Is the UK celebrating NHS’s 70th birthday?

Last weekend, the United Kingdom’s National Health Service (NHS) turned 70.  NHS is a protocolical single payer system.  Whereas Canada is a single payer system, provinces rather than the federal government makes most decisions and providers (i.e., hospitals and physicians) are private, for-profit businesses.  In the Netherlands, on the other hand, both providers and health…

Does more spending improve outcomes?

A number of studies have claimed that increased health expenditures may result in no better, or even worse outcomes.  For instance, a paper by Fisher et al. (2003) looking at patients with acute myocardial infarction, colorectal cancer, or hip fracture finds that “Quality of care in higher-spending regions was no better on most measures and…

Pay caps on nurses in the UK

I’m finishing my time in the UK today and head back home tomorrow.  The British Society for Rheumatology 2017 conference was interesting, on the news the key headlines were pay for National Health Service employees, nurses in particular. Due to budget shortfalls, the NHS froze nurse pay between 2010 and 2012.  Beginning in 2012, pay raises resumed…

Access to cancer care in the UK

Being sick in the United Kingdom has advantages and disadvantages.  Supporters will cite that out-of-pocket costs are generally low, coverage is universal, and the price of health care to the government is lower. One question is, what is the quality of care received?  Critics cite that access to cutting edge, innovative treatments is often restricted or…

P4P in the UK

General Practitioners (GPs) in the UK NHS are paid a mixture of capitation, lump sum allowances, and a pay-for-performance bonus. The P4P element, the Quality and Outcomes Framework (QOF), rewards GPs according to their performance on a large number of indicators. QOF payments represented up to 20% of GPs ’ income in the first year…

What does a NICE health economist do?

What role do health economists at the UK’s National Institute for Health and Clinical Excellence (NICE) play and how do they conduct their cost effectiveness analyses for new treatments? I answer this question today based on NICE’s own documents.  According to their guidelines manual, the role of the health economist in clinical guideline development is to:…