Great britain health system

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Great britain health system

  1. 1. Great Britain Health System By Aditya Sood, Aasim Riyaz Khan,Achint Kumar Post Graduate Diploma In Health Management at Institute of Health Management Research, Jaipur , India
  2. 2. •Total Population=62.6 million •Urban Population (%)=80 •Population Growth Rate(%)=0.5 •Total Fertility Rate=1.9 •Crude Death Rate(Per 1000 population)=10 •Crude Birth Rate(Per 1000 Population)=12 Source=World Bank Data 2011 Health Indicators
  3. 3. • U5 Mortality Rate(1000)=5 per thousand live births • MMR=12 per lakh live births • IMR=4 per thousand live births • Life Expectancy at Birth -80 • Male- 78.3 • Female-82.5 • Health expenditure per capita = US $ 3,503
  4. 4. Manpower in health Infrastructure • Medical and dental staff- 187/100000 population • Nursing and mid wife staff-786/100000 population • Hospital beds- 33/10000 population • Nearly 1.3 million people are employed in NHS hospital community service in GB • In 2009 there were over 117,000 medical and dental staff and over 507,000 nursing and midwifery staff working in hospital and community health services in the GB • In addition, there were over 302,000, 184,000, and 154,000, administration and clerical, professional and technical, and domestic ancillary staff respectively working in hospital and community health services in the GB in 2009. Source( OHE Guide to UK Health and Health Care Statistics, July 2011)
  5. 5. HEALTHCARE EXPENDITURE According to World bank Data, Health (2011), Great Britain is spending 9.6% of its GDP on health. 8.4 8.9 9.8 9.6 7.5 8 8.5 9 9.5 10 2007 2008 2009 2010 PERCENTAGE YEAR
  6. 6. Categories of Great Britain healthcare expenditure Category 1 Publicly funded healthcare expenditure scheme-National Health Service(NHS). 81.3 82.4 84.1 83.9 78 80 82 84 86 2007 2008 2009 2010 PERCENTAGE YEAR Health expenditure, public (% of total health expenditure),Great Britain, 2007-2010 , World Bank Data, Health (2011)
  7. 7. Category 2 Private Health Expenditure. • It is 16% of the total Health Expenditure. • Out of Pocket expenditure as percentage of private expenditure on health is 62% 62.04 62 62 62 61.98 62 62.02 62.04 62.06 2007 2008 2009 2010 PERCENTAGE YEAR OUT OF POCKET EXPENDITURE (World Bank Data, Health 2011)
  8. 8. Category 3 Private Health Insurance • Accounts for 2 % of the total Health Expenditure. • Around 12 % of Great Britain citizens are covered by private health insurance 3881 3801 3440 3503 3200 3400 3600 3800 4000 2007 2008 2009 2010 PERCAPITAHEALTH EXPENDITUREUS$ YEAR PER CAPITA HEALTH EXPENDITURE ON HEALTH IN Great Britain$, 2007-2010,World Bank Data, Health 2011
  9. 9. NATIONAL HEALTH SERVICE • Launched on 5th July 1948. • Due to financial burden Prescription charge was introduced in 1952,which was abolished in 1962 but re-introduce again in 1968. • The NHS Health and Social Care Act 2012 sets out a large- scale program for reform to be implemented by the end of 2014. • Major aim of reform is decentralization. NHS Commissioning Board will be established which will be independent from the day to day control of Secretary of state.
  10. 10. NHS Aims: • To provide medical care free at point of use • To rich and poor alike • in accordance with medical need 2 beliefs: • Those who need care will come forward • Those who provide care know what is required and how to provide it
  11. 11. FUNDED BY General taxation 76% National Insurance contributions 19% User charges 5% (G.B. department of Health, 2010) ** Apart from these, NHS earns from prescription of drugs & dental treatments to general population.
  12. 12. COVERAGE It is universal, all those who are resident or citizens of the Great Britain are entitled to health care. Only treatment in an emergency department and for certain infectious diseases is free to people not ordinarily resident, such as visitors or illegal immigrants. SERVICES OFFERED • Preventive • Inpatient & Outpatient
  13. 13. • Inpatient & Outpatient drugs • Dental care, mental health care • Disabilities & rehabilitation • Hospital care • Physician
  14. 14. COST SHARING • Out patient prescription drugs are subject to a copayment currently US$12.23 per prescription, drugs prescribed in NHS hospitals are free. • NHS Dental services are subject to copayment of upto US $ 334/ per course of treatment • Discount through pre payment certificates-people using large amount of prescription drugs. • Transport costs to and fro from provider sites-low income group people.
  15. 15. People exempted from prescription drug co-payments  Citizens of GB < 16 years of age.  Citizens of GB > 60 years of age  Low income groups  Pregnant women  Those in fulltime education aged 16, 17, or 18.  Those who had a baby in the last 12 months
  16. 16. STRUCTURE Secretary of State Department of Health NHSE Regional Offices Strategic Health Authorities Primary care groups NHS trusts Local authorities
  17. 17. TYPES OF HEALTH SERVICES IN Great Britain PRIMARY CARE SECONDARY CARE TYPES OF TRUSTS Primary care GPs Dentist Pharmacist Opticians NHS direct NHS walk in centres Acute Care Mental Health Ambulance NHS Foundation
  18. 18. PRIVATE HEALTHCARE Private Health Insurance Private Hospitals Out of Pocket Expenditure
  19. 19. REGULATORY BODIES • National Institute of Clinical Excellence  publishes guidelines for healthcare professionals  Private hospitals do not have to follow these • Healthcare Commission  Monitoring Healthcare standards and efficiency  Responsible for publishing NHS performance ratings and indicators
  20. 20. KEY CHALLENGES • Coronary heart diseases and stroke continue to be leading cause of death in UK • Approximately 1 in 6 of all deaths in the UK in 2008 were due to coronary heart disease. • Deaths from strokes accounted for 1 in 14 of all UK deaths. • Crude death rate from liver disease and diabetes continue to rise • Rising alcohol related hospital admissions and alcohol related deaths • Prevalence of adult obesity in Great Britain is highest in the EU ( OHE Guide to UK Health and Health Care Statistics, July 2011)
  21. 21. • Rising demand and treatment cost • Long waiting periods for elective surgeries • Variations in quality of care across Great Britain • Lack of accountability of trusts and Primary Care centers. • Economic downturn in the country • Lack of control by central regulatory bodies over private healthcare.

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