HHE HOPE 2019 - Page 24

UNITED KINGDOM Quote here kpkp pk pkpk pk ppkp pk pkpk pkpk pk kpkp pk pkpk pk ppkp pk pkpk pkpk pk kpkp pk pkpk pk ppkp pk pkpk pkpk pk kpkp pk pkpk pk ppkp pk pkpk pkpk pk kpkp Could you present two/three elements on the impact of such reforms on hospital and/ or healthcare sectors that your organisation/ country has identified? The first challenge concerns the monitoring of costs when there is a market-based system (production driven) while the demand for care is constantly growing. The new financial structure has had its challenges. Doctors have formed separate medical specialist companies within the hospital structure. Hospitals have been struggling for longer to find the best ways to incorporate such companies within the hospitals. Nonetheless the Dutch Health Authority (NZa) concluded in 2018 that this reform has had positive effects on this cooperation (professionalisation, efficiency, shared responsibility). Decentralisation of tasks does not simply lead to a reduction of costs. When you decentralise the long-term care without transferring enough funds, in the long run it might even have an adverse effect. One example is the closing of nursing homes, which led to a rise in the number of vulnerable elderly patients in hospitals. Mr Niall Dickson HOPE Governor, NHS Confederation Decentralisation of tasks does not simply lead to a reduction of costs. When you decentralise the long-term care without transferring enough funds, in the long run it might even have an adverse effect Could you describe the last hospital and/ or healthcare reforms implemented in your country in the past 5 years? NHS Long-Term Plan In January 2019, NHS England published the Long-Term Plan, setting out a strategy for the health service for the next ten years. It is a wide ranging and ambitious document, articulating a new service model with greater emphasis on primary and community care; increased emphasis on mental healthcare, prevention and health inequalities; a clear focus on quality and outcome improvement in areas where greater progress is seen as necessary; some workforce reforms; wholesale rebalancing of the NHS relationship with digital services and significant changes to the financial regime. The plan will be achieved by: • Doing things differently. Giving people more control over their own health and the care they receive, encourage more collaboration between GPs, their teams and community services, as primary care network, to increase the services they can provide jointly. Increasing the focus on NHS organisations working with their local partners, as integrated care systems, to plan and deliver services, which meet the needs of their communities. • Preventing illness and tackling health inequalities. The NHS will increase its contribution to tackling some of the most significant causes of ill health, acting to help people stop smoking, overcome drinking problems and avoid Type 2 diabetes, with a particular focus on the communities and groups of people most affected by these problems. • Workforce. Increasing the NHS workforce, training and recruiting more professionals – including more clinical placements for undergraduate nurses, more medical school places, and more routes into the NHS such as apprenticeships. THE NETHERLANDS Total current health expenditure as % of Gross Domestic Product (GDP) General government/compulsory current health expenditure as % of total current health expenditure Hospital current health expenditure, as % of total current health expenditure Household out-of-pocket health expenditure as % of total current health expenditure All hospital beds per 100,000 inhabitants Acute care hospital beds per 100,000 inhabitants Acute care admissions/discharges per 100 inhabitants Average length of stay for acute care hospitals (bed-days) Practising physicians per 100,000 inhabitants Practising nurses per 100,000 inhabitants 24 HHE 2019 | hospitalhealthcare.com 2002 8.0% 65.5% 38.5% 8.4% 457.0 297.0 9.4 8.4 n.a. 783.0 2008 2016 9.5% 10.4% 81.7% 81.0% 32.1% 34.5% 10.7% 11.5% 470.0 363.0 310.0 320.0 11.0 9.7 6.0 5.0 n.a. 350.0 840.0 1,058.0