9 NICE and Decision making

Question 1

What 3 strategies might be used to organise the health economy?

Answer 1

steady state
planned change
market mechanisms

Question 2

What shifting factors might pressure health economy organisation?

Answer 2

demography
pattern of disease
medial technology
staffing, service, oraganisation
expectations and culture

Question 3

In what 2 ways is the UK demography shifting?

Answer 3

increased life expectancy

ageing population

Question 4

how does health rationing work in the UK?

Answer 4

3 year cash budget determined in parliament
DH allocates budget to NHS england
NHS england allocates 75% to CCG’s - goes to GPs and trusts
trust and GPs allocate to specialities
doctors tailor treatment

Question 5

What sorts of treatments would be supported?

Answer 5

good treatments that aren’t overpriced bascially

Question 6

from what angles are the health services under attack?

Answer 6

media - so called ‘disasters’
taxpayers - want to pay less
professionals - give us autonomy

Question 7

Name the 8 special considerations according to NICE

Answer 7

EoL
Children
Signifiant innovation
disadvantaged populations
search for sub-groups
avoiding exclusions
severity - cancer
primary prevention

Question 8

What sort of chemotherapy is used for pleural mesothelioma?

Answer 8

Vinorelbine, but only on the basis of non-RCT evidence