For Healthcare UK, world-class healthcare needs integrated systems where every part works to improve patient outcomes
Health systems have adapted in response to new diseases, innovations, societal expectations and technological interventions for centuries. As the world emerges from the COVID-19 pandemic, there is renewed effort by developed and developing countries to adapt their health systems again. The pandemic has not only threatened the sustainability of established health systems, but crucially the health-related Sustainable Development Goals (SDGs) including the target to achieve Universal Health Coverage (UHC) by 2030 (SDG 3.8).
Monitoring progress towards achieving UHC focuses on the proportion of a population that can access essential quality health services, and how the burden of personal health costs can be reduced to protect households against financial hardship.
Achieving this requires all countries to continue to strengthen their health systems. The WHO defines health system strengthening as “any array of initiatives that improves one or more of the functions of the health systems and that leads to better health through improvements in access, coverage, quality or efficiency.”
The NHS is leading in new approaches to emerging challenges – sustainability and carbon neutral policy, cutting edge infrastructure and pandemic response.
Effects of the COVID-19 pandemic
The pandemic has shown research, innovation and its translation through to products, services and clinical practice are key to achieving continuous health improvements. The rapid pace in biomedical and technological innovations has transformed the lives of many people. The ability to research and deploy COVID-19 vaccinations is a good example from the UK. Yet, as one risk is reduced, others have emerged.
Health services across the globe have worked to transform their systems to respond to the changes in disease burden from infection to non-communicable disease (NCD) as causes for premature death or disability. In 2020, WHO reported the top three causes of death globally are ischaemic heart disease, stroke and chronic obstructive pulmonary disease. These causes of death remain the same, despite the COVID-19 pandemic, and have even been exacerbated.
In early 2020, health systems rapidly pivoted and managed patients with COVID-19, through information and the reorganisation of services to treat patients suffering with the effects of the virus, and with governments issuing urgent public health messages to underline the importance of transmission control. For many countries, this manifested in lockdowns that disrupted regular health treatment impacting, in particular the diagnosis, treatment and management of NCDs.
The figures are stark. In June 2020 – just weeks into the pandemic – WHO published a survey showing that prevention and treatment services for tackling NCDs had been severely disrupted since the start of the pandemic. WHO said that this situation was of significant concern because people living with NCDs were at higher risk of severe COVID-19-related illness and death.
The pandemic has highlighted the weakness of current health systems – especially those in middle and low-income countries progressing towards the UN’s 2030 goal of UHC, while in stronger health systems, alternative approaches have had to be found to deliver patient services differently, including through digital health.
The UK model of integrated care
The UK system has multiple building blocks of a health system which the Department for International Trade has identified as:
1. Policy
2. Strategy development
3. Regulation and clinical guidelines
4. Primary health care approaches
5. Public health functions including prevention and promotion
6. Health workforce development
7. Data and digital transformation
8. Innovation
9. Future proofing including net zero and pandemic preparedness
Achieving system excellence need not take other countries systems decades; the UK can share its successes and learnings. A diverse range of innovative UK organisations are delivering on the NHS Long Term Plan and driving UHC to build resilience and sustainability into the systems.
DIT has brought a delegation of some of the amazing NHS Trusts on the UK Healthcare and Life Sciences Trade Mission to Arab Health, and the UK pavilion offers hundreds of UK companies with interesting healthcare and MedTech innovations that are all open to international collaborations.
• The UK has an integrated model of care focused on the patient, built and developed over these 70 years. It draws together expertise in healthcare financing, policy & strategy, regulation and clinical guidelines to create comprehensive healthcare systems. Organisations such as NHS England/ Improvement set a strategic direction; NHS Trusts such as Imperial College Healthcare NHS Trust or Guy’s and St Thomas’ NHS Foundation Trust work to deliver and improve services to its local population; private consultancies such as Lexica, Mott MacDonald or Agencia support the UK system with strategic redesign and planning consultancy; and national bodies such as NICE or General Medical Council (GMC) provide guidelines to the wider system.
• It has a nationally coordinated workforce planning – monitoring of healthcare workforce, accreditation of training programmes, delivery of speciality education and continuous professional development. UK organisations such as Health Education England (HEE) build the foundations of capability, while organisations such as Kings Commercial, Linea, Royal College of Practitioners (RCGP) or NHS Leadership Academy provide education & training packages.
• An organised system with sophisticated data collection for direct care, service planning and research is the keystone of organised healthcare in the UK for 100 years. Rich data sources enable digital technology ecosystems, including teleconsultations, self-care and care management, and a highly diverse private sector. Organisations that strengthen the health system include digital health consultancies such BJSS, Difrent, Methods Analytics and AdviseInc, who offer various solutions bespoke to the needs of the system.
• Primary care and public health – foundations of the NHS from education and professional development through to organisation and commissioning services – enable patients to access all NHS services. Organisations that provide innovative local primary care delivery in the UK include AT Medics and Modality to wider national resilience on public health including UK Health Security Agency (UKHSA).
• Quick systematic delivery of innovation is achieved through organisations like Accelerated Access Collaborative (AAC), NIHR, NICE and Academic Health Science Networks (AHSNs). New approaches to emerging challenges such as sustainability, cutting edge infrastructure and pandemic response can be found through organisations such as the Cell & Gene Therapy Catapult or Congenica in precision medicine, Currie & Brown in smarter infrastructure, Newcastle NHS Foundation Trust in decarbonisation and NHS South, Central and West or Diamond Light Source in pandemic resilience
• The UK’s leadership in genomics is recognised globally, from the completion of the 100,000 Genome Project and UK Biobank, Genomics England through to the NHS Genomics Medicine Service. The Genome UK Strategy sets out an ambition for the UK to be the world’s most advanced genomic healthcare ecosystem. This presents opportunities to accelerate research, develop innovations in new technologies and data science, and to apply genomics in the clinical setting to diagnose disease at an earlier stage and also predict and prevent diseases before they might appear. At the cutting-edge of genomic healthcare are informatics tools and precision medicine evidenced by the genomic surveillance of the SARS-CoV-2 virus by the world-leading Wellcome Sanger Institute.