United Kingdom NHS Healthcare Practice Questions and Answers Review

NHS UK Healthcare Practice Questions and Answers Review

Define the NHS

The National Health Service

How is it funded?

General taxation

How much does it’s services cost?

it’s free

what’s the weirdest language people at NHS can speak

Urdu

Do overseas visitors have to pay?

yes

How much does a prescription cost?

£8.05

How much does treating patients privately, in England generate?

0.6%
(which is much less than the rest of the UK)

How much did the World Bank state that the UK spent on health of its GDP?

9.4%

What is the average of the EU?

10.2%

How much does the NHS spend on work and pensions?

167 billion

what is the NHS total spending amount?

694.9 billion

In 2013 how much did the NHS spend per age-adjusted person?

£1980.97

Do legal immigrants have to pay, yes or no?

How much are prescriptions in Wales?

Free

Who are allowed free prescriptions?

people: Over sixty
Children under 16
Under 19 if in full time education
Patients with certain medical conditions
Low income people

What are some disadvantages of the NHS

– resources often restrained due to patient demand- Waiting list on first come first serve basis.
This also causes patient frustration.
-Costly for the British population- cost efficiency
-tax payers who choose to pay for private healthcare in effect pay twice.

What are some advantages of the NHS

-It’s free to most UK residents
-offers a range of services e.g. NHS direct telephone helpline
-you can choose a male or female doctor

what is a ‘bed-blocker’

patients still receiving care, even though their acute ailment has been treated and they are fit for discharge.

What are Superbugs and why are their fatal outbreaks of them?

antibiotic-resistant bacteria

“cutting corners in cleaning” have been blamed for the problem , as has increased drug resistance due to inappropriate prescribing of antibiotics and patients failing to complete courses of antibiotics. This has led to criticisms of hygiene across the UK, leading to controversies.

what is it made up of (systems)

four:
NHS England
NHS Scotland
NHS Wales
Health and Social Care in Northern Ireland

Created by and when

National Health Service Act 1946
brainchild of pioneering Health Minister Aneurin Bevan – founded 1948

Healthcare before NHS

National Insurance Act 1911 = partially funded healthcare for working people by deducting small amount from wakes + employer+gov contributions
BUT medicines still had to be paid for
women and children less likely to be employed – not entitles to free care
BMA initially opposed state-subsidised healthcare

NHS staff rate 2016

300k+ nurses
nearly 150k doctors
nearly 20k qualified ambulance staff
managers accounted for over 2% of staff in 2015

NHS Brexit issues (5)

staffing
2. accessing treatment
3. regulation
4. cross-border co-operation
5. funding

Brexit and staffing

NHS struggles to recruit and retain permanent staff
policies on freedom of movement changing – EU staff v important to healthcare sector
already, numbers of NHS nurses has fallen, and there has been a 96% reduction in EU applicants for NHS posts

Brexit and treatment access

impact of immigration

EHIC – gives access to medically necessary, state-provided healthcare – costs can be reclaimed from country of residence
after Brexit, the approx. 1.2.m British migrants in EU may return

Brexit and regulation

gov needs to clarify whether its intention is to repeal EU regulations and replace them with UK alternative or continue to abide by them
these include:
-working time directive
-procurement and competition law
-regulation of medicines and medical devices
-regulation to enable common professional standards and medical education between EEA countries (which are EU+Iceland, Liechtenstein and Norway)

Brexit and procurement and competition law

rules covered four areas:
procurement of NHS services;
anti-competitive conduct by providers and commissioners;
mergers between NHS organisations;
and false and misleading advertising of NHS services

Brexit and regulation of medicines and clinical trials

EU legislation provides a harmonised approach – UK currently part of centralised authorisation system operated by EMA (European Medicines Agency)
companies submit a single application to EMA
(MRHA – UK-only regulatory agency, but only for marketing solely intended for UK)

Brexit and cross-border co-operation

EU operates systems for surveillance and early warning of communicable disease, managed by European Centre for Disease Prevention and Contrl
facilitates rapid sharing on information and technical expertise
recent e.g. – H1N1 pandemic and efforts to tackle AMR (antimicrobial resistance)
impact of Brexit on future of science and research
2007-2013: UK received a €3.4bn EU-sourced surplus

UN General Assembly – AMR

ruled it to be a dominant global health concern
by 2050, more people will die of bacterial infections than cancer

7 Day NHS – overview and background

a study found that a patient is 15% more likely to die if they are admitted on the weekend rather than id-week
gov wants to prevent these deaths by ensuring that weekend service are available at the same standard

Issues with 7 Day NHS

PAY – to provide non-emergency services over the weekend, current staff will need to work additional hours, for additional pay, of NHS will need to employ more staff. What will this mean in practice and and where will this money come from?
MORALE – if government decides to simply increase targets and workloads without sufficient remuneration, major issues such as burnout, resignations and medical school application drop-offs may ensue

7 Day NHS – ongoing

-gov currently negotiating with BMA, who do not currently support the scheme
-if BMA will not negotiate, gov prepared to impose changes and not allow BMA to act as a roadblock to reforms that will save patients’ lives
-plans to extend GP hours – Theresa May pedged £528m per annum to ensure all surgeries open 8-8 by 2021, unless prove lack of demand
-Stephen Hawking vs Jeremy Hunt – SH says he “cherry-picked” data to support 7-Day

what is Stephen Hawking’s position on the current NHS crisis

blame lies with political decisions
-underfunding
-new JD contract
-removal of student nurses’ bursary

Junior Doctors’ Contract – criteria to guide recommendations

improved patient care
maintaining respect and trust
credibility and practicality of local implementation
appropriate remuneration
help facilitate constructive, continuing relationships
affordability

Junior Doctors’ Contract – changes

basic pay on average increased by 11-12%
BUT
day hours on Saturday will be normal rate
extra premiums offered for night and rest of weekend will be lower than currently
lowers working hours
fewer breaks

what is being done to improve mental health services

-NHS E aiming to develop and implement new national programme by 2020 – gov has pledged £1.25bn
-part of plan includes supporting CCGs to improve mental health for children
-v v important as 1 in 4 people will suffer from mental or neurological illnesses during their lives

NHS Foundation Trusts

provide care commissioned by CCG
include hospital, ambulance, mental health, social care and primary care services

Devolution and its affect on patients and doctors

four countries of the UK have their own NHS services
UK Parliament allocates block funding to each, but it is up to them how to spend it

How many people does the NHS employ?

over 1.5m

Benefits of working for the NHS

flexible hours
final salary pension scheme
some of tuition fees paid
graduate training scheme to get into management
flexible career paths

Negatives of working for NHS

long of unsociable hours
accountability
flexibility – may be necessary to move

Most common chronic diseases of the elderly

adult onset diabetes
arthritis
kidney/ bladder problems
dementia
parkinson’s
lung disease
– number of complications manifest as grow older

Antibiotic resistance – causes

-overuse
-inappropriate prescribing – incorrect in 30-50% of cases; inappropriate exposure can lead to bacteria being able to more easily develop a gene coding for resistance
-extensive agricultural use
-availability of few new antibiotics – companies have shifted to produce more cancer/chronic disease treatment
-regulatory barriers – clinical trials are expensive and time consuming

why are people in hospital more likely to get MRSA

-often have a way for bacteria to get into body (e.g. wound, burn, drip, catheter)
-body may be less able to fight off bacteria
-in close contact with lots of people

MRSA treatments

on skin: decolonisation
-antibacterial cream
-washing with antibacterial shampoo
-changing towel, clothes etc every day during treatment, and washing laundry separately to other peoples’
infection:
-antibiotics
-kept away from others with infection

Current NHS mental health services

CAMHS
community-based adult services
perinatal mental health
programme on crisis care – 24/7 access
acute mental health care
improving access to psychological therapies