integration of Heath and Social Care.

59
Q

Practice Question: Health and social Care Partnerships are being established using what?

A

Using NHS Board and Local Authority Budgets.

60
Q

What are jointly accountable for delivering the 9 national health and wellbeing outcomes in Scotland, used to monitor local and national progress?

A

NHS boards and Local Authorities.

61
Q

Scotland is aiming to be a world leader in improving the publics health through a new vision for organisations and communities across the country. The priorities set a directions for Scotlands public services over the next decade, which the aim of organisations and communities working together to focus on what three things?

A

Focus on:

  • Prevention
  • Reduce health inequality
  • -nIncrease healthy life expectancy.
62
Q

Within the public health priorities for Scotland, what do the priorities reflect a consensus for co-ordinated action on? (6 points)?

A

1) Health places and communities.
2) Early years
3) Mental wellbeing
4) Harmful substances
5) Poverty and inequality
6) Healthy weight and physical activity.

63
Q

Which act required councils and NHSS boards to work together to form new partnerships, known as Integration Authorities (IAs)?

A

The Public Bodies (Joint Working) (Scotland) Act 2014 (the Act)

64
Q

How many Integration Authorities (Its( were established through partnerships between the 14 NHS boards and 32 councils in Scotland?

A

31 IAs.

65
Q

As part of The Public Bodies (Joint Working) (Scotland) Act 2014 (the Act) - what new bodies were created?

A

Integration Joint Boards (IJBs)

66
Q

What boards are a separate legal entity, responsible for the strategic planning and commissioning of the wide range of health and social care services across a partnership area?

A

Integration Joint Boards.

67
Q

How many of the 31 IAs in Scotland are IJBs?

A

Out of the 31 IAs in Scotland, 30 are IJBs

68
Q

Which area continues with a Lead Agency model which has operated for several years?

A

Highlands. - here the NHS board and council each lead integrated services.

69
Q

Who have Clackmannanshire and Stirling Councils created a single IA with?

A

NHS Forth Valley.

70
Q

Which authorities oversee almost £9billion of health and social care recourses, money which was previously managed by the NHS boards and councils?

A

Integrated Authorities.

71
Q

A key part of the reforms is that IJB would direct some services provided directly within acute hospitals to move where?

A

Closer to peoples homes and provide more joined up care.

72
Q

Who do Integration schemes as approved by minister state that hospital service will be delegated to?

A

The IJB as required under the Act - however in practice in most areas, the services have not been delegated.

73
Q

What is the price for prescriptions in Scotland?

A

They are free.

74
Q

What provides advice to NH Scotland about the blue for patients of every newly licensed medicine?

A

The Scottish Medicines Consortium.

75
Q

Before a medicines can be prescribed routinely in Scotland, who’s does it have to be accepted by?

A

The Scottish Medicine Consortium (SMC)

76
Q

When it come to Medicines and prescriptions in Scotland, who makes the assessments?

A

Scotland makes its own assessments.

77
Q

As part of a medicines submission to be prescribed routinely in Scotland, what may pharmaceutical companies propose?

A

A Patient Access scheme (PAS) - to improve the cost effectiveness of a medicine which may otherwise not be cost effective for NHS Scotland.

78
Q

When SMC accepts a new medicines, NHS boards are expected to make it, or an equivalent MC-accepted medicines available - what are the NH boards expected to publish?

A

Updated lists of SMC-accepted medicine is included and excluded from their formularies together with the reason for such decisions.

79
Q

What happens when a medicine is not recommended by SMC but a doctor feels the medicine would be right for a particular patient?

A

All NHS boards have procedures in place to consider individual requests when a doctor feels the medicine would be right for a particular patient.

80
Q

In Northern Ireland, what is the National Health Service (NHS) referred to as?

A

HSC or Health and Social Care

81
Q

Just like the NHS in England, it is free at the point of delivery but in NI what does it also provide?

A

It also provides social care services like home care services, family and children’s services, day care services and social work services.

82
Q

What is the department which has overall authority and allocation of government funding?

A

The Department of Health, Social Services and Public Safety for Northern Ireland (DHSSPS)

83
Q

When was The Department of Health, Social Services and Public Safety for Northern Ireland (DHSSPS) as part of the Northern Ireland Executive and it is one out of how many NI Government Departments?

A

DHSSPS was created in 1999 and it one of 11 NI Government Departments.

84
Q

What sits between the Department and Trusts and is responsible for commissioning services, managing resources and performance improvement?

A

The Health and Social Board

85
Q

What is directly responsible for managing contracts from Family health services provided by GPs, dentists, opticians and community pharmacists

A

The Health and Social Board

86
Q

What is the Health and Social Care Board in NI responsible for? (4 points) (PQ)

A
  • Commissions services
  • Deploys funding
  • Implements NICE guidance
  • Manages performance in Health and Social Care Trusts.
87
Q

What groups are inside the board that focus on the planning and resourcing of services?

A

Local Commissioning Groups (LCGs)

88
Q

What do Local Commissioning Groups (LCGs) cover the same area as?

A

The Health and Social Care Trusts

89
Q

How many Health and Social Care Trusts are there?

A

5

90
Q

What provides health and social services across NI, while the Board commissions services, what actually provide them on the ground?

A

The 5 Health and Social Care Trusts.

91
Q

What does each trust manage of their own?

A

Their own staff and services and controls its own budget.

92
Q

What is a statutory organisation?

A

The Health and Social Care Board

93
Q

What arranges or commissions health and social care for the population of Northern Ireland?

A

The Health and Social Care Board.

94
Q

Who is accountable to the Health Minister, for turning their vision for health and social care into a range of services that deliver high quality and safe outcomes for patient and service users, are good value for the taxpayer and comply with statutory duties?

A

The Health and Social Care Board.

95
Q

The 5 Local Commissioning Groups are co-terminus with their respective Health and Social Care Trust area: What are these areas?

A 
Northern LCG/ HSC Trust 
Belfast LCG/ HSC Trust 
Southern
South East
Western
96
Q

What are committees of the HSCB and responsible for ensuring that health and social care needs of local populations across Northern Ireland are addressed?

A

The 5 Local Commissioning Groups (LCGs)

97
Q

In October 2016, a 10 year approach to transforming health and social care was launched. What was this called?

A

Health and Wellbeing 2026: Delivering Together

98
Q

What ambitious plan was the response to the report produced by an Expert Panel led by Professor Bengoa tasked with considering the best configuration of Health and Social Care Services in Northern Ireland?

A

The 10 year approach to transforming health and social care - Health and Wellbeing 2026: Delivering Together.

99
Q

For too long, what have HSC services been planned and managed around?

A

Structures and Buildings.

100
Q

What was said to put people at the forefront, the focus on enabling people to stay well for longer, where can or support is needed it will be, wherever possible, provided in the community setting. If specialist interventions are required these will be of high quality and delivered in a safe and timely way.

A

Health and Wellbeing 2026: Delivering together.

101
Q

A programme of work is underway to deliver the ambition set out in Delivering Together. What does this work place a strong emphasis on ensuring?

A

That the users voice i heard, as they will play a key role in developing and implementing new services and care pathways.

102
Q

What Groups leads the design, development and implementation of the Transformation Plan?

A

The Transformation Implementation Group (TIG Terms of Reference)

103
Q

An update on the key transformation programmes was published in April 2018 and covers 4 main areas: what are these?

A
  • Build capacity in community and prevention.
  • Enhance support in Primary Care
  • Reform community and hospital services
  • Organise ourselves to deliver
104
Q

How much additional transformation funding is there to be over 2 years?

A

£200m

105
Q

What do prescriptions cost in NI?

A

They are free.

106
Q

What is the Aim for the Northern Ireland Formulary to promote?

A

Safe, clinically effective and cost effective prescribing of medicines.

107
Q

What provides guidance on first and second line drug choices and will cover the majority of prescribing choices in Northern Ireland?

A

The Formulary.

108
Q

Whilst the formulary will aim to standard practice and ensure a level of consistency, what does it also recognise?

A

That individual patients may require medicines which lie outside such guidance.

109
Q

What is intended to cover the majority of prescribing decision and therefore focused on non-specialist prescribing choices? What is also intended to be used across both primary and secondary care sectors in NI to ensure consistency and continuity of supply - which will benefit all patient who require medicines?

A

The Formulary.

110
Q

Are NICE recommendations implemented in Northern Ireland?

A

Yes.

111
Q

Whose responsibility is it to put in place the necessary system for implementing NICE guidance?

A

The HSC organisations.

abpi unit one (10 decks)

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