W1 - Structure/organisation of UK HSC Flashcards
Name of national bodies within UK HSC system
- DHSC = Gov ministerial department
- NICE, UKHSA, CQC, OHID = ALBs with devolved power from gov
Role of national bodies in health system
National policy development, guidance, health intelligence, regulation and quality improvement
What other organisations play role in regulation?
MHRA - regulating and licensing new medicines/devices
HRA - protecting and promoting interests of patients, PH research
What is the main role of NHS England + 2 roles regarding ICBs
- National leadership and direction for NHS organisations
- Allocate funds to ICBs
- Produce annual operational planning guidance for ICBs
Role of OHID? (national and subnational)
National - improve health and reduce inequalities
Subnational - work with LAs and ICBs for joined up PH approach
Role + level of UKHSA?
- Prevent, prep and respond to infectious disease and environmental
- Surveillance
- Local, national and international
2 roles of NICE?
- Standard setting for practitioners, commissioners and managers across system
- Guide NHS on clinical value and cost effectiveness of medicines, procedures, devices etc
Role of CQC, with care providers?
- Independent quality regulatory for HSC in England
- Register, monitor, inspect + rate care providers
Which organisations are involved in commissioning services?
National + regional = NHS England
Local level = ICSs (formalised 2022 HSC act)
Aspects of ICSs + their roles?
- ICBs = plan and fund local level NHS services
- ICPs = bring together broad set of system partners to develop HSC strategy for local area
What are the 4 key aims of ICSs?
- Improve population health + healthcare outcomes
- Reduce health inequalities
- Enhance productivity and value for money
- Allow NHS to support broader social + economic development
Issues with geographies of ICS divisions? Potential aid, formalised?
500,000 - 3 million populations = less effective commissioning of specific needs of local populations
- Place based partnerships = 250-500,000 populations using budget delegated from ICSs
- Not statutory
Role of Local Authorities, specific role from 2012 onward, budget?
- Deliver public services in local area using annual ringed fence budget from DHSC
2012 -> Employ director of public health = lead and advise on local health issues to reduce inequalities - key partner in ICSs and PBPs
Examples of service providers?
- PCNs, pharmacies, GPs, dentists etc.
What are provider collaboratives + their 3 aims?
2022 -> all NHS trusts providing acute and MH services joined
1. Achieve economies of scale
2. Standardise care to reduce inequalities + improve outcomes
3. Share and improve capacity through flexible staff working
Draw out the pyramid for health service provision - what factors increase as you go up?
https://www.notion.so/Week-1-4-UK-HC-structure-1035c224bf2a809fa93fdce6fe709ecf?pvs=4#1035c224bf2a808b8776e5b4f4baf642
Where does most HSC funding come from? % from patient charges?
- Mostly from taxation and NI contribution
- Patient charges like prescriptions + dentist contribute 1%
DHSC spending in 2022/3, how much spent on day to day items like staff salaries? How much to LAs for ring fenced budget?
- £181.7 billion
- 95% on day to day items
- £3 billion to LAs
Breakdown of spending in NHS England on ICBs and direct commissioning?
- 2/3 budget allocated to ICBs
- £30 billion for direct commissioning
Prompts for change in organisation of adult social care (3)?
- Yearly increases in support requests
- Continued retraction in eligibility to receive care = thresholds not changed since 2011
- Vacancies in workforce
Differences with dental care organisation vs PCNs (2) ?
- No national registration system
- Patient charged with increasing amounts based on primary care complexity
Issues with dentist services (acceptance, geography, children)
- 9 in 10 not accepting new adult patients in 2022
- Disparities in available NHS dentists
- Increases in child dental decay