Analyzing The Unıted Kingdom Healthcare System: Lensing On Cancer Management In England
United Kingdom (UK) healthcare system is quite successful for achievingthe goals of good health outcomes, risk protection, and public satisfaction.Based on the Commonwealth Fund study in 2014, UK healthcaresystem ranks first regarding quality, access, efficiency, equity, andhealthy lives among 11 developed nations with even a fair cost. However,when it comes to cancer outcomes, UK lags behind many developedcountries. Cancer survival is a good example of an area in which bothhealth outcomes and public satisfaction, key determinants of quality,are strikingly lacking. Therefore, this paper, to analyze and formulatereforms to address deficient quality in the English health system, willlook at the particular example of cancer survival rates. The key factorsleading to deficient outcomes in cancer survival are delays in diagnosisand access to appropriate care. Policy recommendations to improvecancer survival rates are to timely screening and early diagnostic opportunitieswithin the primary care system, utilize available treatmentcapacity and quick approval and workforce training for utilization ofnew treatments and drugs, and continue prioritizing cancer care coordinationand integration through improved referral services, and increaseprovider decision support.
United Kingdom (UK) healthcare system is quite successful for achieving the goals of good health outcomes, risk protection, and public satisfaction. Based on the Commonwealth Fund study in 2014, UK healthcare system ranks first regarding quality, access, efficiency, equity, and healthy lives among 11 developed nations with even a fair cost. However, when it comes to cancer outcomes, UK lags behind many developed countries. Cancer survival is a good example of an area in which both health outcomes and public satisfaction, key determinants of quality, are strikingly lacking. Therefore, this paper, to analyze and formulate reforms to address deficient quality in the English health system, will look at the particular example of cancer survival rates. The key factors leading to deficient outcomes in cancer survival are delays in diagnosis and access to appropriate care. Policy recommendations to improve cancer survival rates are to timely screening and early diagnostic opportunities within the primary care system, utilize available treatment capacity and quick approval and workforce training for utilization of new treatments and drugs, and continue prioritizing cancer care coordination and integration through improved referral services, and increase provider decision support
British Medical Association (BMA). 2011. International compar- isons of health outcomes. Health Policy & Economic Research Unit: Briefing Note. Available from: http://www.bma.org.uk/ images/srm2011briefingpaperhealthoutcomes_tcm41-204676.pdf, [Accessed March 5, 2014]
Organisation for Economic Co-operation and Development (OECD). 2013. OECD Health Data 2013.
Harrison A., Gregory S., Mundle C., Boyle S. 2011. The English
health care system, 2011. International Profiles of Health Care Systems, 2011. The Commonwealth Fund. Available from: http:// www.commonwealthfund.org/Topics/International-HealthPolicy/ Countries/~/media/Files/Topics/International/Country%20Pro- files/1562_Squires_Intl_Profiles_2011_English.pdf [Accessed 05 June, 2014].
Appleby J. 2011. “How satisfied are we with the NHS?” British Medical Journal 342:1836.
Davis K., Schoen C., and Stremikis K. 2014. Mirror on the wall:
How the performance of the U.S. health care system compares internationally, 2014 update. The Commonwealth Fund.
Roberts MJ., Hsiao W., Berman P., Reich MR. 2008. Getting health reform right new York: Oxford University Press, 2008.
Xu K., Evans DB., Kawabata K., Zeramdini R., Klavus J., Mur- ray CJL. 2003. Household catastrophic health expenditure: a mul- ticountry analysis. Lancet 362: 111-117.
Squires D. 2011. Multinational comparisons of health data. The Commonwealth Fund.
Organisation for Economic Co-operation and Development (OECD). Health Care Quality Indicators Data 2009.
Thorlby R. and Maybin J. (ed) 2010. A high-performing NHS? A review of progress 1997-2010. The King’s Fund. Available from: http://www.kingsfund.org.uk/publications/a_highperform- ing_nh.html. [Accessed 11 March, 2014].
Foot C. and Harrison T. 2011. How to improve cancer survival: Explaining England’s relatively poor rates. The King’s Fund: London.
Berrino F., De Angelis R., Sant M., Rosso S., Bielska-Lasota M., Coebergh J.W., Santaquilani M. 2007. Survival for eight major cancers and all cancers combined for European adults diagnosed 1995-1999: Results of the Eurocare-4 study. EUROCARE Work- ing Group. The Lancent Oncology 8: 773-83.
Olesen F., Hansen RP., Vested P. 2009. Delay in diagnosis: the experience in Denmark. British Journal of Cancer; 101 (2):5–8.
Boyle S. 2011. United Kingdom (England): Health system re- view. Health Systems in Transition 2011; 13(1):1–486.
Department of Health. Financial Planning and Allocations Divi- sion. 2011a. Resource Allocation: Weighted Capitation Formula. 7th ed.
Vedsted P. and Olesen F. 2011. Are the serious problems in can- cer survival partly rooted ingatekeeper principles?. British Jour- nal of General Practice. August 2011: 508-512.
Department of Health. 2011. Improving Outcomes: A Strategy for Cancer. Avaiable from: http://www.dh.gov.uk/prod_consum_dh/ groups/dh_digitalassets/documents/digitalasset/dh_123394.pdf [Accessed on May 2, 2014].
National Institute for Health and Clinical Excellence. 2005. Referral guidelines for suspected cancer. Available from: http:// www.nice.org.uk/nicemedia/live/10968/29822/29822.pdf [Ac- cessed March 4, 2014].
National Health Service Information Centre. 2011. Quality and outcomes framework achievement data 2010/11. Available from: http://www.ic.nhs.uk/webfiles/publications/002_Audits/ QOF_201011/QOF_Achievement_and_Prevalence_Bulle- tin_2010_11_v1.0.pdf [Accessed March 4, 2014].
Cameron D., Stead M., Lester N. et al. 2011. Research intensive cancer care in the NHS in the UK. Annals of Oncology 2011; 22:29-35.
Williams M., Summers E., Drinkwater K., and Barrett A. 2007. Radiotherapy dose fractionation, access and waiting times in the countries of the UK in 2005”. Clinical Oncology, 19; 5:273–86.
Delaney G., Jacob S., Featherstone C., and Barton M. 2005. The role of radiotherapy in cancer treatment: Estimating optimal util- isation from a review of evidence-based clinical guidelines. Can- cer; 104 (6): 1129-37.
Comptroller and Auditor General. 2010. Delivering the cancer reform strategy.
National Lung Cancer Audit. 2009. National Health Service In- formation Centre. Available from: http://www.ic.nhs.uk/webfiles/ Services/NCASP/audits%20and%20reports/NHS%20IC%20 Lung%20Cancer%20AUDIT%202009%20FINAL.pdf [Accessed March 5, 2014].
Raine R.,Wong W., Scholes S. et ali 2010. Social variations in ac
cess to hospital care for patients with colorectal, breast, and lung cancer between 1999 and 2006: retrospective analysis of hospital episode statistics. BMJ; 340:54-79.
Department of Health. 2007. Radiotherapy: Developing a world class service for England: Report to ministers from National Radiotherapy Advisory Group: London. Available from: www. dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/ documents/digitalasset/dh_074576.pdf [Accessed 04 May, 2014].
Richards M. 2010. Extent and causes of international variations in drug usage: A report for the Secretary of State for Health by Professor Sir Mike Richards CBE. Available from: http://www. dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ ps/documents/digitalasset/dh_117977.pdf [Accessed 5 March, 2014].
Wilking N. and Jonsson B.2005. A pan-European comparison regarding patient access to cancer drugs.
Faden RR., Chalkidou K., Appleby J. et al, 2009. Expensive can- cer drugs: a comparison between the United States and the United Kingdom. Milbank Q; 87 (4):789-819.
Wilking N., Jonsson B., Hogberg D., and Justo N. 2009. Compar- ator Report on Patient Access to Cancer Drugs in Europe.
Sikora K. 2009. Was the NHS cancer plan worth the effort? Lan- cet Oncol; 10 (4):312-3.
National Institute for Health and Clinical Excellence. 2010. Eval- uation and Review of NICE Implementation Evidence. Available from: www.nice.org.uk/usingguidance/evaluationandreviewofni- ceimplementationevidenceernie/evaluation_and_review_of_nice_ implementation_evidence_ernie.jsp [Accessed June 4, 2014].
National Health Service. 2009. Ensuring better treatment: Going further on cancer waits. Available from: www.improvement.nhs. uk/cancer [Accessed March 7, 2014].
Bouchardy C., Rapiti E., Blagojevic S. et al. 2007. Older female cancer patients: importance, causes, and consequences of under- treatment. J Clin Oncol 25; (14):1858-69.
Enger SM., Thwin SS., Buist DSM. et al 2006. Breast cancer treatment among older women in integrated health care settings. Journal of Clinical Oncology 24; (27):4377-83.
Peake MD., Thompson S., Lowe D., and Pearson MG. 2003. Ageism in the management of lung cancer. Age Ageing 32; (2):171-7.
Farrar M., Richards G., Doran K. et al. 2008. A cancer plan for
the North West of England to 2012. Northwest National Health Service.