Royal Free Hospital London UK

After a warm welcome and introduction to the Royal Free NHS Foundation Trust we enjoyed several different programm points on RFH: Starting with the positioning of the Royal Free London NHS Trust in the hospital environment; followed by the performance measurement in the NHS.

RFH

Furthermore, we learnt that the Royal Free London is the only center in UK to offer specialist robotic surgery. In June 2019 they marked the 5th year anniversary of Robotic Surgery at RFH!

 

The next programm point covered a subject we haven‘t heard from before on our study trip: Private Practice. Most London NHS teaching hospitals have a private patient unit – so Royal Free Private Patients is one of these. But Royal Free private business is small with a strategic goal to double private patients sectors by doing a lot of marketing and to capitalise on their strengths. NHS budgets are under pressure and Provate Patients profit can help to fill the gap!

After getting a lot of information we had two different tours around the RFH – our personal highlight: Firstly the High Level Isolation Unit – patient pathway and staff involvement. Secondly the Patient Centred Care – Dementia Friendly Ward!

High Level Isolation Unit
Dementia Friendly Ward

Now, everything has an end. And so does our study trip. After a great week with some confusing and some very enlightening experiences, with very fun evenings, many burgers, beers and ciders, we go back home, happy to return to a country with more money in the healthcare system. We say thanks for a great organisation and guidance through the week by Alfred Angerer, Karin Brunner and Eva Hollenstein.

Students, out…!

Birthday, General Practitioners and the plague!

07:00 am, good morning London!

At 08:00 am we started towards Elephant & Castle, where we had to take the Northern line towards Edgware. The first two trains we had to skip because of overcrowded tube. Thus, we also got to know the real London with the commuter traffic in the underground. After a few stations the train emptied and at the station Euston we could leave the tube.

08:45 am, with five minutes delay we reached our first destination: Royal College of General Practitioners (RCGP). As the name suggests, they represent General Practitioners (GP) throughout the UK. It is a huge network with over 52’000 Docters. They act as the voice of GPs on education, training, research and clinical standards. In addition, RCGP International, supporting Family Medicine Worldwide and has been for over 60 years.

Meeting Room at RCGP – Prof. Dr. Alfred Angerer is visibly happy about the provided water.

At 09:00 am the presentation started in a beautiful conference room with plenty of coffee and ballpens not working (only our student Adnan knew how to use them).
After a short introduction we started with a lot of information.

Tricky ballpen.

The importance of the GPs can be illustrated by the following facts:

  • 90% of patient contacts are in general practice (primary care)
  • over 1 million GP consultations every day

The GPs manages both, acute & chronic disease, co-ordinates care, promotes Health and they are responsible for the health of community.

Further, they have the following key features:
First point of medical contact, manages undifferentiated illness, Holistic Care (physical, social, psychological). Very important to know, GPs are free agents and not paided by the NHS.

Nevertheless, recent substantial growth in the number of GPs employed on a salaried basis. To this end, the GPs conclude contracts with the practices, but not with the NHS. This further underpins their independence.

In future (5 year plan of the NHS) groups of neighboring GP practices will work together serving a population of 30’000 – 50’000 people. This shifts towards an integrated care an focuses on population health. This is expected to result in a better patient care, value for money, economy of scale and last but not least, its continuous improvements to population health. Challenges to integrated care are e.g. shared records and it systems, complexity of care, ageing, chronic disease and much more.

Debriefing in the RCGP entrance hall.

After about 2 hours of presentation and a lot of information, we started the lunch break, which lasted until 14:00 pm. At this point we would like to say thanks for the great presentation of the RCGP and are looking forward to the guided tour “Path-ologies” of the National Gallery.

Woman ignoring our group taking a group picture..

14:00 pm, the tour in the afternoon was staggering and mind blowing. First we looked at pictures in the National Gallery, which were always related to diseases. Second, we went outside where we looked at locations that were related to people or diseases. All in all, the tour invited us to think about the past and the future. So the tour ended with a discussion about the origin of the vaccination and its current implementation, which leaves a lot to be desired.
In this sense stay healthy.

Portrait of a woman suffering from Paget’s disease by Quinten Massys (about 1513)

Tonight the whole group will have dinner together. More about that tomorrow.

NOT TO FORGET: Happy Birthday to our fellow student Rahel Stäheli! LET’S CELEBRATE!

What a good, what a brilliant, what a nice day for NICE

Wednesday, 04th September what a good, what a brilliant, what a nice day for NICE – the national institute for health and care excellence.

In front of the NICE entrance.

The publicly funded system delivers evidence based guidance predominantly for the UK Healthcare system under the approach “an ounce of prevention is worth a pound of cure”

Clinicians and GP’s are not always obliged to use the guidelines provided by NICE – we can relate. If you read this blog right now think of it, it’s because we’ve been forced to write it.

Besides the history and current work, one of the main topics been the health technology assessment with some actual cases discussed.

We’re very happy to have visited this NICE facilities, plus for the first time this week we’ve heard slow and understandable English. Thank you, that was NICE.

Finishing off the day with some shopping and food treatment in Camden market we can say this day has been a good one.

NHS Improvement & Health Foundry – Day 2

After yesterday’s pub tour was survived, everyone arrived in time in front of the NHS Improvement building in the morning. Everybody could get a first overview of the development of the English health care system after the Security Check. The pre-briefing about the upcoming daily routine was followed by a labyrinth-like corridor system leading the students into the meeting room.
The presentations contained the following topics:

  • Pricing, Funding and the National Tariff
  • Regulation of oversight
  • Economics and Competition in the NHS
  • NHS Providers: Strong Providers, Collaborations and groups and smaller acute providers

In the late afternoon the journey continued to the Health Foundry, where an impression of the world of Tech Health start ups was given.

The contrast between the rigid structures of the NHS and the entrepreneurial spirit of the Health Foundry could not be overlooked. These two different worlds should work more closely together in the future to overcome the big challenges of the english health system. As different as the NHS and the Health Foundry may seem, they agree at least on one point: the prevention should be given more attention!

Do more with less – the NHS in a nutshell

Beautiful view from the tower bridge

Monday morning 10.30am: the 14 students of the MSc Health Economics and Healthcare Management kicked off their study trip with an introductory meeting. Everyone made it safely to the meeting after some have suffered from delays, cancelled flights and involuntary train trips to London.
The class is now looking forward to an interesting week that will give them the opportunity to have a peek into the English healthcare system.

But before the first point of the agenda, we enjoyed the nice weather and had a stroll along the bank of the Thames river.

Visit NHS England

4 key note speakers took us on a whistle stop tour through the NHS. After an intense 3 hours, the take home messages for the class were:

  • British people are very proud of their free national health care system
  • The NHS is a super complex, chaotic and intertwined organisation
  • Brexit has a huge impact on workforce planning, as in London 25% of nurses are from the EU
  • Mental health problems are a key issue that the NHS is trying to tackle in collaboration with the population and local authorities

The day was rounded off by a Pub visit and dinner at the “Mercato Metropolitano” Food Market near Elephant & Castle.