The NHS

Question 1

healthcare in the uk BEFORE the NHS

Answer 1

The 20th Century
- healthcare was increasingly provided by other bodies
-a network of charitable and voluntary organisations and local municipal authorities established hospitals

Medical care provided by visiting specialists who lucrative private practices elsewhere

Question 2

how were mentally ill people treat before the NHS

Answer 2

generally sent away to large forbidding institutions, not always for their own benefice, but because that was how the system worked

• admission was often for life
  under poor conditions the patient became worse rather than better and institutionalized

there was a basic standard for food and accommodation

Question 3

how were older people treat before the NHS

Answer 3

-older people who could not look after themselves were particularly fared badly

many ended their lives in Public Assistance Institutions

One of the early achievement in the NHS was the development of geriatrics, which tackled the problem of the “back wards” seldom vised by doctors where people went to end their days

Question 4

what drove the change for existing services

Answer 4

The main drivers for change included the following:

• the emergence of a view that healthcare was a right not something bestowed erratically by charity

-an increasing view among the younger members of the medical profession that there was a better way of doing things

Question 5

what was the first steps of making a Nationalised Health Service

Answer 5

1. the war obliged the government to establish an Emergency Medical Service- all types of hospitals were registered, funded and centrally to prepare for large numbers of expected casualties

Beveridge Report described a vision for welfare reform based on eradication of the five giants of: idleness, squalor, hunger, disease and ignorance

Question 6

when was the NHS formed

Answer 6

1948

Question 7

what are the principles of the NHS

Answer 7

That it met the needs of everyone

that it be free at the point of delivery

that it be based on clinical need, and not ability to pay

Question 8

how is healthcare provided in the UK

Answer 8

healthcare is provided using a GP gateway model
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This means with the exception of walk in services, patients need to go to a GP first before being granted access to a specialist service

Question 9

Primary care

Answer 9

refers to first point of contact in the healthcare system

in the NHS, the main source of primary healthcare is general practice (GP)

The aim:
an accessible route to care

Question 10

what is primary care based on

Answer 10

caring for people rather than specific diseases

Question 11

what are GPs

Answer 11

best known provider for primary care

important role:
- acting as the patients advocate and coordinating the care of many people who have multiple problems

Question 12

how do GPs usually work

Answer 12

in practices with other GPs

not employed by NHS and are effectively businesses

Question 13

secondary care

Answer 13

provided by medical specialists and healthcare professionals who generally do not have fist hand contact with the patient

e.g. cardiologists

usually referred by GP

Question 14

tertiary specialists

Answer 14

super specialists

e.g. plastic surgeons neurosurgery

Question 15

Quaternary care

Answer 15

very specialised which a few people with vert rare problems will ever need it

e.g. uncommon diagnostic

Question 16

how do hospitals operate in the UK

Answer 16

In England, each hospital essentially operates as an independent business

Question 17

what is commissioning

Answer 17

awarding contracts to private hospitals as they may provide better quality of care

Question 18

why can’t CCGs commision GP services

Answer 18

they are GP services themselves

and they can’t commission services that need to be provided on a more global scale because of he specialist nature, such as heart and lung transplant surgery or eye cancer care for two reasons:

-they don’t have the skills and knowledge to understand the exact nature of the services

-those services are provided on a regional or national basis

Question 19

who commissions primary care services and specialists services

Answer 19

NHS commissioning Board

which is called the NHS England

Question 20

what is a block contract

Answer 20

before 2005 hospitals were paid a fixed amount of money every day to cover the cost of healthcare

Question 21

what is a block contract

Answer 21

before 2005 hospitals were paid a fixed amount of money every day to cover the cost of healthcare

if hospitals need more money then the government would simply pay more money to that hospital

if the hospital was paid less money then they would pay it back to the governemnt

Question 22

what is the issue with the block contract

Answer 22

the problem with the approach were that there was no incentive for hospitals to save money or work efficiently

Question 23

what is the payment result

Answer 23

Labour government introduced this principle

hospitals no longer receive a fixed amount of money instead be paid for each activity undertook

e.g. a hip replacement might have a tariff of £5,000, which would cover the cost of the hospital stay,imaging,the surgery and some follow up

Question 24

what is the problem with payment result

Answer 24

it did not encourage hospitals to provide quality care

actions made to make sure good care was provided e.g. ensuring hospitals are penalised for poor qualities

Question 25

private practice doctors

Answer 25

they have to use their own money unless that have private insurance

Question 26

what do private companies often do

Answer 26

“cherry - pick” they easy cases that are the most profitable, leaving the NHS

Question 27

Wales

Answer 27

reorganisation of NHS in Wales created local health organisations that are responsible delivering all healthcare services within a geographical area

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Question 28

what are the distinct four roles of the GMC

Answer 28

1.keeping a register of all qualified doctors

2. fostering good medical practice - by issuing guidance or standards that doctors need to adhere to
3. promoting high standards of medical education and training

4.dealing with doctors who may not be fit to practice - those doctors are investigated and in some cases may be suspended

Question 29

what is the GMC

Answer 29

The General Medical Council - one of the key parties

Question 30

what are the royal colleges

Answer 30

the royal colleges are institutions charges with setting standard within the field and for supervising the training of doctors

Question 31

what is the British medical association

Answer 31

The BMA is essentially the trade union representing doctors

Unlike the GMC and Royal Colleges, membership is not compulsory