By Hugo Greenhalgh on 10 Nov 2015
Global comparison key to NHS improvement
The latest report by the OECD on world healthcare does not make for pleasant reading for the NHS. The Health at a Glance study, which reviews the healthcare systems of 34 countries, found that too many lives in the UK were being lost “because the quality of care is not improving fast enough”.
The UK lags behind many other developed countries on a range of measures such as cervical, breast and bowel cancer survival and stroke survival. Mark Pearson of the OECD spoke of the NHS’s “somewhat mediocre performance across the board – from relatively low staffing levels, to high rates of avoidable admissions for asthma and lung disease”.
Worryingly, as Pearson suggests, the OECD report also points out that NHS workforce levels are below average – there are 2.8 doctors per 1000 people in the UK, compared to the OECD average of 3.3. This comes amid the on-going junior doctors debacle, with thousands of young medics leaving the country for careers abroad.
The report presents a rather different picture to the Commonwealth Fund’s report last year, which declared the NHS to be the best healthcare system. “The United Kingdom ranks first overall, scoring highest on quality, access and efficiency”, it revealed. Yet, as debate continues about how much the NHS will be allotted in the next spending round, its efficiency in real terms is far from favourable.
As Professor Chris Ham, Chief Executive of the King’s Fund, tweeted: “Can’t help thinking that the @OECD assessment of NHS is overly critical while the @commonwealthfnd assessment is overly generous”.
Rather than placing too much emphasis on league tables and international performance, however, the NHS could benefit by investing more time understanding what is working in other healthcare systems around the world.
As former NHS manager Mark Britnell put it recently in his book In Search of the Perfect Health System, the product of six years of research across 60 countries to find lessons of improvement in healthcare, there are countless examples of systems worldwide we could learn from: Israel’s IT-enabled primary care system and Brazil’s “activist community health teams”.
One of the most effective systems, Britnell also finds, is Singapore’s: “Any country that produces 83-years age expectancy from 4.9% of its GDP is doing remarkably well”.
International comparison is a key area for our client Dr Foster. Their “Global Comparators” programme brings together over 40 leading hospitals from 12 different countries to be the first truly global hospital benchmarking collaborative. The programme allows hospitals to pool data and participate in knowledge-sharing networks in order to learn more about outcomes and best practice. These cross-continental links are a crucial step to improving quality of care.
Dr Foster also allows participating hospitals to collaborate on Global Outcomes Accelerated Learning groups or ‘GOALs’. These are participant-led programmes, with comparative data at their foundation, working on very specific health issues including stroke patient outcomes, gastro-intestinal surgery, heart failure and acute myocardial infarction.
This November Dr Foster’s bi-annual Global Comparators conference will take place in Shanghai. It will feature talks on healthcare from around the world, from the Netherlands and Australia to Saudi Arabia and China. There’ll also be updates on how the GOALS are progressing.
The OECD’s report no doubt contains some hard-hitting truths for the Government about the NHS. There are calls from all corners that the UK’s healthcare service must get its own shop in order first and foremost. However, it would be foolish not to maintain a global outlook and consider the possibilities of international collaboration.