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Current Issues in Health Service Management

Current Issues in Health Service Management. Chan Yuk King, Irene Lui Ching Man, Man Wan Sau Ying, Irony Wong Shun Tim, Ray Leung Chi Kit, Jackson Chan Wai Fung, Anita. What are the measure and policies adopted. United Kingdom. Main Challenge of UK Health Care System.

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Current Issues in Health Service Management

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  1. Current Issues in Health Service Management Chan Yuk King, Irene Lui Ching Man, Man Wan Sau Ying, Irony Wong Shun Tim, Ray Leung Chi Kit, Jackson Chan Wai Fung, Anita What are the measure and policies adopted United Kingdom

  2. Main Challenge of UK Health Care System Allocation of Resources 2003-2004 12 NHS trust & 4 primary care trusts overspend more than £5m. 106 NHS bodies failed to balance their books

  3. Political-led NHS I The NHS was setup by the Attlee Labour government in 1948 Principle: From Cradle to Grave All citizens would have access to the health care they needed regardless of income

  4. Political-led NHS I “Vote-catching”-reluctant to change the payment system The financing of the NHS through taxation, with Parliament voting on money to cover costs, proved to be an immediate problem

  5. Political-led NHS I Allocation of Resource tax-funding monopoly

  6. Political-led NHS II Reform of the NHS Patient-led NHS Redefine the NHS as the facilitator not provider Allocation of resources Money follow patients Payment by result Primary Care Trust (PCTs) Private Finance Initiative (PFI) Public-private Partnership (PPP) Local Improvement Finance Trust (LIFT) Foundation Hospital Trusts

  7. NHS Funding

  8. Overcentralisation I In 1990s; Central government and the NHS Command-and control model Market fragmentation model Result in hierarchic

  9. Overcentralisation II Introduce the internal market model Separation of the roles of provider and purchaser Competition: Shape services around patient’s needs

  10. Services vs Patients; Too hierarchical and paternalistic patients do not have their own records The complaints system is discredited in the NHS Patients have few rights of redress when things go wrong Disempowered patients I

  11. Disempowered patients II Information to empower patients “Expert Patient” Programme NHS Direct online NHS Direct information Strengthening patients choice Pateint Choice GPs who willl not the ‘fundholders’ within the PCT

  12. Disempowered patients II (cont’d) Patient advocacy services “Supporting Doctors, Protecting Patients” Doctors - as a condition of contract Annual appraisal and clinical audit Establish of the National Clinical Assessment Authority Protection for patients NHS-wide patient advocacy and Liasion Service (PALS)

  13. Improving health & Reducing Inequality I Wide gap between health needs and health services Disadvantage in all forms; Poverty Lack of educational attainment Unemployment Discrimination and social exclusion

  14. Improving health & Reducing Inequality II Particular emphasis on health inequalities at ministerial level in 1997 In 2004, DoH stated that different needs and equalities should be taken into account Geographic region Socio-economic group Gender and age Faith and ethnicity Disability Race Sexual orientation

  15. Improving health & Reducing Inequality II (cont’d) Setting a national inequalities target The White Paper-”Saving Lives: Our Healthier Nations Reducing inequalities in access to NHS services “The inverse care Law” Ensuring a healthy start in life A new sexual health and HIV strategy Screening programme for women and children Teenage pregnancy strategy

  16. Improving health & Reducing Inequality II (cont’d) Reducing smoking White Paper-”Smoking Kills” Improving diet and nutrition Tackling drugs and alcohol-related crime New partnerships to tackle inequality NHS Government’s National Strategic Partnership

  17. Aging Population I People over 65 account for 2/3 of hospital patients 40% of all emergency admissions

  18. Aging Population II Assuring standards of care NSF ensure that ageism is not tolerated ,with the elimination of any arbitrary policies based on age alone Extending access to services NHS retirement health check Promoting independence in old age Ensuring fairness in funding Establish of the Royal Commission on Long-Term Care Nursing homes is fully funded by the NHS

  19. Standard of Health Care I Different healthcare provider: 1. NHS Foundation Trusts 2. Prviate health care providers 3. Voluntary health care providers

  20. Standard of Health Care II Monitor the “Standard for Better Health” Healthcare Commission (HC) of all health care organization Commission for Social Care Inspection (CSCI) Standard Based System National Service Frameworks (NSFs) National Institute for Clinical Excellence (NICE)

  21. Standard of Health Care II PCTs working with Local Authorities (LAs), NHS partners and other organization; Contribute to the achievement of national priorities and targets

  22. Conclusion As the cost containment of the UK Health services system Health services system is undergoing a series of reform for its improvement

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