Access to Health Care in the United Kingdom - Research Paper Example

Access to Health Care in United Kingdom Access to Health Care in United Kingdom United Kingdom as a region collectively refers to an amalgamation of numerous regional territories namely: England, Scotland, Northern Ireland and Wales. Each of them has independent Public as well as Private health care systems however; these regions differ greatly in their organizations of healthcare services. According to World Health Organization, in the year 2000 provision of healthcare in United Kingdom was ranked 18th best in the world. In England, healthcare is given utmost preference and reportedly, during 2010 9.6% of England’s GDP was spent on it. In this paper, the current health care policy of UK will be analyzed critically along with mentioning of key suggestions and recommendations in encouraging further improvement. Health care in UK In UK healthcare is mainly facilitated by a publicly financed service called National Health Service (NHS), which is funded by general taxation and national insurances. Most of the mainstream primary and secondary health services (such as Hospital services, preventive services, prescribed Hospital drugs and physician services) are provided free of cost to all permanent UK residents. (Siciliani & Borowitz et al., 2013) However, treatments for infectious diseases like AIDS/HIV and emergency visits are free for visitors or illegal residents. Restricted co-payments are taken for dental care, mental healthcare, palliative care and vision care. Senior citizens, children, pregnant women and lower-income families are kept devoid of these payments. General practitioners are used for provision of primary healthcare and necessary future referrals in NHS. Specialist outpatient care including primary dental care, mental care and eye services are based on private sector contracts. Long-term care such as residential care and continued services are quite restricted in NHS. (Harrison, 2014) Healthcare policies in UK In UK, NHS is provided under National Health Service Act 1946.It covered England and Wales while Scotland and Northern Ireland were provided with separate legislations. According to this Act, NHS was to be availed freely by all citizens irrespective of race, gender, marital status, age or disability. However, reforms in the initial policies led to the invention of Health and Social Care Act, 2012. It focuses more on health care improvement and quality of services provided. Maternity and Childcare policy: Pregnant women are provided with best available health services and maternity care at NHS hospitals. Provision of a midwife for labor, birth, pre-and-post-delivery care is ensured. In case of miscarriages and postnatal depressions, special care is given. Babies and children up to age of 5 years are entitled under Family Nurse Partnership programs and health visiting services. Freedom of choice in Health and social care policy: By providing accurate information, patients are given more control and choice over hospital, referrals, specialists, GPs and health and social care arrangements. Integration of social and healthcare policy: With funding of 2.7 million pounds, local councils are given responsibility to integrate social and healthcare services so as to minimize time spent at hospitals. Dementia policy: By improving diagnostic rates, providing dementia training and funding will help wards and care homes to better adapt with these patients. Drug misuse and dependence policy: Efforts are focused on preventing youth to become drug addicts, providing education on drug misuse through FRANK service and helping in recovery from drug dependence. Respectful treatment of patients and service users’ policy: NHS aims at avoiding cases of abuse of patients suffering from learning difficulty and patient maltreatment by healthcare staff. Programs such as Friends and family and HealthWatch England will help take patients’ feedback about hospitals and staff performance. Recruitment, appraisal and training of hospital staff in compassionate, dignified treatment of patients. Protection from avoidable harm policy: Patient safety through proper training of staff and urging cosmetic surgeries to be safe will result in prevention of inexcusable healthcare associated harm. End-of-life care policy: Treatment and healthcare for older patients and management of health support in end-of-life days should be emphasized. Cancer survival policy: By reducing smoking, drinking and changing to healthy lifestyles, cancer survival rates can be increased in UK. Early diagnosis via screening and improving treatments will be the focus. Mental health policy: By providing easy access to psychological therapies, mental healthcare and reducing waiting times and preventing suicides will be NHS priority. (Department of health, 2013) Current Healthcare system in UK Healthcare restraints such as restricted healthcare spending and longer waiting times greatly affected the responsiveness of NHS. It resulted in slower access to primary care, low quality services but current reforms has focused on increasing NHS spending to 10-12% of GDP on healthcare and speedy responsive access to health services. As shown in figure 1 (Walshe, 2003) companies that were previously directly involved in NHS like strategic health authorities (SHAs) and primary care trusts (PCTs) are now eradicated from the system and taken over by local authorities and clinical commissioning groups (CCGs). Primary health care services: As the first point of contact in patient interaction with NHS, this includes all General Practitioner services like 24-hour NHS helpline, diagnosis and treatment of diseases, basic injuries, dental diagnosis, common pharmaceutical services, referrals to specialists if required, basic maternity, mental, dental and vision care services, palliative treatments, child healthcare, prevention of epidemics and promotion of healthcare. General practitioners (GPs) and related health professionals in NHS hospitals are paid through NHS payment schedules. Secondary health care services: These acute healthcare services include treatments in hospitals, specialist visits and treatments, scheduled surgeries, unplanned surgery or emergency care, specialist community services. These fall under co-payments, i.e. partially covered within NHS. Long-term healthcare services or ailing patients’ treatments are funded through private sector. Supplementary services: These services include long-term disease treatment and management, dental care, foot care and vision care, treatments for serious mental illnesses, community services for senior citizens, children and certain low-income communities. These are covered under private insurances or facilitated through company-covered health insurances. Outcome of current NHS NHS framework for Public Health focused on certain domains analyzing NHS performance. These include preventing premature deaths, improving quality of life, speedy recovery from illness and injury, enhancing positive experience of healthcare and carrying out treatments in a safe environment. (Flory, 2013) 1. Enhanced quality of life: Since Feb 2012, NHS has given better access to cancer drugs to approximately 12, 500 patients. Moreover, NHS bowel Cancer screening and breast cancer screening helped in extending or improving quality of public health. Mortality rates are reduced around 5.1% as compared to 8.9% previously. Double than previous numbers of Diabetics are receiving NHS services. (Flory, 2013) 2. Armed forces convent care: Injured veterans are provided with easy access to high quality prosthetics. 3. Positive and safe treatment environment: Improvements in sanitary conditions, on-time appointments, respect and explanation of treatments given to patients are seen. Infections rate has been reduced after mandatory health surveillance measures such as screening for venous thrombo-embolism (VTE) have been taken. (Flory, 2013) 4. Reduced waiting times: According to 2011 report, 90% of admitted and non-admitted patients were given treatment within 18 weeks of referral. 96% of patients spent less than 4 hours in A and E departments. (Siciliani & Borowitz et al., 2013) Health indicators NHS performance is better assessed under the stated 5 domains of NHS public healthcare framework. However, in 2014, these indicators will also include measures related to cancer, heart failure, acute stroke, fractures, alcohol admissions and mental health. Basic 5 health indicators of NHS include: 1. Prevention of premature mortality in people: Reducing deaths from mental illness, major diseases and in children. 2. Improving quality of life of people with long term ailments: Reducing hospital time, improving functional abilities. 3. Aiding full recovery from major episodes of illness or injury: Especially those with mental illness, injuries, stroke, fractures and infections. 4. Ensuring a positive experience of healthcare: Experiences of primary care, outpatient and inpatient care, staff behaviors, emergency services and maternity services. 5. Treatment of people in a safe hospital environment and protection against avoidable harm. Reducing healthcare associated infections, securing maternity services and safe delivery care (NHS England, 2014) Patient satisfaction for NHS According to British Social Attitudes Survey, 61% of the respondents were found to be satisfied with NHS. 28.9% of UK residents felt that minor reforms can improve the healthcare system. (Flory, 2013) Figure 2 (Taylor, 2013) shows fluctuations in patient satisfaction during last ten years. Growing rate of satisfied patients is a result of Governments reforms for increasing health expenditure and reducing waiting times in Hospitals. 75% of older citizens were far more satisfied than 63% of youth. NHS reforms and its impact After the introduction of Social and Health Act, 2013, reforms in NHS focus on devolving powers of doctors and give patient choice of treatment. It also makes efforts to minimize bureaucracy in NHS. Following major steps are undertaken: Clinical commissioning groups, health and wellbeing boards are made responsible for monitoring payment and healthcare as well as enabling integration to tackle inequalities in healthcare provision. Further increase in health expenditure, 100 million pounds, are transferred to local bodies for improving healthcare and social services. This step will reduce time spent in hospitals and initiate independent health services at home. Older citizens are to be provided with intermediate post-discharge care at home and support plans to regain health. End-of-life care facilities are introduced via new funding system. The impact of these important reforms can be seen in the current NHS. According to Secretary of State Annual Report, 2012 (Department of Health UK) this healthcare system has performed well even with financial difficulties. Waiting times and referrals to treatment have been reduced to 18 weeks and infections control with effective screenings is made possible. Health promotion programs such Change4life has led to health awareness in 85% of public. Long term illnesses are better facilitated and improvements are seen in single sex accommodations and cleanliness of wards. Access to NHS dentistry has improved thus greater public influx is seen since 2010. Ambulance trusts also show improvements since call connect. Increase in life expectancy and decrease in infant mortality is also evident. (Department of Health UK, 2012) Conclusion and recommendations NHS in the last few years has shown remarkable performance in bringing efficient health and social care. However, there are some loopholes in the healthcare systems that require utmost attention. If these proposed changes are introduced in NHS funded healthcare, then it will further improve the quality of services rendered to the patients. These include the following. GPs should be made responsible of performing clinical actions which are in accordance with the commissioning consortia. The Government should focus on healthy competition among private sector and charities for involvement in NHS. The overall effect of these changes should result in improvement of elective operations (knee and hip replacements), mental health facilities, management of cancer and diabetes. Efforts should also be centered towards minimizing queues in A&E departments as well as giving easy access to GPs and appointments on the same day. Emergency centers should be set up to assess and initiate treatments in cases of life-threatening emergencies. An efficient integration of GPs, hospitals, healthcare staff, community services will result in quality health and social care. Government should analyze NHS spending to proper usage in healthcare and show efficiency in fund savings. This will help NHS in giving better response to new technologies and increasing rate of older patients in society. Bureaucracy in NHS should be eradicated to make NHS perform effectively. Significant developments in cancer and diabetes screening procedures as well as better access for long-term treatments are required. This will result in improving mortality rates and ensuring better healthcare facilities. However, inequalities in access to health and social care still require utmost attention. References Department of Health UK. (2012). Caring for our future: reforming care and support. Policies. [report] Crown Copyright, pp. 13-45. Department of health. (2013). Treating patients and service users with respect, dignity and compassion. Crown copyright. Harrison, A. (2014). The English healthcare system, 2012. [online] Retrieved from: http://www.commonwealthfund.org/Topics/International-Health-policy/Countries/~/media/Files/Topics/Country%20Profiles/New%20Folder/England_profile_2012.pdf) [Accessed: 12 Mar 2014]. Flory, D. (2013). National Health Service and public health service in England: secretary of state: annual report2011/2012. The Operating Framework for NHS in England 2011/12. [report] The National Health Service, pp. 21-50. NHS England. (2014). CCG outcome indicator set 2014/15 at a glance. [online] Retrieved from: http://www.england.nhs.uk/wp-content/uploads/2013/12/ccg-ois-1415-at-a-glance.pdf [Accessed: 12 Mar 2014]. Siciliani, L., Borowitz, M. & Moran, V. (2013).Waiting time policies in the health sector. Paris: OECD. Taylor, A. (2013). The british are surprisingly satisfied with their controversial socialized health care system. [online] Retrieved from: http://www.businessinsider.com/british-satisfied-with-nhs-2013-9 [Accessed: 12 Mar 2014]. Walshe, K. (2003). Regulating healthcare. Maidenhead: Open University Press. Read More