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Life Expectancy in the UK Medical Care and Health System

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Table of Contents
Introduction......................................................................................................................................3

Country Analysis.............................................................................................................................4

PESTLE Analysis........................................................................................................................5

Analysis of health funding...........................................................................................................8

Analysis of commissioning and health strategies........................................................................8

International policies, National policies, Government strategies for health, and Universal
health coverage............................................................................................................................9

Primary drivers for health services in the UK..............................................................................9

Principal obstacles to universal health coverage and the provision of high-quality healthcare.10

Health priorities..........................................................................................................................11

Commissioning..............................................................................................................................11

Overview of Commissioning.....................................................................................................11

Different funding mechanisms...................................................................................................12

Change and service redesign/implementation and contracts.........................................................13

Monitoring and evaluation.........................................................................................................14

Conclusion.....................................................................................................................................14

Recommendations......................................................................................................................15

Reference List................................................................................................................................16
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Introduction

“Primary Care Trusts” were replaced on April 1 2013 by a clinical commissioning group

(CCG) which was created in 2012 under the “Health and Social Care Act” ([Link], 2024).

They are clinically run NHS statutory bodies that prepare and commission local health services.

On 2021 there were 106 CCGs in England as a result of some mergers. The goal is to provide the

local population with the best possible health outcomes. This entails assessing regional needs

establishing priorities and plans and then acquiring services from suppliers like clinics hospitals

healthcare associations etc. in the interest of the populace. It is an ongoing process. CCGs are

required to respond and adjust on a regular basis to evolving local circumstances

([Link], 2024). They are accountable for the general well-being of their populace and

the extent to which they improve outcomes. Decision-making processes in the social and health

care sectors can be complex and involve many people from different organizations. As

integrated healthcare systems continue to advance so does the most recent attempt to

strengthen ties between the NHS and social services. Public health the NHS and social care all

have different organizational structures and methods for handling finances decision-making and

accountability. Through the NHS’s five-year forward vision and its shared planning guidelines

for instance NHS England and its partners determine the NHSs overall commissioning strategy

and clinical goals.

GPs dentists and opticians are among the primary care providers commissioned by NHS

England. However primary care co-commissioning for GPs (primary medical services) transfers

this to the majority of CCGs ([Link], 2018). Additionally, NHS England directly
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commissions military and veteran health services jail health services (including youth offender

institutions) and specialized services (like rare and secure mental health treatment)

([Link], 2018). Continuous commissioning refers to the process of planning

approving and providing services. Continuous quality assessment encompasses a number of

activities such as clinical design of patient pathways service specifications contract negotiation

and procurement in addition to the evaluation of population health requirements (Camacho et

al., 2023). It is not possible to commission all services in a single location. While services for rare

diseases must be considered nationally services for a population of a few thousand people may

be planned and acquired. The NHS like other national healthcare systems has a long history of

providing predictive preventative and/or personalized medical services that are part of illness

diagnosis and treatment (Main et al., 2022). Preventive medicine is an established field unlike

personalized or predictive medicine (Razzak et al., 2020). Public health oversees the related

services which are provided by general practitioner’s community services or hospitals. Excellent

doctors have long practiced patient-tailored therapy in the UK and other healthcare systems.

Country Analysis

Since primary care physicians in the UK may record 90% of reported health issues

primary care statistics are extremely important particularly when the iceberg effect is taken into

account (McKinnell et al., 2020). Although a vast amount of information on population health

could be provided historically it has been very challenging to access. The majority of general

practitioners’ offices are now computerized and in certain areas public health professionals may

have instant access to the data. Data collection for primary care was improved as a result of
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NHS changes. Because of the decline in mortality since the 19th century life expectancy has

increased over time for both men and women (Walsh et al., 2022). Their high childhood and

infant mortality rates may be primarily due to the fact that males born in 1841 are 40–2 years

old while females are 42–3 years old. By 1920 life expectancy had increased by 59 years for

women and 56 years for men due to improvements in infectious disease control diet sanitation

hygiene and other public health measures ([Link], 2023). The 20th century saw

significant increases in life expectancies because of policies like childhood vaccination universal

health care medical advancements in the treatment of adult conditions like cancer and heart

disease and lifestyle changes most notably a decrease in smoking. By 2019 a century later

men’s life expectancy in England had risen to 80 years while women had reached 83 points.

However due to the COVID-19 pandemic the life expectancy of women dropped to 82 years ago

and that of men to 78 years in 2020 ([Link], 2024). In the UK the current healthcare

system is called the “National Health Service (NHS)”. Every UK citizen is eligible for free all-

inclusive healthcare through the NHS. It also signifies the end of the healthcare system. Even

though the NHS has been around for more than 50 years it has recently struggled to maintain

its operational standards and deliver high-quality care ([Link], 2023).

PESTLE Analysis

Political

Brexit will have a negative impact on the NHS just like it will on other UK institutions. Its

ability to operate as a public organization will be significantly impacted by the EU exit (Jones et

al., 2021). Many policymakers and business experts share Brexits views on this even though we
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are unable to state the impact on the NHS directly. The scarcity of resources is one of the main

issues at hand. From all over the EU they ship a lot of medications and medical supplies to the

UK. If Brexit occurs this would have an impact on business, that would need to address the

severe shortage of essential medications (Dayan et al., 2020; Ghazaryan et al., 2020). Another

significant issue will be the staff’s absence. A significant portion of the NHSs workforce was

foreign-born. Following Brexit there will be a decrease in this consistent supply of skilled

workers. There will be a shortage of workers for the NHS.

Economic

The NHS has experienced a number of issues since the financial crisis of 2008 (Fleming

et al., 2023). Additionally, the UK as a whole thought that other industries were not bearing the

consequences of that economic failure. This also applies to the NHS. NHS faced pressure to

reduce employee salaries due to a lack of resources and disparate economic laws (Regmi &

Mudyarabikwa, 2020).

Social

The British populations average age is rapidly rising. The differences in the population of

the different generations are caused by this pervasive phenomenon. As people age, they face

an increasing number of health issues. Since cancer and diabetes are linked to aging their

prevalence is rising steadily (Jakovljevic et al., 2021). This has put additional strain on the NHS

and considering its current state providing high-quality care for the growing number of cases is

becoming increasingly difficult for the organization.

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Technological

The technological evolution also fostered the convenience in service delivery within this

sector. However, lack of effective monitoring on the ethical data optimization and data security

is essential for this sector in London. Moreover, NHS England has highly invested in

technological aspects such as they have introduced their service delivery app “NHS Application”

(Wymant et al., 2021). This allows patients in user-friendly navigation of their appointments,

health records, and order prescriptions focusing on the digital health solutions (Wymant et al.,

2021).. Additionally, the growth telemedicine also embraced by the national healthcare

commission of England. Effective use Artificial Intelligence in medical aspects with predictive

analysis fostered the diagnosis accuracy and manage patient important data as well as

identifying critical diseases like cancer (Hunter et al., 2022). Healthcare providers can

communicate more easily thanks to the continuous development of Electronic Health Records

(EHR) systems which improves the effectiveness of patient care.

Environmental

Medical wastes and disputes have been a significant challenge for the country which

develops a potential barrier towards their goal to achieve net-zero by 2040 (Audhali et al.,

2021). NHS England is highly committed towards the environmental and sustainability effects as

they effectively focus on reducing their carbon-footprint. Prioritizing efforts to cut down on

medical waste, including single-use plastics, will also help to reduce environmental damage

(Audhali et al., 2021).

Legal
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The legal barriers have significant effect on the national health care as stringent

regulations focusing on the protecting privacy of patient and data protection, adhering of GDPR

act are crucial for the health institutions in this country (Hansen et al., 2021). In addition, NHS

England is subject to a number of healthcare laws that regulate its operations and care delivery

including the “Health and Social Care Act of 2012” (England, 2022).

Analysis of health funding

Figure 1: Healthcare Funding in the UK

(Source: Gille et al., 2021)

“The Chancellor of the Exchequer” announces the government’s budget each year after

which the “Department of Health and Social Care” distributes health care spending. In total this

came to £122.2 billion between 2016 and 2017 ([Link], 2017). NHS England is directly
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given the majority in order to carry out the “Health Secretary’s mandate for the NHS. This

money is then sent straight to clinical commissioning committees specialty care providers and

the NHS. The funding situation is likely to change further as integrated care systems are created

and NHS foundation trusts are under increasing pressure to balance their budgets due to NHS

improvement.

Analysis of commissioning and health strategies

Clinical commissioning groups start and use the NHS British process for planning

deciding and keeping track of results. Commissioning has changed dramatically over the past

ten years particularly since the “Health and Social Care Act of 2012” went into effect (Miller et

al., 2021). The extent of commissioning varies local clinical commissioning committees

commission other services while “NHS England commissions” specialized treatments and

certain primary care services nationally. “NICEs” responsibility is to develop performance

metrics and quality standards for the commissioners use (Bauer et al., 2021).

International policies, National policies, Government strategies for health, and

Universal health coverage

When it first started in 1948 the “British National Health Service (NHS)” was regarded as

highly unique due to its extensive provision “universal health coverage (UHC)” and free point-

of-care treatments. In the ensuing decades Britain also created new universalization of the

finest methods so UHC did more than merely increase access to subpar treatments

(Fredriksson, 2024). Prior to the NHS Britain had a mixed healthcare economy that included

government private and nonprofit services and it appeared to be successful (Hodgson et al.,
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2022). Under the Poor Law institutional care was provided by the local government mostly in

deplorable stigmatized workhouses. Additionally, the local government has offered more

clinical and environmentally friendly public health services for women children and infectious

patients (Anderson et al., 2021). Primary care was offered by amiable businesses and was

partially marketable as a form of health insurance based on occupational culture. The

establishment of the welfare state as its foundation in 1911 marked the first shift. By extending

the friendly society’s protection against diseases the national health insurance (NHI) legislation

—which was modeled after Bismarck’s—has made it mandatory for manual laborers (Moyo,

2020).

Primary drivers for health services in the UK

A rudimentary examination of health care environment trends may draw attention to

pressures and stimulate research into pertinent performance factors. Redistributing spending

within current budgets and improving workforce and budget planning may also result from an

understanding of how spending activity and cost patterns vary depending on the situation

(Asamani et al., 2021). However, the factors relying on care have not been extensively

examined by HCE drivers. HCE growth is rarely broken down into activity and cost components

despite the fact that HCE trends are routinely studied. Between 2008–09 and 2016–17 the

English NHSs three main areas of care were broken down by costs and activity patterns

(Rodriguez Santana et al., 2020). These areas account for over 80% of all NHS spending. One of

the biggest challenges to the HCEs long-term financial viability is real year-over-year growth like

that seen in the English NHS. To ensure HCEs financial sustainability the NHS needs to
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understand how it might change in the future. This entails keeping an eye on past trends in

costs and activities across the board and understanding how these trends differ from the health

environment (Rodriguez Santana et al., 2020).

Principal obstacles to universal health coverage and the provision of high-quality

healthcare

The challenges that underprivileged and vulnerable groups face in obtaining healthcare

are becoming more apparent to researchers and others. Access problems especially in low-

income countries could jeopardize UN goals through the MDGs (Hignett, Tutton & Tatlock

2017). Consequently, identifying barriers to health care for individuals with disabilities is a top

research priority. The current study estimated the impact of disability on barriers to receiving

medical care generally and identified the extent of specific barriers. In this review the benefits

and drawbacks of universal health care in the UK are examined ([Link],

2024). The drawbacks of universal healthcare include significant initial costs and real-world

issues. However universal health care can result in healthier citizens which should help offset

the long-term economic costs of a sick nation There are significant health disparities in the UK

with low socioeconomic status population segments experiencing a decrease in access to high-

quality healthcare and an increased risk of chronic non-communicable diseases like Type II

diabetes and obesity among other factors influencing poor health (Hignett Tutton & Tatlock

2017).

Health priorities
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With the exception of commitment and skill managers and clinicians have been able to

provide services with rapid development. In some areas the NHS the local government and

other local services have collaborated more than ever before in order to provide services in a

safe manner. The crisis also highlighted public support for the NHS (Dutton et al., 2023).

Commissioning

Overview of Commissioning

Patients’ needs are at the centre of the commissioning method a strategic and evidence-

based approach to service planning and procurement. The outcomes of each commissioning

cycle are part of the commissioning process which offers a thorough approach to service

procurement (Power et al., 2021). The goal of the purchasing process is to motivate individuals

to take a different approach to their health and well-being. Every NHS commission is covered by

the 2009 Procurement Regulations which also cover the ideas of corporate performance and

competition and the best value for the money market research and the most cost-effective

service available (McDermott et al., 2020). In England commissioning is governed by the Service

and Competition Committee.

Different funding mechanisms

Six funding mechanisms are:

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Figure 2: Six funding Mechanisms

(Source: Khunti et al., 2021)

 “Knowledge and influences”

 “Assessment and analysis”

 “Planning and partnership”

 “Change and service redesign”

 “Implementation and contracts”

 “Outcomes and monitoring”

Change and service redesign/implementation and contracts

To guarantee the continuous availability of a suitable pool of qualified human resources

for health Nigeria has developed HRH policies strategies and plans. The active participation and

involvement of all important HRH stakeholders including the large business sector is crucial for

the successful implementation of these goals and initiatives. Various stakeholders also

encountered difficulties in acquiring sufficient data for HRH planning and surveillance. Many

Nigerians according to researchers are unable to purchase basic necessities. Findings from a
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recent study revealed that community members used the financial limit as an excuse for not

using PHC (Richterich 2020). In order for people to use the PHC additional waiver measures

must be developed. Perhaps more than anything else the national health insurance program

ought to revitalize the PHCs financial constraints. Nigerian experts have pointed out that brain

drain has historically represented a significant reversal in the nations medical staffs migration to

affluent environments. The distribution of healthcare workers in Nigeria is extremely unequal

and the lack of national policies governing posting or transfer frequently leaves it up to the

whims of conflicting interests and multi-influenced administrative officers (Nwankwo et al.,

2020).

Monitoring and evaluation

In order for governments funders and others to improve program efficacy and validate

investments evaluation is crucial in both domestic and international public health initiatives.

MandE skills are essential for public health professionals. The absence of M&E in terms of

knowledge skills and practices however hinders health systems in developing countries. To

address this deficiency the supply of this talent must be expanded to meet the growing demand

among these countries (Hongal & Kinange, 2020). Many public health professionals around the

world offer public health training particularly in masters level programs. Academic education

has shifted from the traditional knowledge approach of the 20th century. This is due to

significant reforms in public education and the use of skill-based models has grown in

importance because skill-based education can align public health education with the priorities

of the health system. In order to meet the objectives of national and international public health
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systems numerous public health institutions are developing and implementing new curricula

that address contemporary approaches to public health issues ([Link], 2024).

Conclusion

As a social-cultural factor the NHS is also impacted by the increase in patient awareness.

Patients are better informed about the intricacies of the system and how it functions.

Consequently, the NHS expects patients to receive the best possible care. However, such

services cannot be provided at this time. In order to improve the health status of the

population the new government plan also intends to bring general practitioners from the

peripheral organizations into the center of the NHS. It does this by arranging them into

geographic units called primary care trusts and bringing them together with community service

providers and a health agenda. Most of the NHS’s segments are addressed by this new Master

Plan.

Recommendations

 In general, the organizational ideological and health issues that the UK healthcare

system faces are the same as those that many other national health systems around the

world face. Their life expectancy is steadily rising globally due to chronic illnesses like

cancer and neurological disorders. Negative lifestyle and environmental factors have

caused a pandemic in obesity and related conditions like diabetes and cardiovascular

diseases (Stefan et al., 2021).

 In the UK about 16% of all National Health Service (NHS) spending 12% of all morbidity

and 40–70% of all deaths including those from diabetes cancer kidney disease adult
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mental health and coronary heart disease occur ([Link], 2019). The majority of

ethnic and minority groups experience the most severe diseases early mortality and

disability contributing to the perplexing growth of health disparities in western nations.