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IF7 > 1A - 1C6 > Flashcards

1A - 1C6 Flashcards

1
Q

How many people does PMI cover in the UK?

A

7 million

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2
Q

When was the NHS set up?

A

1948

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3
Q

National Insurance Act 1911

A

David Lloyd George created a comprehensive scheme to provide national insurance for a range of risks for working people.

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4
Q

National Insurance Scheme eligibility

A

All manual and low-paid non-manual employees for less than four pence.

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5
Q

NHS Act 1946

A

Established by Minister of Health Bevan – effected in 1948.

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6
Q

NHS concept

A

Healthcare free at point of use for every citizen.

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7
Q

How are GPs contracted?

A

Continue to be self-employed, but have a contract with the NHS and paid per patient (although some are now salaried members of GP practices)

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8
Q

NHS projected costs

A

1944 – £132/y
1946 – £110m/y
1947 – £179m
1949 – actual cost was much higher at £248m and this grew to £384m in 1950/51

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9
Q

NHS charges imposed

A

IN1 951, charges on spectacles, dental treatment and prescriptions.

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10
Q

How was NHS made equitable?

A

Priority given to emergencies and those with the greatest medical need.

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11
Q

How many people work for the NHS?

A

Around 1.6m (full-time 1.4m) of which 1.3m are in England – GPs, dentists, optometrists excluded

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12
Q

NHS funding pressures

A
  1. Effects of an ageing society
  2. Medical developments
  3. Drug costs
    - NHS funding has to grow above inflation each year
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13
Q

Ways of improving NHS productivity

A
  1. More day surgery
  2. Improved medicines
  3. Closing inefficient wards
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14
Q

NHS devolvement

A

Each country is separately funded and managed, setting its own budgets

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15
Q

NHS cost 21/22

A

£159bn

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16
Q

NHS cost for COVID-19

A

£22.4b

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17
Q

NHS charges

A
  1. Prescriptions
  2. Eye care
  3. Dentistry (although some exempt based on age or income)
  4. Other services such as treating road accident victims and personal injuries where a third party is to blame
  5. Patient telephone calls
  6. Hospital parking
  7. Vaccinations
  8. Insurance claims forms
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18
Q

NICE

A

National Institute for Health and Care Excellence – recommends which treatments the NHS should and should not provide

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19
Q

Advantage of NICE

A

Better treatment for all (no postcode lottery – where the best treatment depends on where you live)

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20
Q

Disadvantage of NICE

A

Acts to restrict certain health treatments, especially where the economic cost is too great or the
treatment does not provide good value for money

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21
Q

Health and Social Care Act 2012

A

Outlines how the NHS is structured

22
Q

Secretary of state and Department of Health and Social Care

A

Provide strategic leadership

23
Q

GP-Led clinical commissioning groups

A

Responsible for commissioning services from
local hospitals, meaning that decision-making is close to patients –
manage around 80% of the NHS budget

24
Q

HealthWatch and local health boards

A

Exist within local councils as a forum for local commissioners

25
Q

Trusts and foundation trusts

A

Trusts can become foundation trusts through independent regulation (these have more local autonomy)

26
Q

Public Health England

A

Exists to provide national leadership in support of public health

27
Q

NHS England and NHS Improvement

A

Independent body responsible for health in
England

28
Q

When did Department of Health and social care stop publishing waiting list times?

A

2009

29
Q

Median wait for NHS hospital admission (as of Apr 22)

A

12.6 weeks

30
Q

Standard government waiting time

A

18 weeks

31
Q

NHS constitution waiting list rights for non-urgent conditions

A

Right to start consultant-led treatment within a max of 18 weeks

32
Q

NHS constitution waiting list rights for suspected cancer

A

Maximum of two weeks

33
Q

NHS constitution rights when cancer is diagnosed

A

Maximum wait of 31 days from diagnosis to the first definitive treatment for all cancers

34
Q

Contracting with privately run treatment centres

A

Privately run treatment centres contract with the NHS to provide a specified number of
treatments a year at a fixed price – This takes some pressure off the NHS & centres are not likely to be
disrupted by emergencies, which can affect general hospitals

35
Q

What happens where NHS patients cannot get key treatments within a fixed timescale?

A

They may choose to
be treated at another hospital and this may include private and overseas hospitals. The
NHS e-Referral service allows patients to book an appointment with a specialist and to
pick from a choice of hospitals.

36
Q

What % of income can NHS earn from private patients?

A

Up to 49%

37
Q

NHS principles

A
  1. NHS provides a comprehensive service to all.
  2. Access based on clinical need, not on an individual’s ability to pay.
  3. NHS aspires to the highest standards of excellence and professionalism.
  4. NHS aspires to put patients at the heart of everything it does.
  5. NHS works across organisational boundaries
  6. Committed to providing best value for taxpayers’ money
  7. NHS is accountable to the public, communities and patients that it serves.
38
Q

What are six reasons the private sector is different to the public sector?

A
  1. Waiting lists and choice of time
  2. Choice of facilities
  3. Choice of specialist
  4. Exclusive technology
  5. No ICU
  6. No A&E
39
Q

Advantages of choosing facilities

A

– No need to share a room
– Fewer HCAIs

40
Q

HCAI

A

Healthcare-associated infections

41
Q

Emergencies

A

Sudden or unexpected illnesses or injuries that need immediate hospital attention

42
Q

Comp/alternative med

A

Therapies outside of ‘traditional’ medicine

43
Q

Cosmetic surgery

A

Non-essential surgery to change appearance (usually excluded from PMI unless direct consequence from treatment)

44
Q

Surgicentres/specialist hospitals

A

Independent sector treatment centres

45
Q

Advantages of PMI

A
  1. Waiting lists and admission times
  2. Choice of consultant
  3. Choice of facilities (private room) (cleaner hospitals )
  4. Exclusive treatments
46
Q

What was the NHS private hospital income in 2016/17?

A

£620m

47
Q

Routine PMI exclusions

A
  1. Pregnancy
  2. Chronic
  3. Long-term disability or psychiatric illness
  4. Comp-med
  5. Cosmetic surgery
48
Q

Provident insurers

A

– Non-profit making organisations
– No shareholders
– All surpluses part of reserves (not subject to corp tax)
– Cannot attract tax relief from losses

49
Q

Provident Associations governance

A

Governed by FSA 2012 and 2016 and subject to insurance company solvency rules including Solvency II

50
Q

MGA

A

Managing general agent – insurance agent or broker granted underwriting authority by an insurer or Lloyd’s syndicate.

51
Q

Advantages of MGAs

A
  1. Market its own products and use brand to access potential customers
  2. Underwriter can gain access to insurance market without risking reputation
  3. Economies of sclae for underwriter (if underwriting more than one scheme)
52
Q

Purpose of wellbeing providers

A
  1. Reduced sickness absence
  2. Improved employee health
  3. Better mgment of long-term conditions
  4. Greater fitness levels
  5. Better MI for employees
  6. Caring employer image
  7. Minimising employees’ costs

IF7 (11 decks)

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