UK healthcare system Flashcards
What are the leading causes of mortality in the UK?
Heart disease and stroke
What is the obesity rate?
30%
What are the 1948 NHS guiding principles?
The NHS shall:
- meet the needs of everyone
- be free at the point of delivery
- be based on clinical need, not ability to pay
What is the 2015 NHS constitution?
- Provides comprehensive service available to all
- Aspires to the highest standards of excellence and
professionalism - Shall be based on clinical need not ability to pay
- Shall put patients at the center of everything it does
- Shall work across organizational boundaries in the interest of the
wider population - Is committed to providing the most value for its money and using
the most fair sustainable use of resources - Is accountable to the public, communities and patients
What is NICE?
The National Institute for Clinical Effectiveness, and it is meant to decrease variations in the system through evidence based efficiency guidelines. Handles cost-effectiveness of procedures, drugs, devices, and drug pricing
How would you describe the UK healthcare system?
Beveridge model: single gov’t payer AND gov’t employment
What is covered and what is not covered?
Covered: hospital care, primary care, specialty care, mental health, dental, pharmacy, optometry, drugs
Not covered: LTC on a sliding scale
Is there payment at the point of service?
No co-pays. Yes co-insurance.
How are care providers employed?
50% of PCPs are gov’t employed, 50% are private.
Nearly 100% of specialists are gov’t employed.
T/F: Patients must register with a PCP
True. Primary care emphasizes the role of the gatekeeper and care coordinator in addition to the treater.
How does private/voluntary insurance work in the UK system?
11% of the population has voluntary insurance. Doctors and hospitals are private, lower wait times, better pharma benefits, more choice among specialists.
How is the system financed?
80% is funded by taxes, 19% is funded by internal insurance. The NHS pays Clinical Commissioning Groups, who then provide population based payments to hospitals, physicians, and community-based orgs.
How are PCPs, specialists, and hospitals financed/paid?
PCPs are paid with a global pop-based payment for acute care. Some FFS exists for preventative care, and some pay for performance for for chronic care.
Specialists are employed by hospitals and receive a salary, no FFS.
Hospitals are paid by the CCGs (global budget) but as of 2018, are moving more to DRGs and grants (non-DRG)
What is the cost per capita and %GDP?
$3300 USD per capita, 9.1% GDP with a growth rate of <3%
What is the public versus private funding?
85% of the total cost is public, 15% is private (mostly drugs, OTC)
**very little OOP for individuals
