9 Key Challenges to Medicine

Question 1

Q: What are the 2 achievements of NHS Healthcare so far?

Answer 1

A: 1) Longevity (people are living longer BUT this also creates challenges)

2) Access to health services

Question 2

Q: Describe longevity as an achievement by NHS healthcare. Life expectancy. Health LE. Inequalities. Change in LE. Child mortality.

Answer 2

A:  Life expectancy for F=84 M=80. Majority of people living healthier lives
 Health life expectancy= people living lives without disease/disability
 There are still health inequalities according to geographical location.
 N.B. huge change in life expectancy in Syria and Iraq due to wars
 Progress in child mortality rates across globe

Question 3

Q: Name 10 challenges to medicine.

Answer 3

A: 1) The Evidence

2) Unhealthy behaviours
3) Burden of disease
4) Ageing population
5) Shortage of HRH
6) Organisation of Health Services (Health System Development)
7) Quality, Safety, Effectiveness
8) Information, Technology, People, Power
9) Health Leadership
10) Medical Advances- Use and Misuse

Question 4

Q: How is evidence a challenge to medicine? (4)

Answer 4

A:  It is said that half of scientific literature might be “simply untrue”
 Can we trust research findings?
 Can we rely on current systems of evidence?
 Therefore, clinicians must try to look at the best evidence, for the sake of the patient

Question 5

Q: How is unhealthy behaviour a challenge to medicine? Smoking. Obesity. Cost.

Answer 5

A:  Inequalities in smoking prevalence due to different exposures in different ethnic groups
 Those who smoke/drink/eat unhealthy food are 4 times more likely to die in the next 10 years or prematurely compared to someone who doesn’t
 Childhood obesity- the less prosperity, the more obese
 These unhealthy behaviours mean the NHS is losing a lot of money (billions spent as a result of smoking, obesity, alcohol and sedentary lifestyles)

Question 6

Q: Name 2 illnesses that are a burden of on the health care system?

Answer 6

A:  Coronary heart disease

 Mental illnesses

Question 7

Q: How is an ageing population a challenge to medicine? (3 + stat)

Answer 7

A:  Increasing life expectancy
 People living longer means these older people in the population need more resources
 Many are living with non-communicable/chronic diseases or disabilities (some have more than one of these)
 Sickest 3% of UK account for about 45% of hospital costs

Question 8

Q: How is shortage of HRH a challenge to medicine? (4)

Answer 8

A:  Not enough doctors
 Junior doctor contract disputes which mean many graduates may not stay in UK and work for the NHS
 US have more supply than demand- may attract doctors from UK
 Health Care Professionals suffering because they do not have enough support (lack manpower)

Question 9

Q: How is organisation of health services a challenge to medicine? (3)

Answer 9

A:  Most countries have weak public health, hospital based(curative) and no/weak primary care.
 Universal Health coverage
 Moving into arena of comprehensive Proactive Primary Care (not waiting for people to see you- you go and see them)

Question 10

Q: How is 20-40% of health spending wasted on?

Answer 10

A:  ineffective treatment
 counterfeit
 not indicated (misuse)
 no evidence
 incompetent health care professionals not well trained/need validation
 A&E costs 4 times as much as going to GP