NHS Resource and Patient Rights Flashcards
When was the NHS set up?
1948
What was the initial aim of the NHS
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)
Give some reasons that explain why the NHS is over stretched
- 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
What is rationing on the NHS?
- rationing does NOT mean that everyone gets the same fixed amount of resource
- Rationing instead refers to the discretionary allocation of scarce resources
What are the first 3 strategies to resource allocation?
- Equal access to treatment
- Rationing according to clincal need
- Maximising health gains (QALY)
What is a QALY?
number on cost and benefit, used for comparative purposes
What does QALY mean?
Quality adjusted life year
What is the theroy of a QALY?
consequentialism
QALY =
Quality of life X life expectancy (before + after), then cost it
What do QALYs tell us?
- Beneficial healthcare activity = positive # of QALYs
- Efficient healthcare activity = cost per QALY is low
- Quantity + Quality = overall welfare of patient
What are the next 6 strategies for resource allocation?
- Discriminating according to age
- taking individual responsibilkity for ill health into account
- Rationing according to ability to pay
- Singling out certain types of excluded treatment
- Dilution of care
- Random allocation
What is the function of NICE?
Produce evidence-based guidance and advice for health, public health and social care practitioners
What type of guidance does NICE give?
- Clinical guidelines
- Technology appraisals
- Public health
- Interventional procedures
What are the four technology appraisals recommendations possible from NICE?
- Recommended for use in NHS
- Restricted use to certain categories of patients
- Use confined to clinical trials
- Should not be used in NHS
What are some of criticisms of NICE?
- Status of guidelines ambiguous
- Implementation is variable
- Topic selection is not random
What is the SMC?
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.
What are the possible recommendations of the SMC?
- 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
What occurs if the SMC approves a new medication?
When SMC accepts a new medicine, NHS boards are expected to make it, or an equivalent SMC-accepted medicine, available
