1. Great Britain Health System
By
Aditya Sood, Aasim Riyaz Khan,Achint Kumar
Post Graduate Diploma In Health Management at Institute of
Health Management Research, Jaipur , India

2. •Total Population=62.6 million
•Urban Population (%)=80
•Population Growth Rate(%)=0.5
•Total Fertility Rate=1.9
•Crude Death Rate(Per 1000 population)=10
•Crude Birth Rate(Per 1000 Population)=12
Source=World Bank Data 2011
Health Indicators

3. • U5 Mortality Rate(1000)=5 per thousand live births
• MMR=12 per lakh live births
• IMR=4 per thousand live births
• Life Expectancy at Birth -80
• Male- 78.3
• Female-82.5
• Health expenditure per capita = US $ 3,503

4. Manpower in health Infrastructure
• Medical and dental staff- 187/100000 population
• Nursing and mid wife staff-786/100000 population
• Hospital beds- 33/10000 population
• Nearly 1.3 million people are employed in NHS hospital
community service in GB
• In 2009 there were over 117,000 medical and dental staff and
over 507,000 nursing and midwifery staff working in hospital
and community health services in the GB
• In addition, there were over 302,000, 184,000, and 154,000,
administration and clerical, professional and technical, and
domestic ancillary staff respectively working in hospital and
community health services in the GB in 2009.
Source( OHE Guide to UK Health and Health Care Statistics, July 2011)

5. HEALTHCARE EXPENDITURE
According to World bank Data, Health (2011), Great Britain is
spending 9.6% of its GDP on health.
8.4
8.9
9.8
9.6
7.5
8
8.5
9
9.5
10
2007 2008 2009 2010
PERCENTAGE
YEAR

6. Categories of Great Britain healthcare expenditure
Category 1
Publicly funded healthcare expenditure scheme-National Health
Service(NHS).
81.3
82.4
84.1 83.9
78
80
82
84
86
2007 2008 2009 2010
PERCENTAGE
YEAR
Health expenditure, public (% of total health
expenditure),Great Britain, 2007-2010 , World Bank Data,
Health (2011)

7. Category 2
Private Health Expenditure.
• It is 16% of the total Health Expenditure.
• Out of Pocket expenditure as percentage of private
expenditure on health is 62%
62.04
62
62
62
61.98
62
62.02
62.04
62.06
2007 2008 2009 2010
PERCENTAGE
YEAR
OUT OF POCKET EXPENDITURE (World Bank Data,
Health 2011)

8. Category 3
Private Health Insurance
• Accounts for 2 % of the total Health Expenditure.
• Around 12 % of Great Britain citizens are covered by private
health insurance
3881
3801
3440
3503
3200
3400
3600
3800
4000
2007 2008 2009 2010
PERCAPITAHEALTH
EXPENDITUREUS$
YEAR
PER CAPITA HEALTH EXPENDITURE ON HEALTH IN
Great Britain$, 2007-2010,World Bank Data, Health
2011

9. NATIONAL HEALTH SERVICE
• Launched on 5th July 1948.
• Due to financial burden Prescription charge was introduced in
1952,which was abolished in 1962 but re-introduce again in
1968.
• The NHS Health and Social Care Act 2012 sets out a large-
scale program for reform to be implemented by the end of
2014.
• Major aim of reform is decentralization. NHS Commissioning
Board will be established which will be independent from the
day to day control of Secretary of state.

10. NHS Aims:
• To provide medical care free at point of use
• To rich and poor alike
• in accordance with medical need
2 beliefs:
• Those who need care will come forward
• Those who provide care know what is required and
how to provide it

11. FUNDED BY
General taxation 76%
National Insurance contributions 19%
User charges 5%
(G.B. department of Health, 2010)
** Apart from these, NHS earns from prescription of
drugs & dental treatments to general population.

12. COVERAGE
It is universal, all those who are resident or citizens of
the Great Britain are entitled to health care. Only
treatment in an emergency department and for certain
infectious diseases is free to people not ordinarily
resident, such as visitors or illegal immigrants.
SERVICES OFFERED
• Preventive
• Inpatient & Outpatient

13. • Inpatient & Outpatient drugs
• Dental care, mental health care
• Disabilities & rehabilitation
• Hospital care
• Physician

14. COST SHARING
• Out patient prescription drugs are subject to a
copayment currently US$12.23 per prescription,
drugs prescribed in NHS hospitals are free.
• NHS Dental services are subject to copayment of
upto US $ 334/ per course of treatment
• Discount through pre payment certificates-people
using large amount of prescription drugs.
• Transport costs to and fro from provider sites-low
income group people.

15. People exempted from prescription
drug co-payments
 Citizens of GB < 16 years of age.
 Citizens of GB > 60 years of age
 Low income groups
 Pregnant women
 Those in fulltime education aged 16, 17, or 18.
 Those who had a baby in the last 12 months

16. STRUCTURE
Secretary of State
Department of Health
NHSE
Regional Offices
Strategic Health
Authorities
Primary care groups
NHS trusts
Local authorities

17. TYPES OF
HEALTH
SERVICES
IN Great
Britain
PRIMARY CARE SECONDARY CARE
TYPES OF TRUSTS
Primary care
GPs
Dentist
Pharmacist
Opticians
NHS direct
NHS walk in
centres
Acute
Care
Mental Health
Ambulance
NHS Foundation

18. PRIVATE
HEALTHCARE
Private Health
Insurance
Private
Hospitals
Out of Pocket
Expenditure

19. REGULATORY BODIES
• National Institute of Clinical Excellence
 publishes guidelines for healthcare professionals
 Private hospitals do not have to follow these
• Healthcare Commission
 Monitoring Healthcare standards and efficiency
 Responsible for publishing NHS performance ratings
and indicators

20. KEY CHALLENGES
• Coronary heart diseases and stroke continue to be leading
cause of death in UK
• Approximately 1 in 6 of all deaths in the UK in 2008 were due
to coronary heart disease.
• Deaths from strokes accounted for 1 in 14 of all UK deaths.
• Crude death rate from liver disease and diabetes continue to
rise
• Rising alcohol related hospital admissions and alcohol related
deaths
• Prevalence of adult obesity in Great Britain is highest in the
EU
( OHE Guide to UK Health and Health Care Statistics, July 2011)

21. • Rising demand and treatment cost
• Long waiting periods for elective surgeries
• Variations in quality of care across Great
Britain
• Lack of accountability of trusts and Primary
Care centers.
• Economic downturn in the country
• Lack of control by central regulatory bodies
over private healthcare.