NHS Resource and Patient Rights

Question 1

When was the NHS set up?

Answer 1

1948

Question 2

What was the initial aim of the NHS

Answer 2

imrpove the health of the nation, and thus decrease the demand for healthcare (based in the premise that there is an finite amount of ill health)

Question 3

Give some reasons that explain why the NHS is over stretched

Answer 3

• increase in life expectancy
• increased costs of treatment
• patients expectations have increased
• cost of admun and salaries
• free means less constraints in demand
• increase in negligence cases

Question 4

What is rationing on the NHS?

Answer 4

• rationing does NOT mean that everyone gets the same fixed amount of resource
• Rationing instead refers to the discretionary allocation of scarce resources

Question 5

What are the first 3 strategies to resource allocation?

Answer 5

1. Equal access to treatment
2. Rationing according to clincal need
3. Maximising health gains (QALY)

Question 6

What is a QALY?

Answer 6

number on cost and benefit, used for comparative purposes

Question 7

What does QALY mean?

Answer 7

Quality adjusted life year

Question 8

What is the theroy of a QALY?

Answer 8

consequentialism

Question 9

QALY =

Answer 9

Quality of life X life expectancy (before + after), then cost it

Question 10

What do QALYs tell us?

Answer 10

• Beneficial healthcare activity = positive # of QALYs
• Efficient healthcare activity = cost per QALY is low
• Quantity + Quality = overall welfare of patient

Question 11

What are the next 6 strategies for resource allocation?

Answer 11

1. Discriminating according to age
2. taking individual responsibilkity for ill health into account
3. Rationing according to ability to pay
4. Singling out certain types of excluded treatment
5. Dilution of care
6. Random allocation

Question 12

What is the function of NICE?

Answer 12

Produce evidence-based guidance and advice for health, public health and social care practitioners

Question 13

What type of guidance does NICE give?

Answer 13

• Clinical guidelines
• Technology appraisals
• Public health
• Interventional procedures

Question 14

What are the four technology appraisals recommendations possible from NICE?

Answer 14

• Recommended for use in NHS
• Restricted use to certain categories of patients
• Use confined to clinical trials
• Should not be used in NHS

Question 15

What are some of criticisms of NICE?

Answer 15

• Status of guidelines ambiguous
• Implementation is variable
• Topic selection is not random

Question 16

What is the SMC?

Answer 16

Scottish Medicines Consortium

We are the national source of advice on the clinical and cost- effectiveness of all new medicines for NHS Scotland. Our aim is to ensure that people in Scotland have timely access to medicines that provide most benefit based on best available evidence.

Question 17

What are the possible recommendations of the SMC?

Answer 17

• Accepted
• Accepted with restrictions (“(for example, the medicine can only be recommended in a particular group of patients with the condition. This typically occurs because the company has requested this explicitly in their submission)”
• Not recommended

Question 18

What occurs if the SMC approves a new medication?

Answer 18

When SMC accepts a new medicine, NHS boards are expected to make it, or an equivalent SMC-accepted medicine, available