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This content is taken from the Coventry University's online course, Policy Formulation and Analysis in Healthcare. Join the course to learn more.

Skip to 0 minutes and 11 seconds In 2019, public satisfaction within the UK’s National Health Service dropped to a low that hasn’t been seen in over 10 years. With accident and emergency waiting times now being the longest on record, patients line the corridors of A&E. Sally has been waiting 11 hours to see a doctor. The symptoms of her irritable bowel syndrome have worsened and she is struggling to cope with the pain in her abdomen. While nurses are being redeployed from already busy wards to cope with the staff shortage, Sally continues to wait as her condition has been classed as non-urgent.

Skip to 0 minutes and 48 seconds The NHS has been pushed to provide a service at a lower cost, making short-term fixes to try and cover long- standing problems and there is still no end in sight. Boris Johnson, the UK prime minister, declared that waiting times had become unacceptable and vowed to end the long delays. Johnson has positioned his party towards supporting the NHS, saying the NHS will always be his top priority. This is despite the coalition and Conservative-led governments reducing the budget for the NHS compared to the previous ten years. Unfortunately for Sally, after eventually seeing a doctor, she found out that she had previously been misdiagnosed. She was in fact suffering from bowel cancer, which had spread to her liver.

Skip to 1 minute and 44 seconds Staff shortages have had a direct impact on the NHS’s ability to effectively detect bowel cancer early on, with as many as 1100 people every year slipping through the net. Hospitals simply cannot keep up with the growing number of people with suspected cancer being referred for tests. What do you think would help pull the NHS out of the crisis it is currently facing?

Welcome to the course

The video above highlights some of the policy issues facing the UK’s public healthcare system, the National Health Service (NHS), by looking at the case of Sally, a patient. In many ways, her situation is indicative of the complexity of issues confronting policymakers in many countries.

The courses in this program critically consider the relationship between the political process, the development of policy and the leadership challenges of implementing service changes locally, resulting from national policy drivers.

You’ll also explore the tensions that can arise when broad policy objectives are transferred into specific local contexts without fully considering all relevant contextual factors.

Finally, you’ll consider the ways in which patients, service users and the general public are informed and educated about such changes, either through official policy development via the media or through local processes of governance and engagement.

What are policies?

The term ‘policy’ is a poorly understood concept and means different things to different people.

In an interesting analogy, policy has been likened to the elephant which cannot be easily defined but can be easily recognised when seen (Hirsch 2013). This presents the idea that identifying policies can be quite challenging sometimes, and that difficulties may be encountered in defining a policy.

According to Barker (1996), policies give content and consistency to the delivery of healthcare. They are generally a set of decisions which determine the course of action within a sector. These decisions can be expressed as statements, regulations, legislatures or practice protocols and provide the context for practice. For example, in determining the number of patients a clinic can attend to daily, or the types of services it can provide, policy guidelines are often referenced.

Without such policies in place, it’s almost impossible to carry out what can be considered daily routine tasks. This means that for every decision or action that needs to be undertaken, the complex processes of consultation are required.

Through this week’s activities, you’ll be introduced to the concept of healthcare policy.

Specifically, you will:

  • Explore what is meant by healthcare policy and look at some examples of healthcare policies
  • Examine healthcare policy within the global and national context
  • Learn about the interrelationship between healthcare policy and politics

Meet the team

Your lead educator is Gareth Hooper Assistant Professor, School of Nursing, Midwifery and Health, at Coventry University.

You can follow Gareth by following the link to his FutureLearn profile page and selecting ‘follow’. That way, you’ll be able to see all the comments that he makes.

Checking your progress…

Don’t forget you can check your progress page by selecting the icon at the top of the step, where you’ll see what percentage of the course steps you’ve marked as complete.

And finally…

Don’t forget to share your thoughts on the task in the comments area and like or reply to posts you find useful or interesting.

Your task

Returning to the video you saw at the beginning of this step, what policies do you think might improve Sally’s situation?

Share your thoughts in the comments area.


Barker, C. (1996). The Healthcare Policy Process. Sage

Hirsch, L. (2013). The Elephant and the Blind Men: Understanding Patient Satisfaction. https://patientexperience.com/elephant-blind-men-understanding-patient-satisfaction

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This video is from the free online course:

Policy Formulation and Analysis in Healthcare

Coventry University