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Five ideas from other health systems that could transform NHS

Reported in the Guardian (3 July 2018): No health system has all the answers, and there are certainly lessons the NHS can impart. But if the NHS is to thrive it needs to draw on the knowledge and experiences of other countries.

New Zealand: integrated health and social care
In the early 2000s, the health system in Canterbury on New Zealand’s South Island was under pressure as a result of increasing demand, leading to questions about its sustainability. But since it introduced an integrated health and social care system in 2007, Canterbury has turned around its fortunes.

Sweden: paediatricians on the frontline
When it comes to the increasing pressures on the NHS, the spotlight often falls on Britain’s ageing population. But demand for services is also increasing among other age groups. In the UK the first port of call for parents is usually the GP, who will often have limited training in paediatrics. By contrast, in Sweden GPs and paediatricians are co-located in health centres where there is parental support, health education and promotions, all important for preventing ill health.

Israel: single patient record
Nigel Edwards, the chief executive of the Nuffield Trust, says other countries have reaped dividends from adopting a single record for each patient. He cites Israel, where health maintenance organisations (HMOs) oversee care, as an example of what can be achieved.

“If you’re using the health system in the HMO your health practitioner knows exactly what is happening to you, what your needs are,” says Edwards. “They’ll get reminders it’s time for you to have various preventative care, they have alerts about drugs which might interact negatively with each other.”

Canada: innovation procurement
The NHS is the world’s single biggest buyer of healthcare products and its spending has long been under scrutiny. It has been claimed that it could save billions by making procurement more efficient. In Canada, which like the UK has a publicly funded health system, the province of Ontario is exploring the benefits of what it calls “innovation procurement”.

Instead of just buying a drug or piece of equipment, health providers in Ontario are inviting companies to take part in design competitions and come up with solutions, focusing on measurable outcomes such as improving care by a certain amount or cutting costs by a specified sum.

Examples have included surgeons wanting to improve their accuracy by gaining greater visibility of the surgical field during operations, and an attempt to get care services to the community as quickly as possible, a challenge in Canada where the population is spread over a large area.

Denmark: one-stop cancer screening
The UK has long had cancer survival rates that lag behind countries with similar health systems and expenditure. One of the reasons for this is that cancer tends to be diagnosed later than in other countries. The later it is diagnosed the less the chance of surviving it – and the greater the cost of treating it. In Denmark, a one-stop service is offered to people presenting possible cancer symptoms through multi-disciplinary diagnostic centres (MDCs). Instead of the NHS approach, which involves different tests carried out consecutively, in Denmark all the tests are done at once enabling them to come to a decision as to whether the patient has any form of cancer.

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