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Systems, design and value-for-money in the NHS: mission impossible?
Terry Young1, Alec Morton2, Sada Soorapanth3
1Brunel University London, Uxbridge, UK.
Future Healthcare Journal
|May 18, 2019
Summary
Integrating systems approaches with economic evaluation, like NICE
Area of Science:
- Health Services Research
- Health Economics
- Systems Engineering
Background:
- UK National Health Service (NHS) organizations face pressure for sustainable transformation amid rising demands.
- Effective transformation requires integrating systems approaches for service design/implementation with economic evaluation.
- Current NHS transformation efforts inadequately embed these two distinct expertise streams.
Purpose of the Study:
- To demonstrate the integration of design methods within a value-for-money framework for operational and clinical planning.
- To illustrate how health economic tools can aid in managing trade-offs during service transformation.
- To highlight under-utilized systems tools and the NICE cost/quality-adjusted life year (QALY) framework in NHS service redesign.
Main Methods:
- Case study analysis of three real-world NHS transformation challenges.
- Application of systems design principles within a value-for-money (health economics) framework.
- Utilisation of the NICE cost/QALY framework for evaluating trade-offs.
Main Results:
- Three anonymized case examples illustrate the practical deployment of design methods within economic evaluation.
- The health economics cost/QALY framework offers a valuable lens for strategic decision-making in service transformation.
- Systems tools, when combined with economic evaluation, can enhance operational and clinical outcome planning.
Conclusions:
- Integrating systems approaches and economic evaluation is crucial for sustainable NHS transformation.
- The NICE cost/QALY framework and systems tools provide under-appreciated resources for managing complex trade-offs.
- Further development of this integrated discipline is needed to optimize NHS service design and implementation.
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