United Kingdom Healthcare System

WHY IT STARTED

NHS

NHS

- Roles

- Overall: Department of Health

- Day-to-day: public body of NHS England

- Rights for those eligible are in the NHS consitution

- The right to access care without discrimination and within time limits

- Manages

- the budget

- all Clinical Commission Groups

- ensures that the objectives set out by the secretary of state for health in the annual mandate are met

BUDGET

• budgets for public health are held by local government

• local governments hosts health and well-being boards

• improve coordination between local and state gov.

PUBLIC

ASPECTS OF COVERAGE

PRIVATE INSURANCE

locum tenens physicians and advanced practitioners typically get larger paychecks than those their peers receive from full-time employers.

Employees

National Health Care System (NHS)

Independent Contractor/Locum

HOW PROVIDERS ARE COMPENSATED

Employs largest number of staff in UK

66% of GPs and practices operate under the National Medicine Services contracts, negotiates between the British Medical Association and government

Employees of hospitals or other practices

- All doctors working within the hospital sector of the NHS receive a salary

- Outpatient Specialist Care: salaried employees of NHS hospitals, and Clinical Commissioning Groups (CCGs) pay hospitals for outpatient consultations at nationally determined areas.

- 60% of income is from payment using mix of capitation, 15% from optional fee-for-service payments, 10% optional performance-related scheme

• The National Health Services provide the majority of healthcare in England, including primary care, in-patient care, and long-term healthcare.

• The UK government department responsible for the NHS is the Department of Health and Social Care, headed by the Secretary of State for Health and Social Care.

- NHS trust hospitals contract with Clinical Commissioning Groups (CCGs) to provide services.

- They are reimbursed mainly at nationally determined diagnosis-related group (DRG) rates, which include medical staff costs and account for about 60% of income.

- Often receive funding from government to take NHS patients, and their services are "purchased"

- Bulk of GPs are reimbursed monthly for the services they deliver on the basis of extracted automatically from practices' electronic records.

- Government owns hospitals; hospital employees are salaried government employees.

- May share costs with another "share holder"

-If employ other doctors to work in practice, they receive a fixed salary and have no responsibility of the costs of running the practice.

- As an independent contractor you can take many tax deductions for business-related expenses.

PRIMARY CARE

• Delivered through general practitioners
• act as the gatekeeper in order to access secondary care (such as specialists)
• people are required to register with whomever they want, but choice is effected by practices being full

PRIMARY CARE

OUTPATIENT SPECIALISTS

OUTPATIENT SPECIALIST

• employees of NHS or CCG hospitals are free to have private practices inside the hospital

• patients are free to choose which hospital to visit, but gov chooses which specialist you see

• most consultations are held in the hospitals but some are carried out by the general practitioner

• some GPs have special interests and are paid on a fee-for-service basis

AFTER HOUR CARE

• provided in ER of hospitals, urgent care centers, or minor injury units staffed with nurses and GP's

• Telephone advice is offered 24/7 through NHS 111 with urgent/non-life threatening conditions

AFTER-HOURS CARE

HOSPITALS

HOSPITALS

• publicly owned hospitals are NHS trusts and contract with local Clinical Comminssion Groups to provide services

• private hospitals offer a range of services either not offered by the NHS or have long waiting times

• bariatric surgery or fertility treatment

• do not have emergency, trauma, or itensive-care units

MENTAL HEALTH CARE

MENTAL-HEALTH CARE

• provided by the NHS

• less serious illnesses treated by GPs; mild depression and anxiety

• Those needing more advanced care is provided by mental/hospital trusts
• provided by community-based staff

• focus on increasing access but there are still long waiting times

LONG TERM CARE

LONG-TERM CARE

• Most is provided by local authories and the private sector

• local authorities legally obliged to assess needs with whoever requests it

this type of care is not universal

• NHS provides end of life palliative care in:
• patients homes, hospices, in care homes, or hospitals

UK Quality of Care Ratings

UK Quality of Care

• (2014) 9.9% GDP spent on healthcare
• Public spent about 79.5% of this

• Longer life expectancy and infant mortality than the United States

• In 2015 to 2017, life expectancy at birth in the UK saw no improvement from the previous 2014 to 2016 national life tables and remained at 79.2 years for males and 82.9 years for females.

• The UK ranks number 1 of 11 nations on healthcare according to internationalisurance.com.

• World Health Organization (WHO) Ranking of the World’s 100 Best Health Systems: ranks the UK 18th

STRENGTHS

• Protects people better from heavy financial costs

• Small gap between rich and poor

• Universally accessible

• Higher life expectancy

• More jobs created

• Increase in treatments available

• Women have more access

WEAKNESSES

• Healthcare outcomes

• Government’s role in participating in healthcare

• Overuse of medical services

• Waiting period

• Expensive