Lecture 7 - Intro To Healthcare Systems In UK

Question 1

What is the definition of Health systems?

Answer 1

All activities whose primary purpose is to promote, restore and maintain health

Question 2

What are the different types of healthcare financing?

Answer 2

Out of pocket Payments
Private health insurance
Social health insurance
Tax based financing

Question 3

What are out of pocket payments?

Answer 3

Direct payments by patients for medical care
There’s no reimbursement by insurers or government

Question 4

What are some examples of out of pocket payments?

Answer 4

Paying for medication
Consultations with doctors

Question 5

What is the advantage of out of pocket payments?

Answer 5

Contains health service demand

Question 6

What is the advantage of out of pocket payments?

Answer 6

Contains health service demand

Question 7

What are the disadvantages of out of pocket payments?

Answer 7

People may under use health services

EXACERBATES HEALTH INEQUALITIES

Serious illness could result in catastrophic health expenditures

Costs those on lowest incomes proportionally more

Question 8

What is the principle of private health insurance?

Answer 8

Individuals contribute to a fund by paying voluntary premiums in advance to an insurance company
The costs of healthcare are then covered when required

Question 9

What are the advantages of private health insurance?

Answer 9

Protection against catastrophic expenditure (pool the risk)

Patients have a choice of insurer and competition may drive up standards of care

Reduces burdened Ono public finances

Question 10

What are the disadvantages of private health insurance?

Answer 10

Costs those on lowest iiincomes proportionally more
EXACERBATES HEALTH INEQUALITIES

Moral hazard (over consumption and over provision of health care)

Adverse selection (those at lower risk will not purchase)

Question 11

What is social health insurance?

Answer 11

Where employers and employees contribute to a fund (employers contribute a proportion of their salary and employers match it)

Type of insurance system

Government pays contributions for those out of work

Question 12

What are the advantages of social health insurance?

Answer 12

Protection against catastrophic expenditure
UNIVERSAL coverage through government contributions
Access based on need
Social insurance funds can. Be kept separate from other government funds

Question 13

What are the disadvantages of social health insurance?

Answer 13

High adminsitration costs (reimbursement)

May be opt out for higher earners

Question 14

What is taxation for health care funding??

Answer 14

Where health care is funded through general taxation (NHS) provided mostly by state controlled privders and doctors

Question 15

What are the advantages of taxation method of funding healthcare?

Answer 15

UNIVERSAL COVERAGE
Access based on needs
Fewer inequalities
Lowers administration costs
Controls on spending prioritisation

Question 16

What are the disadvantes of taxation in healthcare funding?

Answer 16

Healthcare budgets less predictable (dependant on government funding)

Moral hazard (overuse of healthcare)

Less choice of providers

Question 17

How many NHS boards are in Scotland?

Answer 17

14

Question 18

How many local health boards are in wales?

Answer 18

7

Question 19

How many health and social care trusts are in Northern Ireland?

Answer 19

5

Question 20

What are integrated care systems?

Answer 20

Partnerships that bring together providers and commissioners of NHS services across a geographical area

Question 21

What is the purpose of integrated care systems?

Answer 21

Plan health and care services to meet the needs of their population

Integrate are across different organisations joining up hospital and commmunity based services,s

Question 22

What are the advantages of integrated care systems?

Answer 22

Focus on. Collaboration not competition
Improving care for people with long term conditions
Potential to tackle inequalities

Question 23

What is the responsibility of local authorities under public health England?

Answer 23

Improving h earth of their local population and for public health services including most sexual health services and services aimed at reducing drug and alcohol misuse

Question 24

What is clinical prioritisation and resource allocation dependant on?
What’s the criteria?

Answer 24

Burden of disease
Clinical effectiveness of the interventions
Cost effectiveness
Equity
Needs clear framework
Explicit processes for rationing
Process for appeals audits and evaluation

Question 25

Why may there be variation in services provided by a region?

Answer 25

Different eligibility criteria between different ICBs leads to different proportion of NHS funding which is allocated

Question 26

What are individual funding requests?

Answer 26

For patients who fall outside what is currently commissioned and have genuinely exceptional circumstances

Question 27

What is the panel checklist?

Answer 27

Essentially validates whether a patients individual funding request is valid

Question 28

What is exceptionality?

Answer 28

Patient is ina different clinical condition when compared to the typical patient population with the same condition
AND
Because of the difference patient is likely to receive additional clinical benefit from treatment