FW: NEJM on NHS changes and drugs provision

[Guest guest]

Thanks for passing these links on to me Pete. I am forwarding

them to the forum for all members.

Luv - Sheila

perspectives from the US

English NHS

Embarks on Controversial and Risky Market-Style Reforms in Health Care

http://healthpolicyandreform.nejm.org/?p=14126 & query=TOC

Patient and Public Influence

…….A third key area of reform relates to patient influence

on NHS services. Patient voice is to be strengthened at every stage of care.

The catchphrase “no decision about me without me†is to set the tone for future

interactions between patients, doctors, and the wider health service community.

To ensure that patients’ voices are heard in the planning and development of

local services, a new organization called HealthWatch is being developed to

play both national and local roles. Elected local government officials will

also run statutory health and well-being boards whose job it will be to

scrutinize general practitioner commissioning decisions and refer those

decisions to the secretary of state as needed. The public’s new ability to

scrutinize commissioning decisions may bring a fresh element of local democracy

to health services, but it could also stifle innovation in situations in which

payers want to develop services in a way that involves the loss of existing

local facilities.

Choice will be strengthened, too, and the patient’s right

to choose will be extended beyond the current ability to choose between

different hospitals to include choice of treatment options, when clinically

appropriate, and choice of the specialist-led team that will provide treatment.

Patients will also have increased choices in their selection of a primary care

practice — they will, for example, be able to register with a practice located

near their workplace rather than near their home, as is now required. In

theory, patients will be empowered by the health information technology that

provides them with detailed information on quality of care and by a national

set of quality standards, although there is little evidence that patients in

the United Kingdom currently use information on quality of care or that choice

has driven an effective NHS market.23 The information provided to

patients will increasingly be focused on outcomes rather than processes of

care. However, there is real doubt as to whether outcomes data can produce

useful information quickly enough to form a basis for patient choice, provider

accountability, or regulation……

NOTE: Has anybody noticed their doctors (who previously never

listened to them) suddenly actually starting to listen to us and take our

" rights " into consideration i.e. giving us a choice of treatment of

the one and only levothyroxine doesn't take away our symptoms? "

See also:

Determining the Value of Drugs — The Evolving

British Experience

http://healthpolicyandreform.nejm.org/?p=14118 & query=TOC