Resource Allocation in the National Health Service

1997 ◽  
Vol 23 (2-3) ◽  
pp. 291-318
Author(s):  
Christopher Newdick
Keyword(s):  
Resource Allocation ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Legal Framework ◽  
Allocation Of Resources ◽  
Standing Committee ◽  
The United Kingdom ◽  
Health Authorities ◽  
The Government

In the United Kingdom, how does the National Health Service (NHS or the Service) respond to the pressures imposed on it by patients, doctors and the government? What techniques for distributing resources have been adopted for managing these pressures? Part I of this Article explains the administrative evolution of the NHS. Part II discusses the legal framework surrounding the allocation of resources throughout the different tiers of the NHS: (1) from the Secretary of State for Health to health authorities, (2) from health authorities to hospitals and general practitioners (GPs), and (3) from doctors to patients. Part III comments on the case for a standing committee to advise the government on matters of resource allocation within the NHS. It also considers the legal, political, and managerial contributions to the debate and, in particular, comments on the future of the traditional notion of clinical freedom.Section A describes the culture that developed within the NHS, Section B discusses the pressure for reform that developed during the 1980s, and Section C reviews the system of the “internal market” for health that was introduced in 1990.

Provision of care for congenital heart disease in the United Kingdom

1994 ◽  
Vol 4 (3) ◽  
pp. 231-234
Author(s):  
Stewart Hunter
Keyword(s):  
United Kingdom ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Health Expenditure ◽  
Total Health Expenditure ◽  
Regional Health ◽  
The United Kingdom ◽  
Health Authorities ◽  
Regional Health Authorities

The organization of the national health service in the United Kingdom has been under constant review and revision since its inception after the Second World War. Central government spends £35,894 million each year on the Health Service and it is the country's largest employer. Total health expenditure in the United Kingdom accounts for 6.1% of the Gross Domestic Product. This apparently compares unfavorably with 12.4% total health expenditure in the United States.States. However the public health expenditure is identical in the two countries, 5.2%, and this figure is similar in most developed countries including Australia, Denmark, Spain and Switzerland. The overall regional administration of the Health Service in England (Scotland, Wales and Northern Ireland have slightly different organizations) is well established, although the names of the different strata of administration change from time to time. The Secretary of State for Health oversees the Department of Health including the National Health Service Management Executive. Under this Management Executive are 14 Regional Health Authorities covering 100% of the total population.There are within the London area several Special Health Authorities set up in the past because of the particular expertise which they provided. These are under review and will almost certainly lose their special status in the future because of the improvements and increase in services nationwide. The Regional Health Authorities have under their care 177 District Health Authorities and 90 Family Health Service Authorities.They do not manage the National Health Service Trusts—a new development which allows hospitals and other organizations within the Health Service to work autonomously to provide NHS services.

Patient and carer participation in old age psychiatry in England. Part II: models of participation

2011 ◽  
Vol 24 (2) ◽  
pp. 185-196 ◽  
Author(s):  
Susan Mary Benbow
Keyword(s):  
United Kingdom ◽  
Organizational Learning ◽  
National Health Service ◽  
Health Service ◽  
Old Age ◽  
National Health ◽  
Balance Of Power ◽  
Learning And Development ◽  
The United Kingdom ◽  
Old Age Psychiatry

ABSTRACTBackground: There are a number of models of patient and carer participation. Their usefulness and applicability to old age psychiatry is considered.Methods: Models of participation are reviewed and related to examples of participation initiatives drawn from the author's work in the context of the National Health Service in the United Kingdom.Results: Models of participation which emphasize collaboration and partnership are found to be useful. Simple interventions such as copying letters to patients and/or carers can lead to change in the balance of power between staff and patients/carers. Initiatives which draw on the experiences of patients and carers can facilitate organizational learning and development. Involving patients and carers in education offers a way to influence services and the staff working in them.Conclusion: Participation is better understood as a spectrum rather than a hierarchy. Old age psychiatry services would benefit from developing greater patient and carer participation at all levels.

scholarly journals Homebirthing in the United Kingdom during COVID-19

2020 ◽  
Vol 20 (3) ◽  
pp. 183-200
Author(s):  
Elizabeth Chloe Romanis ◽  
Anna Nelson
Keyword(s):  
Mental Health ◽  
Human Rights ◽  
United Kingdom ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Place Of Birth ◽  
Physical And Mental Health ◽  
The United Kingdom ◽  
Failure To Protect

COVID-19 has significantly impacted all aspects of maternity services in the United Kingdom, exacerbating the fact that choice is insufficiently centred within the maternity regime. In this article, we focus on the restrictions placed on homebirthing services by some National Health Service Trusts in response to the virus. In March 2020, around a third of Trusts implemented blanket policies suspending their entire homebirth service. We argue that the failure to protect choice about place of birth during the pandemic may not only be harmful to birthing people’s physical and mental health, but also that it is legally problematic as it may, in some instances, breach human rights obligations. We also voice concerns about the possibility that in the absence of available homebirthing services people might choose to freebirth. While freebirthing (birthing absent any medical or midwifery support) is not innately problematic, it is concerning that people may feel forced to opt for this.

More Patient Choice in England's National Health Service

2005 ◽  
Vol 35 (3) ◽  
pp. 479-483 ◽  
Author(s):  
Richard Lewis
Keyword(s):  
Health Care ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Urban Areas ◽  
Patient Choice ◽  
Private Provider ◽  
National Quality ◽  
The Government ◽  
English National Health

A new political consensus has emerged over the benefits of new rights for patients to choose their provider of elective health care in the English National Health Service. From December 2005, patients will be able to select from a number of alternative providers at the time they are referred for treatment. In the longer term, patients will be able to access care at any public or private provider that meets national quality and cost standards. The government intends that this policy will lead to improvements in the quality and efficiency of health care and will reduce levels of inequity among patients. Pilot schemes have shown that a majority of patients will exercise a choice of provider when this is offered. However, the policy of patient choice may involve significant costs to the NHS and may be more difficult to implement outside urban areas. Further, the information needed to support patients' choices is not yet available. Whether such a policy will increase or decrease levels of equity in the English NHS remains open to debate.

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