Comparative Healthcare Systems: Roles and Responsibilities of Patients as Stakeholders

This report compares the healthcare systems of the UK and the US, focusing on the roles and responsibilities of patients as stakeholders. The report uses the six building blocks of healthcare systems for comparative analysis. The UK's NHS is a public-funded healthcare system, while the US healthcare system is a mixture of public and private funding. The report discusses the differences in service delivery, health workforce, health information systems, access to essential medicines, and financing between the two countries.

Comparative Healthcare Systems

Table of Content
INTRODUCTION...........................................................................................................................1
MAIN BODY...................................................................................................................................1
Findings .......................................................................................................................................1
Roles and responsibilities of Patients as stakeholder .......................................................1
Criteria used for the comparative analysis: the six building blocks..................................3
CONCLUSION ...............................................................................................................................8
RECOMMENDATIONS ................................................................................................................8
REFERENCES................................................................................................................................9

INTRODUCTION
Healthcare system can be defined as the formal structure of people, policies and actions
which primary work for promoting, restoring and maintaining the health of people who are
requiring an intensive care. A healthcare organisation consist of patients, doctors, nurses,
pharmacists, employees and employers which are collectively referred as stakeholder of
healthcare system. Stakeholders can be defined as the individual, group, system or organisation
that collectively work for a same interest and can affects or get affected by the outcome of the
project (Chambers and Storm, 2019). As per World Health Organisation, examples of
stakeholders are physician, nurses, ambulance services, pharmacists, social workers, hospital
discharge planners, alternative medicinal practitioners, physical therapist and nursing
professionals. The report is based on a comparative research methodology of stakeholders in
between the two countries that is United Kingdom and United States of America using Patients
as the Stakeholders. Comparative research methodology is the science that aims for making
comparisons in between various countries and cultures. It has advantages like, in discovery of
cause and effect relationships between two or more exclusive events, it ignore artificiality and
have no ethical issues. Disadvantages of comparative methodology includes, no control over
variables and typical experiments. Further the report is based on the comparison of roles and
responsibilities of patients within the healthcare of both counties, and their contribution in
improving health outcomes. The report will further use six building blocks for the comparative
analysis of both the countries.
MAIN BODY
Findings
Roles and responsibilities of Patients as stakeholder
In United kingdom, national health service (NHS) has its own unique structure as well as
the organisation for each country. NHS is the public funded healthcare system of UK, divided
into three cares that are: primary care, secondary care and tertiary care. Whereas the healthcare
system of US is not like the countries and around 64% of the health care funds are provided by
the government and rest through funding from various programmes. As NHS provides free
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health care services to an extent to the patients so the health care system of UK is more patient
dependent. The patients might have their say in the regulation formulation in the health care
system of UK as it is regulated by Care quality commission but the patients will not have any
role in regulation formulation because in US the health care system work on the rules formed by
the government. The health care system of UK offers higher commissioning to the patients than
the US. The NHS aims at elevating the level of quality of care and to decrease the health related
inequalities so to accomplish these goals it provides the patients with increased choices and
autonomy regarding the health care services that the patient is going to receive. The service
delivery of the health care system of UK is more patient centred in nature as UK aims at
emphasising more at the provision of quality care to the patients whereas the care practices at the
health care institutions of the US are less patient centred (Dimitropoulos and et.al. 2019).
The patient’s involvement in the framing of health care policies is very important in order to
ensure formation of more efficient policies that can result in better patient centred care provision.
This will result in elevation of the health status of the entire nation. Both US and UK involve and
give importance to the feedbacks related to health care provision offered at various health care
centres of the country. Thus the point of view of patients about the health care services are
valued in both US and UK health care systems. The ownership of patient in the care provided to
him is linked with the role of the patient in making decisions for his own care. In UK the patients
are provided more involvement in the decisions regarding the treatment regime than US
therefore the patients of UK practice more patient care ownership than patients of US (Zibrowski
and et. al., 2021). The table below consist of role and responsibilities of a patient in the following
mentioned fields while presenting a contrast between UK and USA.
Roles and Responsibilities UK USA
Funding Public Funded Mixture of Public and Private
funding
Regulations Regulated by Care Quality
Commission
Regulated by Government
Commissioning Patient commissioning is Patient commissioning is less
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significant than in UK
Service delivery Patients have a say in the
maintenance of the quality of
services provided
Patients have a say in the
maintenance of the quality of
services provided
Policymaker Patient needs are considered
while policy making
Patient needs are considered
while policy making
Ownership Patients practice
comparatively high care
ownership
Patients practice comparatively
less care ownership.
Criteria used for the comparative analysis: the six building blocks
WHO framework describes the healthcare system by six building blocks, that are: service
delivery, health workforce, health information systems, access to the essential medicines, finance
and leadership and governance. These building blocks have overall objectives like, improving
the health, responsiveness, risk protection and improved efficiency.
Service Delivery
Service delivery is one the most important element in maintaining the quality of the
health care services that are being provided to the service users. The service delivery has a direct
impact on the overall health of the population of a nation. The patients play an important role in
determining the standards of the services being provided at the various health care centres of the
nation. The feedbacks receive from the patients are considered to be very important in elevating
the levels of services delivery of the health care professionals. The services delivery to the
patients depend on their communication with the care providers so that the patient's care needs
can be efficiently conveyed to the care provider. The treatment regime is designed on the basis of
the health and care needs of the patient. Therefore, it is essential for the healthcare providers to
practice good communication skills with the patients and it is the responsibility of the patient to
convey the truest health related information to the care providers. This would result in efficient
decision making by the care providers which are in the benefit of the patients.
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The health care system of UK is one of the largest healthcare system in the world. The
NHS at UK aims at making the health services even more responsive towards the patient, using
patient centred approach for providing treatment so that the best and positive health outcomes
can be achieved by it (Gordon and et.al., 2018). The health care system of UK also focuses on
predictive and preventive strategies for treatment and also emphasises on the use of the concept
of personalised medicine. These all contribute to elevation of the levels of quality of the health
care provided at the UK health centres.
The health care system of US has faced many monetary and quality relate challenges in
the past which resulted in the government of US to contribute more funds on health care than any
other country of the world (Flannery, 2018). The health outcomes of the services provided at the
health care centres of US does not have as many positive health outcomes as the amount that is
being invested in the health industry by the government.
Health Workforce
In US, medical education system has mostly trained and qualified staff where all the
practitioners are required to have a medical license for practice. Medical students are required to
be qualified in order to start their practices as a qualified practitioner in US. Workforce in US
have increased due to increase of the investments within healthcare. Large number of
investments in US have promoted the healthcare organisations to provide employment to a large
number of healthcare organisation. A data says that in US out of eight persons, one is working in
health related field that account for more than 13% of overall country's workforce. Around 22
million workers are working in healthcare industries which makes it the largest and fastest
growing sectors in United States,
UK healthcare system is funded by central governments that are developed and give
funds in a large amount. The UK healthcare workforce is accountable to National Health Service.
NHS is public funded organisation in UK responsible for providing health related services to
each country (Liu and et. al., 2022). The estimation says that NHS is providing employment to
more than 1.3 millions of workers in healthcare system, which is making it the greatest employer
of UK.
When a comparison is established in between both the countries, a increased demand of
social health workers is observed because of large population of old age citizens, different
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diseases and emergency conditions. Different disease state and a large number of people seeking
for care have increased the demand of healthcare services in both the countries. Pandemic like
situations increases the demand of healthcare workers, such as doctors, physicians, nurses,
pharma etc.
Health and Information Systems
The health information system enables the health organisations to gather, arrange,
manage, analyse and sortied the data of patient history along with other related data. In US,
healthcare system is considered to be the hybrid system (a mixed system) as it funded by
different organisations with different characteristics. The estimation says that non-profit
community hospitals are contributing to 58% of overall health system. Among overall health
system, 21% are privatised and 21% are public hospitals funded by government. OECD
(Organisation for Economic Co- operation and Development) is a world wide organisation which
works for developing the policies for enhancing the lives world wide. US is the member of
OECD and is among the few member states of OECD which failed in establishing the basic
rights of human and also it does not guarantee the access to healthcare. The mixed nature of US
health care system is consisting different providers, public and private as well as different
entities (Yaqoob and et. al., 2019). Primary providers which include healthcare facilities,
personnels of healthcare system and medical products. The largest financier of US healthcare
system is federal government which collaborates with state and local authorities via conducting
some specialised programme like the Children's Health Insurance Program, Veterans Health
Administration, Medicaid and Medicare. The US health care and information system framework
requires modifications for improving health status of US people.
The UK healthcare and information system is devolved with England, North Ireland,
Scotland and Wales, among all of these each one is having its own unique system which is
funded publicly and are responsible towards its own respective government as well as
parliament. The performance of National Health Service (NHS) across the UK is measured for
making the comparisons internationally. Private sector contributes for a smaller portion in UK
healthcare system. UK government provide finance to healthcare services via applying taxes.
National Health Service outcomes are the basis of primary health indicators.
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In both US and UK, mortality and morbidity rates are improving but also there are
significant increase in the numbers of chronic disease which are becoming threat for healthy
populations of both the nations.
Access to Essential Medicines
Access to required medication is one of the most important determinant of health
outcomes. Though the patient has consulted with the physician about his illness and the
physician has prescribed the medicines for the illness but the health outcome is dependent on the
availability of the medicine prescribed by the physician. The category which is most affected by
this concept of essential medicine is the poor people because money plays an important role in
the availability of the medicine. The concept of essential medicine is based on preparation of a
list of medication that are to be made available to the poor at low rates (Atif and et.al., 2019) . It
is responsibility of the patients to not to buy the essential medicines more than the required
amount so that those medicines are available in sufficient amounts to be provided to the deprived
category of people at minimum cost possible. The list of essential medicines is decided by the
WHO which is then followed by the rest of the countries and enough inventories of those
medicines are maintained to ensure availability to the poor people.
The US health care system has a incorporated a program in its system by the name of
Medicaid which was designed for providing health care services to the low income groups and
also to the elderly and disabled people. Approximately 20% of the entire population of the US is
enrolled under this program. It is expected that this number of 60 million is further going to
increase as the health care system are going to reform with time.
On the other hand, UK have a history of being involved in taking care of the public health
needs by engaging nine governmental departments in analysing the issues that are affecting the
people due to unavailability of the essential medicines (Hill, Barber, and Gotham, 2018).
Financing
The main element of the health care system of UK is the NHS which provides Free at the
point of use services to the people of UK. The NHS is currently receiving its major funds from
the general taxation which is provided by the contributions from National insurance. The
services provided by NHS are not all free of cost but it does requires the patients to pay funds for
certain services like prescriptions and dental treatment related services. But there are a lot of
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exemptions that are provided by the NHS therefore, it receives a very minimal amount of funds
from the payments by the patients (Jenkins,and Maheswaran, 2020). Thus the health care system
of UK is more dependents on the funding from the government through taxations. But the NHS
is currently experiencing a lack of funds as the government is currently spending around 5 to 6 %
of the GDP on health care provision.
On the other hand the American system of health care funding is mixture in nature that is
it is dependent for the funds on the government as well as the on the payments from its patients.
The American system provides public as well as private insurance to more than 100 million
people through Medicare and Medicaid programmes which has been initiated for providing
affordable health care services to the elderly, low income and disabled group (Niles, 2019).. As
per the data of 2015, American government contributed around 17.5 % of the GDP to the health
care. The contribution of America from its GDP to health care is usually higher when compared
with other countries. The reason behind the comparatively higher GDP share of the health care is
the high administrative cost and more expenditure on the same services and less efforts by the
government in order to reduce the cost of health care service provisions. This is the reason that
US has to reduce around one third of the funds being made available for the health care system.
Leadership and Governance
Governance is the key element for any process to be efficiently fulfilled. Similarly good
governance is also important for a strong health care system of a nation. The governing body of
the health care setting is responsible for providing services in the benefit of the patients and to
promote health of the service users. The governance ensures this by forming evidence based
policies for healthcare provision, by ensuring proper availability of the resources for the care
professionals to provide efficient services. The governance is also required to be responsive
towards the health care needs of the public and formulate policies for fulfilling those needs
while practising transparency with the public.
The health care system of UK is governed by the unitary board system which is
composed of executive directors who are the head of various departments in the system and the
other members are the non executive members which are a part of the community. This board
system is responsible for formation of the strategies to tackle the risks that are being faced by the
organisation (Al Hashmi and Arnold, 2021). But this approach is not followed by the four main
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nations of UK. England is currently focusing on the development of the NHS and in Wales a
debate is going on the changes required to be made in the structure of commissioning market .
The health system of US is mainly governed by the decisions of the federal government.
The federal government is responsible for surveying the health status of the population and
assessing the health needs of the people (Weintraub, and McKee, 2019). Thereafter, the policies
and strategies are designed, laws are passed and financial help is sanctioned in order to provide
efficient services for the health need. Other than the department of health and human services,
Health care Financing Administration is also a main federal unit which is responsible for
fulfilling the health needs of the public.
CONCLUSION
The report overall makes a comparative research methodology between two nations, United
Kingdom and United States in terms of their health care and information system taking Patients
as the stakeholder. The report concludes that both the nations have their own distinct methods for
providing desirable care to patients as well as uniqueness in terms of their regulations, funding,
commissioning, service delivery and ownerships. United States is not having health insurance
coverage universally. Whereas, in United Kingdom health care is free at need and is fully paid
via general taxes. Further, the report uses six building blocks such as service delivery, health
workforce, health and information systems, essential medicine access, financing, leadership and
governance for comparing the analysis of both the nations. The analysis draws that both the
nations have different healthcare culture but need similar level of modifications within their
healthcare system to provide optimum care to their people.
RECOMMENDATIONS
On comparison of the health care systems of two different nations it can be said that the
health services of UK are found to be better than health care services provided at the health
centres of US. The health system of US needs to learn from UK for increasing the positive health
outcomes that are received by US. The care provided at the health care centres of UK are more
efficient as the health professional there practice patient centred approach which results in
fulfilment of the care and health needs of the patients. Fulfilled health needs result in elevation of
the quality of the care provided at the health care settings thus resulting in better health
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outcomes. Thus the US should learn how to efficiently practice the patient centred approach so
that the public health needs can be fulfilled.
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REFERENCES
Books and Journals:
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Andrew, G., Guilcher, G., Hamiwka, L., Lang, E. and McBrien, K., 2019. Health care
stakeholder perspectives regarding the role of a patient navigator during transition to
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Marciniuk, D., Stobart, C., Verrall, T. and Groot, G., 2021. A rapid realist review of
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medicine list, policies, and the World Health Organization. Encyclopedia of pharmacy
practice and clinical pharmacy, 1, pp.239-249.
Hill, A.M., Barber, M.J. and Gotham, D., 2018. Estimated costs of production and potential
prices for the WHO Essential Medicines List. BMJ global health, 3(1), p.e000571.
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Niles, N.J., 2019. Basics of the US health care system. Jones & Bartlett Learning.
Weintraub, P. and McKee, M., 2019. Leadership for innovation in healthcare: an
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Al Hashmi, W.S.G. and Arnold, B., 2021. Governance and Leadership in Health and Safety: A
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