The socioeconomic context of the UK is overshadowed by the referendum (i.e. the Brexit) ruling that the UK will leave the EU. It is still too early to speculate with any certainty what the effects and repercussions will be economically, upon the strength and market dynamics of England, Wales, Northern Ireland and Scotland. Also up in the air is whether all UK member states will participate in the Brexit, or whether further divisions will occur.
Current UK healthcare organization
The healthcare organization in the United Kingdom is decentralized and managed by each of its member nations for their respective territories. The NHS in the UK, and other versions of the NHS operating in Scotland, Northern Ireland, and Wales, serve as the centralized public healthcare insurers and payers.
The current challenges facing the UK healthcare systems and the NHS are marked throughout by funding constraints, and the need to realign the supply capacity of the healthcare provisions to the changing demands of the population´s age and illness conditions.
Following is a list of the UK´s most pressing healthcare challenges:
- NHS funds continue to suffer from the aftermath of the global recession which will put pressure on budgets in all care sectors.
- Improving the efficiency and funding approaches of the NHS
- New treatments, technologies and medication must be absorbed by the NHS budget, paired with greater volumes of patients requiring such care.
- UK citizens are living longer and staying more and longer in hospitals; hospitals that are traditionally more equipped to serve acute and elective short-term care.Meanwhile there are delays in discharging patients. The current patient pool demands a change in the type of infrastructure and of care provisions available, in order to cater to more long-term, chronic and multiple-morbidity cases.
- New approaches are being investigated to provide long-term care solutions.
- Some sources state that the market of public and private providers does not offer fair competition and that corporate takeovers are taxing the affordability and availability of healthcare services.
- Tendering processes at the moment are causing fragmentation in the market. The states are working on revisions to prevent this.
- Creating more integrated care models and streamlined care tracks to avoid fragmented markets and gaps in care provision.
- Reducing waiting times for urgent operations, cancer treatments and A&E care, and ensuring that the quality of standard procedures does not deteriorate due to structural and or financing problems.
- Private insurance providers are at liberty to choose the “best” (i.e. the healthiest) subscriber profiles, leaving the NHS with the typically more expensive and riskier patient groups, whilst losing insurance contributions from the privately insured.
- A&E department visits have steeply increased in the last years and their capacities are being strained. The UK seeks to improve the information available to its citizens to ensure the right type of patient only attends an A&E facility, and that non-urgent patients seek care with their GP.
- Using IT solutions and applications to improve access to healthcare and personal health management. Healthcare-related IT applications, in general, are often seen as inefficient.
- Breaches in security have further impeded a fluid adoption of e.g. electronic patient files, along with other applications intend on making healthcare more efficient and cheaper.
- Encouraging life style changes to reduce preventative illnesses later on in life (or at any other point in life).
- Providing care 7 days a week that is nearby and free (or affordable) for all citizens, requiring a rethink of how and where to provide services effectively and strategically.
- Some of the most densely and least populated regions in the UK suffer from understaffing.
- Increasing the number of MRI and CT scanners, to match demand and speed up diagnosis and treatments.
What are the priorities and areas of focus in the UK at this moment?
Secondary healthcare, mostly embodied and provided through the hospital sector, is one of the key places to re-focus and address the given healthcare challenges.
Priorities for the administration and organization of hospitals are the following :
- Devolving healthcare responsibilities and improving accountability
- Making departments accountable, regarding expenditure and quality
- Delegating profit and loss accounting to hospital management
- Creating realistic targets, both in terms of quantity and quality, for each year and creating measures/pressure to ensure that they are met
- Reducing overheads and expenses in general
- Reducing external consultants by 50%, reducing marketing and communication costs by 25%, and making hospital managerial structures smaller yet more efficient
- Improving patient satisfaction
- Boosting transparency by publishing hospital ratings, to improve a patient´s care and facility their provider selection
- Seeking to generate alternative and additional revenues, for example, through interhospital trading and inter-departmental activities, research-collaborations with the medtech and pharmaceutical industries, and serving as subcontractors for the private sector
- Improve the handling of patients, the public image of public sector provisions, and the performance of care
- Fostering greater consumer, i.e. patient, information and decision-making over their own healthcare
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