United Kingdom Vol. 17 No. 5 2015 - UK-HiT.pdf

Vol. 17 No. 5 2015Health Systems in Transition

Jonathan Cylus Erica RichardsonLisa Findley Marcus LongleyCiaran O'Neill David Steel

Jonathan Cylus and Erica Richardson (Editors) and Ellen Nolte and Ewout van Ginneken (Series editors) were responsible for this HiTEditorial Board

Series editorsReinhard Busse, Berlin University of Technology, GermanyJosep Figueras, European Observatory on Health Systems and PoliciesMartin McKee, London School of Hygiene & Tropical Medicine, United KingdomElias Mossialos, London School of Economics and Political Science, United KingdomEllen Nolte, European Observatory on Health Systems and PoliciesEwout van Ginneken, Berlin University of Technology, GermanySeries coordinatorGabriele Pastorino, European Observatory on Health Systems and PoliciesEditorial teamJonathan Cylus, European Observatory on Health Systems and PoliciesCristina Hernndez-Quevedo, European Observatory on Health Systems and PoliciesMarina Karanikolos, European Observatory on Health Systems and PoliciesAnna Maresso, European Observatory on Health Systems and PoliciesDavid McDaid, European Observatory on Health Systems and PoliciesSherry Merkur, European Observatory on Health Systems and PoliciesDimitra Panteli, Berlin University of Technology, GermanyWilm Quentin, Berlin University of Technology, GermanyBernd Rechel, European Observatory on Health Systems and PoliciesErica Richardson, European Observatory on Health Systems and PoliciesAnna Sagan, European Observatory on Health Systems and PoliciesAnne Spranger, Berlin University of Technology, GermanyInternational advisory boardTit Albreht, Institute of Public Health, SloveniaCarlos Alvarez-Dardet Daz, University of Alicante, SpainRifat Atun, Harvard University, United StatesJohan Calltorp, Nordic School of Public Health, SwedenArmin Fidler, The World BankColleen Flood, University of Toronto, CanadaPter Gal, Semmelweis University, HungaryUnto Hkkinen, Centre for Health Economics at Stakes, FinlandWilliam Hsiao, Harvard University, United StatesAllan Krasnik, University of Copenhagen, DenmarkJoseph Kutzin, World Health OrganizationSoonman Kwon, Seoul National University, Republic of KoreaJohn Lavis, McMaster University, CanadaVivien Lin, La Trobe University, AustraliaGreg Marchildon, University of Regina, CanadaAlan Maynard, University of York, United KingdomNata Menabde, World Health OrganizationCharles Normand, University of Dublin, IrelandRobin Osborn, The Commonwealth Fund, United StatesDominique Polton, National Health Insurance Fund for Salaried Staff (CNAMTS), FranceSophia Schlette, Federal Statutory Health Insurance Physicians Association, GermanyIgor Sheiman, Higher School of Economics, Russian FederationPeter C. Smith, Imperial College, United KingdomWynand P.M.M. van de Ven, Erasmus University, The NetherlandsWitold Zatonski, Marie Sklodowska-Curie Memorial Cancer Centre, Poland

Health Systems in TransitionJonathan Cylus, European Observatory on Health Systems and PoliciesEr ica Richardson, European Observatory on Health Systems and PoliciesLisa Findley, Editorial ConsultantMarcus Longley, Welsh Institute for Health and Social Care, University of South WalesCiaran ONeill, NUI Galway and Queens University Belfast David Steel, University of Aberdeen, (formerly Chief Executive, NHS Quality Improvement Scotland)

Health System Review2015

United Kingdom:

The European Observatory on Health Systems and Policies is a partnership between the HO Reional Oice or Europe the overnments o ustria elium inland reland orway Slovenia Sweden the nited indom and the eneto Reion o taly the European ommission the orld an rench ational nion o Health nsurance unds the ondon School o Economics and Political Science and the ondon School o Hyiene Tropical edicine The European Observatory has a secretariat in russels and it has hubs in ondon at SE and SHT and at the Technical niversity o erlin

Keywords:

World Health Organization 2015 (acting as the host organization for, and secretariat of, the European Observator on Health stes and olicies

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Printed and bound in the nited indom

11 12 ol 1 o 5

Suggested citation:

Health Systems in Transition

Contents

Preface vAcknowledgements viiList of abbreviations ixList of tables and figures xiiiAbstract xvExecutive summary xvii

1 Introduction 1

Organization and governance 13

3 Financing 41

4 Physical and human resources 63

5 Provision of ser vices 77

6 Pr incipal health reforms 99

7 Assessment of the health system 105

8 Conclusions 113

9 Appendices 115

Preface

Acknowledgements

List of abbreviations

bbreviation

P ny ualiied Provider

ritish ental ssociation

ritish edical ssociation

PT est Practice Taris

S ritish Social ttitudes survey

omplementary and lternative edicines

linical ommissionin roup

H ommunity Health ouncil

HP ommunity Health Partnerships

ompetition and arets uthority

OP hronic Obstructive Pulmonary isease

P ontinuin Proessional evelopment

are uality ommission

ommissionin or uality and nnovation

S ommissionin Support nit

isability dusted ie ears

R octors and entists Remuneration Review ody

H epartment o Health

HSSPS epartment o Health Social Services and Public Saety

ET Electroconvulsive Therapy

EE European Economic rea

E European edicines ency

EPS Electronic Prescription Service

E European nion

O reedom o normation

T oundation Trust

eneral ental ouncil

P ross omestic Product

eneral edical ouncil

bbreviation

S eneral edical Services

P eneral Practitioner

Ph eneral Pharmaceutical ouncil

HET Health improvement Eiciency ccess Treatment

HS Healthcare mprovement Scotland

H Healthcare nspectorate ales

H Healthy ie Epectancy

HR Her aestys Revenue and ustoms

HR Healthcare Resource roup

HS Health and Social are ct 2012

HS Health and Social are normation entre

HT Health Technoloy ssessment

iTPP nnovative Technoloy doption Procurement Proramme

ocal ommissionin roup

H ocal Health oard

aret orces actor

HR edicines and Healthcare products Reulatory ency

P ember o Parliament

P inimum Practice ncome uarantee

HS ational Health Service

ational nsurance ontributions

E ational nstitute or Health and are ormerly linical Ecellence

PT ational Proramme or normation Technoloy

S ational Screenin ommittee

SE ational Service ser Eperience

OE Oranisation or Economic ooperation and evelopment

OS Oice or ational Statistics

OOH Outohours

OT Over the ounter

PP Pay or Perormance

PS Picture rchivin and ommunications Systems

PS Patient dvice and iaison Service

PaS Procurement and oistics Service

PbR Payment by Results

PT Primary are Trust

P Public ividend apital

P Private inance nitiative

PS Personal edical Services

PO Prescription Only edicines

PP Personal and Public nvolvement

bbreviation

PPE Public Patient nvolvement Eperience

PPP Public Private Partnership

PPRS Pharmaceutical Price Reulation Scheme

PS Public Service reements

PS Public Services oards

R Royal ollee o ursin

R Reulation and uality mprovement uthority

RTT Reerral to Treatment

SH Strateic Health uthority

S Strateic nvestment oard

S Scottish edicines onsortium

T Tuberculosis

T Trust evelopment uthority HS

nits o ental ctivity

nited ations

H oluntary Health nsurance

HO orld Health Oraniation

TO orld Trade Oraniation

ears o ie ost

List of tables and figures

Tables paeTable 11 Trends in populationdemoraphic indicators selected years

Table 12 acroeconomic indicators selected years 5

Table 1 ortality and health indicators selected years

Table 1 Healthy years o lie

Table 15 Standardied death rates selected years

Table 1 orbidity and actors aectin health status selected years 10

Table 1 aternal child and adolescent health indicators selected years 11

Table 1 Trends in health ependiture in the nited indom 15 to 201

Table 1 ianostic imain in the nited indom 2012

Figures paei 11 ap o the nited indom 2

i 21 Overview o the health system 15

i 1 Health ependiture as a share o P in the HO European Reion latest available year

i 2 Total health ependiture as o P HO estimates 5

i Health ependiture in PPP per capita in the HO European Reion latest available year

i Health ependiture rom public sources as a percentae o total health ependiture in the HO European Reion latest available year

i 5 inancial lows

i 1 Hospital beds by type per 100 000 population 200 200 and 201

i 2 cute care hospital beds per 100 000 population

i verae lenth o stay acute care hospitals only

i Physicians per 100 000 population 0

i 5 urses per 100 000 population 1

i Physicians and nurses per 100 000 population 2

i entists per 100 000 population

i Pharmacists per 100 000 population

Abstract

Executive summary

Introduction

Organization and governance

Financing

Physical and human resources

Provision of services

Principal health reforms

Assessment of the health system

1. Introd

uctio

n1. Introduction

1.1 Geography and sociodemography

2ig 11ap o the nited indom

Source: httpwwwmapoucom

3able 11 Trends in populationdemoraphic indicators selected years

10 10 15 2000 2005 2010 2011 2012 201 201Population total 5 52 50 5 0 2 1 5Population emale o total

51 51 51 51 510 50 50 50 50 50

Population rowth annual

01 0 0 0 0 0 0 0 0 0

Population aed 01 o total

210 10 15 10 1 1 15 15 1 1

Population aed 5 and above o total

1 15 15 15 10 1 1 12 15 1

e dependency ratio o worinae population

51 52 55 5 51 51 52 51 50 5

irth rate crude per 1 000 people

1 1 12 115 120 12 12 12 122

eath rate crude per 1 000 people

11 112 111 10 0

Population density people per s m o land area

22 2 2 2 2 25 215 2 250 2

rban population o total

5 1 1 1 1 21 2

Source: orld an 2015

41.2 Economic context

5able 12 acroeconomic indicators selected years

10 10 15 2000 2005 2010 2011 2012 201 201P current S billions

55 1 0 1 2 1 5 2 12 2 0 2 52 2 15 2 2 2

P PPP current international billions

1 00 1 22 1 10 2 05 2 255 2 12 2 1 2 52 2 525

P per capita current S

10 02 1 05 21 2 2 2 5 2 0 5 1 051 1 5 0

P per capita PPP current international

1 5 21 0 2 0 525 5 20 5 255 1

P rowth annual

22 05 25 2 1 1 0 1 2

eneral overnment inal consumption ependiture o P

20 10 11 15 202 21 20 20 201 1

ash surplusdeicit o P

52 2 5 2 55

Ta revenue o P

2 21 25 252 25 25

entral overnment debt total o P

12 2

ndustry value added o P

1 2 2 20 20 210 205 201 1

riculture value added o P

1 15 0 0 0 0 0 0 0

Services etc value added o P

1 22 2

abour orce total millions

2 2 25 0 20 2 2 2

nemployment total o total labour orce modelled O estimate

5 0 5

Per cent at ris o poverty or social eclusion total population

2 22 22 21 2

coeicient 20 20 2 1 02 Real interest rate

1 2 1 5 1 2 1 11 1 12

Oicial echane rate per S period averae

0 0 0 0 05 0 0 0 0 0

Sources: orld an 2015 European ommission 2015

61.3 Political context

71.4 Health status

able 1 ortality and health indicators selected years

10 10 15 2000 2005 2010 2011 2012 201ie epectancy at birth emale years

5 02 12 2 2 2

ie epectancy at birth male years

0 1 5 5 1 2

ie epectancy at birth total years

5 0 0 10 0 10

ortality rate adult emale per 1 000 emale adults

5 1 25 5 1 55 55

ortality rate adult male per 1 000 male adults

11 12 11 10 5 12 5


8able 1 Healthy years o lie

2005 200 200 200 200 2010 2011 2012eales t birth 55 0 1 5 52 5 t ae 5 11 111 11 11 11 11 11 105ales t birth 2 50 50 50 52 t ae 5 10 10 10 10 10 10 110 105

Source: European ommission 2015

9able 15 Standardied death rates selected years

ndicators 10 10 15 2000 2005 2010ounicable diseasesSR inectious and parasitic diseases all aes per 100 000

2 1 55 5 05

SR tuberculosis all aes per 100 000 1 0 0 0 05 0oncounicable diseases SR diseases o circulatory system all aes per 100 000

50 51 10 202 2112 11

SR malinant neoplasms all aes per 100 000

210 220 201 1 10 10

SR disease o enitourinary system all aes per 100 000

1252 2 10 10 11

SR tracheabronchuslun cancer all aes per 100 000

51 51 2 0 01

SR malinant neoplasm emale breast all aes per 100 000

022 0 10 2 2

SR cancer o the cervi uteri all aes per 100 000

51 1 2 2

SR diabetes all aes per 100 000 10 11 5SR mental disorders diseases o nervous system and sense orans all aes per 100 000

10 22 252 22 52

SR ischaemic heart disease all aes per 100 000

250 215 121 101 101 25

SR cerebrovascular diseases all aes per 100 000

115 15 51 25 5 211

SR diseases o respiratory system all aes per 100 000

115 1102 105 5

SR diseases o diestive system all aes per 100 000

25 20 2 21 5 11

Eternal causes SR transport accidents all aes per 100 000

120 1002 1 5 5

SR suicide and selinlicted inury all aes per 100 000

1 1 1 2

SR symptoms sins and ill deined conditions all aes per 100 000

2 25 2 2 20

Source: HO Reional Oice or Europe 2015 Health or ll httpdataeurowhointhadb

10

able 1 orbidity and actors aectin health status selected years

10 15 2000 2005 2010 2011 2012 201Hospital dischares all neoplasms per 100 000

1 02 01

ncidence o cancer per 100 000 05 520 1 22 52 52 5 ncidence o trachea bronchus and lun cancer per 100 000

5 5 0 0

ncidence o emale breast cancer per 100 000

111 120 1 1 15 155 152

ncidence o cervi uteri cancer per 100 000

1 11 1 0 5

Prevalence o diabetes mellitus 5 5 51 o reular daily smoers in the population aed 15

0 2 2 2 20 20 20 1

Pure alcohol consumption litres per capita aed 15

100 105 115 105 10

Source: HO Reional Oice or Europe 2015

11

able 1 aternal child and adolescent health indicators selected years

10 10 15 2000 2005 2010 2011 2012 201 201 2015dolescent ertility rate births per 1 000 women aed 151

2 1 10 2 2 25 25 25 25

aternal mortality rate national estimate per 100 000 live births

10 11 11 12 11

ortality rate inant per 1 000 live births

120 1 5 51 2 1 5

ortality rate neonatal per 1 000 live births

5 1 5 0 2 2 2 25 2

ortality rate under5 per 1 000 live births

11 2 0 52 50 2


2. Organization and governance

2.1 Overview of the health system

2.2 Historical background

ig 2

1 Ov

ervie

w o

th

e he

alth

syst

em

Regu

lator

y role

Man

ager

ial re

lation

ship

Finan

cial f

low

s

UK Pa

rliam

ent

NHS

Scot

land

NHS

North

ern

Irelan

d

Scot

tish

Parli

amen

t

Depa

rtmen

t of H

ealth

NI

Mon

itor

MHR

NHS ng

land

en

tral

oer

nmen

tHM

re

asur

y

Pulic

He

alth

ng

land

ar

e

ualit

yom

miss

ion

en

eral

Med

ical

ounc

il

Healt

h an

d So

cial

are

Dire

ctor

ates

Depa

rtmen

t of H

ealth

Socia

l Serice

s an

d Pulic

Sa

fety

Regu

latio

n

uality

Impr

oem

ent

utho

rity

Healt

hcar

e In

spec

tora

te

ales

Healt

hcar

e Im

pro

emen

tSc

otlan

d

NHS

ales

Barn

ett f

orm

ula

Natio

nal

ssemly

for

ales

Min

ister

fo

r He

alth

and

Socia

l Serice

s

North

ern

Irish

ss

emly

rm

slen

gth od

iesRe

gulat

ors

2.3 Organization

United Kingdom Government

NHS in England

NHS in Scotland

NHS in Wales

Health and Social Care in Nor thern Ireland

National Institute for Health and Care Excellence (NICE)

Medicines and Healthcare products Regulator y Agency (MHRA)

Trade unions

Royal colleges

The pr ivate and not-for-profit sectors

2.4 Decentralization and centralization

2.5 Planning

NHS in England

NHS in Scotland

NHS in Wales

Health and Social Care in Nor thern Ireland

2.6 Intersectorality

2.7 Health information management

2.7.1 Information systems

2.7.2 Health technology assessment

2.8 Regulation

2.8.1 Regulation and governance of third party payers

2.8.2 Regulation and governance of providers

England

Scotland

Wales

Nor thern Ireland

2.8.3 Regulation and planning of human resources

2.8.4 Regulation and governance of pharmaceuticals

2.8.5 Regulation of medical devices and aids

2.8.6 Regulation of capital investment

2.9 Patient empowerment

2.9.1 Patient information

2.9.2 Patient choice

2.9.3 Patient rights

2.9.4 Complaints procedures

2.9.5 Public participation

2.9.6 Patients and cross-border health care

3. Financing

3.1 Health expenditure

able 1 Trends in health ependiture in the nited indom 15 to 201

ndicators 15 2000 2005 2010 2011 2012 201Total health ependiture THE ross omestic Product P

1 2 1

Total ependiture on health capita at Purchasin Power Parity per S

1 1 211 22 22 25 11

verae annual rowth rate in per capita ependiture

1 5 00 0 2

Private insurance as o PvtHE 1 1 20 201 11 11 11Private ependiture on health PvtHE as o THE 11 20 1 10 1 10 15Out o pocet ependiture as o THE 10 111 0 Out o pocet ependiture as o PvtHE 5 51 5 5 5 5HE as o eneral overnment ependiture 10 151 152 15 11 12 12eneral overnment ependiture on health as o P

5 55

eneral overnment ependiture on health cap rate

11 1 25 20 00 01 00

eneral overnment ependiture on health cap Purchasin Power Parity per S

110 150 220 20 20 21 2

eneral overnment ependiture on health HE as o THE

1 1 0 0 5

Source: HO 201 HO lobal Health Ependiture atabase

ig 1 Health ependiture as a share o P in the HO European Reion latest available year


ig 2 Total health ependiture as o P HO estimates


4

6

8

10

12

EU members since May 2004

EU members before May 2004

EUUnited Kingdom

Sweden

GermanyFrance

2013201220112010200920082007200620052004200320022001200019991998199719961995

ig Health ependiture in PPP per capita in the HO European Reion latest available year


ig Health ependiture rom public sources as a percentae o total health ependiture in the HO European Reion latest available year


3.2 Sources of revenue and financial flows

ig 5 inancial lows

HM Treasury

Nationaltaxes

GOVERNMENT

Governmental financing system Private financing system

Transfers within systemOut-of-pocket financing

Clinical commissioning group

Local Authority

Private medical insurance companies

Enterprises

Population

Public health

ERVE PROVER

PRVTE

Mental health

Hospital services

out-o-pocet payments

pecialist services

Private healthcare acilities

Community pharmacies

Primary care

Community service

Local health social care boards

evolved nations

epartment o Health

Public Health England

NH England

3.3 Overview of the statutory financing system

3.3.1 Coverage

3.3.2 Collection

3.3.3 Pooling of funds

England

The Barnett formula

Nor thern Ireland, Scotland and Wales

3.3.4 Purchasing and purchaserprovider relations

3.4 Out-of-pocket payments

3.4.1 Cost-sharing (user charges)

3.4.2 Direct payments

3.5 Voluntary health insurance

3.6 Other financing

3.7 Payment mechanisms

3.7.1 Paying for health services

Payment by Results (PbR) in England

Pay for Per formance (P4P) in England

3.7.2 Paying health workers

GPs

Consultants/Specialists

Junior doctors

Nurses, midwives and other NHS staff

NHS dentistr y

Pharmacists

4. Physical and human resources

4.1 Physical resources

4.1.1 Capital stock and investments

Cur rent capital stock

Investments

4.1.2 Infrastructure

ig 1 Hospital beds by type per 100 000 population 200 200 and 201


ig 2 cute care hospital beds per 100 000 population


0

100

200

300

400

500

600

700

800



EU

United KingdomSweden

Germany

France

2013

2012

2011

2010

2009

2008

2007

2006

2005

2004

2003

2002

2001

2000

1999

1998

1997

1996

1995

1994

1993

1992

1991

1990

ig verae lenth o stay acute care hospitals only


0

2

4

6

8

10

12

14



EU

United KingdomSweden

Germany

France

2013

2012

2011

2010

2009

2008

2007

2006

2005

2004

2003

2002

2001

2000

1999

1998

1997

1996

1995

1994

1993

1992

1991

1990

4.1.3 Medical equipment

able 1 ianostic imain in the nited indom 2012

er i ll ion population Eas per 1 000R units 0T scanners 55

Source: OE 201 OE Health at a lance httpwwwoecdilibraryordobserverdownload11211edNote: Eams outside hospital are not included

4.1.4 Information technology

4.2 Human resources

4.2.1 Health workforce trends

ig Physicians per 100 000 population


0

50

100

150

200

250

300

350

400

450


EU members before May 2004EU

United Kingdom

SwedenGermany

France

2013

2012

2011

2010

2009

2008

2007

2006

2005

2004

2003

2002

2001

2000

1999

1998

1997

1996

1995

1994

1993

1992

1991

1990

ig 5 urses per 100 000 population


0

200

400

600

800

1000

1200

1400



EUUnited Kingdom

Germany

France

20132012201120102009200820072006200520042003200220012000

ig Physicians and nurses per 100 000 population


ig entists per 100 000 population


0

10

20

30

40

50

60

70

80

90

100


EU members before May 2004EU

United Kingdom

SwedenGermany

France

2013

2012

2011

2010

2009

2008

2007

2006

2005

2004

2003

2002

2001

2000

1999

1998

1997

1996

1995

1994

1993

1992

1991

1990

ig Pharmacists per 100 000 population


4.2.2 Professional mobility of health workers

20

40

60

80

100

120


EU members before May 2004EUUnited KingdomSweden

Germany

France

2013

2012

2011

2010

2009

2008

2007

2006

2005

2004

2003

2002

2001

2000

1999

1998

1997

1996

1995

1994

1993

1992

1991

1990

4.2.3 Training and career paths of health workers

Physicians

Dentists

Nur ses and midwives

Pharmacists

5. Provision of services

5.1 Public health

5.2 Patient pathways

5.3 Primary/ambulatory care

5.4 Specialized ambulatory care/inpatient care

5.5 Emergency care

5.6 Pharmaceutical care

5.7 Rehabilitation/intermediate care

5.8 Long-term care

5.9 Services for informal carers

5.10 Palliative care

5.11 Mental health care

5.12 Dental care

5.13 Complementary and alternative medicine

6. Principal health reforms

6.1 Analysis of recent reforms

England

Nor thern Ireland

Scotland

6.2 Future developments

England

Nor thern Ireland

Scotland

7. Assessment of the health system

7.1 Stated objectives of the health system

7.2 Financial protection and equity in financing

7.2.1 Financial protection

7.2.2 Equity in financing

7.3 User experience and equity of access to health care

7.3.1 User experience

7.3.2 Equity of access to health care

7.4 Health outcomes, health service outcomes and quality of care

7.4.1 Population health

7.4.2 Health service outcomes and quality of care

7.5 Health system efficiency

7.5.1 Allocative efficiency

7.5.2 Technical efficiency

7.6 Transparency and accountability

8. Conclusions

9. Appendices

9.1 References

Workforce planning in the NHS

Public payment and private provision: The changing landscape of healthcare in the 2000s

Best practice tariffs and their impact

Accident and Emergency Statistics

Social care cap to be set at 75,000

Edwin Poots: Prescription charges could buy cancer drugs

Scotland Decides

The four health systems of the United Kingdom: how do they compare

Four hundred-plus deprived area GP practices face MPIG withdrawal

General Practitioners Committee: MPIG Changes

Pay for doctors

BMA Annual Report Financial Statements for the year ended 31 December 2014

). EWTD for junior doctors

Out-of-hours care

Personal Medical Services (PMS) Agreements

. Health Systems in Transition

Delayed discharges in England reach record high

The Mortality Effects of Long-Term Exposure to Particulate Air Pollution in the United Kingdom.

BMJ Mirror, Mirror On The Wall: How the

Performance of the U.S. Health Care System Compares Internationally

Code of Conduct for Payment by Results in 201314

Government agrees breakthrough drug pricing deal with pharmaceutical firms

The Mandate explained

Hard Truths: The Journey to Putting Patients First

NHS buildings: obstacle or opportunity

Whats behind the drop in A&E performance

Health inequalities in the EU Final report of a consortium

Eurostat Database

Integrated care in Northern Ireland, Scotland and Wales: Lessons for England

The NHS under the coalition government. Part one: NHS reform

Integrated Care Partnerships

The Barnett Formula

Pulse

An alternative guide to the new NHS in England.

The New NHS

Medical workforce

The Francis Inquiry report.

Making best use of the Better Care Fund

The UK private health market

). Whats going on in A&E? The key questions answered

Health Systems in TransitionNews

Letter

Public Money and ManagementThe Better Care Fund: do the sums add up?

The NHS payment system: evolving policy and emerging evidence.

The Lancet

Financial failure in the NHS: What causes it and how best to manage it.

Pay Modernisation: A New Contract for NHS Consultants in England

The National Programme for IT in the NHS: an update on the delivery of detailed care records systems

The financial sustainability of NHS bodies

Palliative Care Explained

The Operating Framework for the NHS in England 2012/13

Complaints about the NHS up by 8%.

How much will I pay for NHS dental treatment

Patient choice of GP practices

Key statistics on the NHS

Quality and outcomes framework

NHS England Business Case Approvals Process for Capital Investment, Property, Equipment and ICT

Transforming Participation in Health and Care

Transforming Participation in Health and Care, Guidance for Commissioners

Commissioning for Quality and Innovation (CQUIN): 2014/15 guidance. London, NHS England

NHS England publishes outcomes of GP Personal Medical Services review. London, NHS England

Technical Guide to the formulae for 201415 and 201516 revenue allocations to Clinical Commissioning Groups and Area Teams

Understanding the new NHS.

NHS standard contract

Working in the NHS

The Healthcare Quality Strategy for NHS Scotland

Public and Patient Involvement and Experience in NHS Wales

Pharmaceutical spending. London, Organisation for Economic Co-operation and Development

Health at a Glance 2013: OECD indicators

Health at a glance: Europe 2014.

Health at a glance 2015: OECD indicators

. Health Systems in Transition,Table 2 2011 Census: Usual resident population and population density, local

authorities in the United Kingdom

Internet Access Households and Individuals, 2014.

Mortality in the United Kingdom, 19832013

Public Sector Employment, Q2 2014

Trend in life expectancy at birth and at age 65 by socioeconomic position based on the National Statistics Socio-economic Classification, England and Wales, 19821986 to 20072011

). Personal and Public Involvement (PPI).

Tuberculosis (TB) in the UK: annual report

Bulletin of the World Health Organization

BMJ

The 2022 GP Compendium of Evidence

About the Act

Patient Focus and Public Involvement

Waiting times in NHS at worst for six years The Telegraph

Tory MP Redwood leads calls for English Parliament

Health Systems in Transition

The LancetThe future of devolution in Wales

New system for emergency ambulance services to prioritise patients in most need of care.

European Health for All database

The Telegraph

World Development Indicators Online (WDI) database

9.2 Useful web sites

Agenda for Change: http://wwwnhsemployersorg/your-workforce/pay-and-reward/pay/agenda-for -change-pay/how-agenda-for-change-works

Br itish Medical Association: http://bmaorguk/

General Medical Council: http://wwwgmc-ukorg/about/UK_health_and_social_care_regulatorsasp

Healthcare Improvement Scotland: http://wwwhealthcareimprovementscotlandorg/about_usaspx

HSCIC: http://wwwhscicgovuk/suppor tandguidance

Independent Community Pharmacist: http://wwwindependentpharmacistcouk/aboutuscfm

Integrated Care and Suppor t Exchange: http://wwwicaseorguk/pg/dashboard

MATCH: http://wwwmatchacuk/

MHRA: https://wwwgovuk/government/organisations/medicines-and-healthcare-products-regulator y-agency/about

NHS Choices: http://wwwnhsuk/Pages/HomePageaspx

NHS Direct Wales: http://wwwnhsdirectwalesnhsuk/

NICE: http://wwwniceorguk/

NI Direct: http://wwwnidirectgovuk/

NIHR: http://wwwnihracuk/

Office for National Statistics: http://wwwonsgovuk/ons/indexhtml

Pr ivate Healthcare UK: http://wwwpr ivatehealthcouk/health-insurance/

RQIA: http://wwwrqiaorguk/home/indexcfmThe Scottish Char ter of Patient Rights and Responsibilities: http://wwwgovscot/Resource/0039/00390989pdf

SHOW Scotland: http://wwwshowscotnhsuk/

Spine Ser vices: http://systemshscicgovuk/spine

Universal Credit: http://wwwnhsuk/NHSEngland/Healthcosts/Pages/univer sal-creditaspx

9.3 HiT methodology and production process

9.4 The review process

9.5 About the authors

Jonathan Cylus

Er ica Richardson

Lisa Findley

Marcus Longley

Ciaran ONeill

David Steel

The Health Systems in Transition profiles

A series of the European Observatory on Health Systems and Policies

How to obtain a HiT

Eurohealth

info@obseurowhoint

www.healthobservatory.eu

Albania (1999, 2002a)Andor r a (2004)Armenia (2001, 2006, 2013)Austr alia (2002, 2006)Austr ia (2001e, 2006e, 2013)Azerbaijan (2004, 2010)Belarus (2008, 2013)Belgium (2000, 2007, 2010)Bosnia and Herzegovina (2002)Bulgar ia (1999, 2003b, 2007, 2012b)Canada (2005, 2013c)Croatia (1999, 2006, 2014)Cypr us (2004, 2012)Czech Republic (2000, 2005, 2009, 2015)Denmark (2001, 2007, 2012)Estonia (2000, 2004, 2008, 2013)Finland (2002, 2008)France (2004c, 2010, 2015)Georgia (2002d, 2009)Ger many (2000e, 2004e, 2014e)Greece (2010)Hungar y (1999, 2004, 2011)Iceland (2003, 2014)Ireland (2009)Israel (2003, 2009)Italy (2001, 2009)Japan (2009)Kazakhstan (1999, 2007, 2012)Kyrgyzstan (2000, 2005, 2011)Latvia (2001, 2008, 2012)Lithuania (2000, 2013)Luxembourg (1999)Malta (1999, 2014) Mongolia (2007)Nether lands (2004, 2010)New Zealand (2001)Nor way (2000, 2006, 2013)Poland (1999, 2005, 2012)Por tugal (1999, 2004, 2007, 2011)

Republic of Korea (2009)Republic of Moldova (2002, 2008, 2012)Romania (2000, 2008)Russian Federation (2003, 2011)Slovakia (2000, 2004, 2011)Slovenia (2002, 2009)Spain (2000h, 2006, 2010)Sweden (2001, 2005, 2012)Switzer land (2000, 2015)Tajikistan (2000, 2010l)The former Yugoslav Republic of

Macedonia (2000, 2006)Turkey (2002i, 2011)Turkmenistan (2000)Ukraine (2004, 2010, 2015)United Kingdom of Great Br itain and

Nor ther n Ireland (1999)United Kingdom (England) (2011)United Kingdom (Nor thern Ireland) (2012)United Kingdom (Scotland) (2012)United Kingdom (Wales) (2012)United States of Amer ica (2013)Uzbekistan (2001, 2007, 2014)Veneto Region, Italy (2012)

e

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HiT country profiles published to date:

ISSN

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Documents

United Kingdom Vol. 17 No. 5 2015 - UK-HiT.pdf