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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

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
Main Challenge of UK Health Care System

Allocation of Resources


12 NHS trust & 4 primary care trusts overspend more than £5m.

106 NHS bodies failed to balance their books

Political led nhs i
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

Political led nhs i1
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

Political led nhs i2
Political-led NHS I

Allocation of Resource

tax-funding monopoly

Political led nhs ii
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

Overcentralisation i
Overcentralisation I

In 1990s;

Central government and the NHS

Command-and control model

Market fragmentation model

Result in hierarchic

Overcentralisation ii
Overcentralisation II

Introduce the internal market model

Separation of the roles of provider and purchaser


Shape services around patient’s needs

Disempowered patients i

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

Disempowered patients ii
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

Disempowered patients ii cont d
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)

Improving health reducing inequality i
Improving health & Reducing Inequality I

Wide gap between health needs and health services

Disadvantage in all forms;


Lack of educational attainment


Discrimination and social exclusion

Improving health reducing inequality ii
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



Sexual orientation

Improving health reducing inequality ii cont d
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

Improving health reducing inequality ii cont d1
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


Government’s National Strategic Partnership

Aging population i
Aging Population I

People over 65 account for 2/3 of hospital patients

40% of all emergency admissions

Aging population ii
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

Standard of health care i
Standard of Health Care I

Different healthcare provider:

1. NHS Foundation Trusts

2. Prviate health care providers

3. Voluntary health care providers

Standard of health care ii
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)

Standard of health care ii1
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


As the cost containment of the UK Health services system

Health services system is undergoing a series of reform for its improvement