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Skip to 0 minutes and 12 seconds Hello and welcome back. In our last film we met Sally as she waited in A&E. Due to the staffing crisis, she had to wait 11 hours to see a doctor as her condition had been classed as non-urgent. Unfortunately, she had previously been misdiagnosed and was actually suffering from bowel cancer, which had spread to her liver. Sadly, Sally passed away. Her family were furious at the NHS for the misdiagnoses and contacted a lobbyist group to investigate the case. While conducting their research, the lobbyist group discovered that the NHS use a higher threshold than other European countries when screening for bowel cancer, causing cases to go undetected, leading to the unnecessary loss of lives.

Skip to 1 minute and 2 seconds The lobbyist group took this information to the Healthcare Secretary, demanding that more be done to prevent the deaths of those like Sally. The Healthcare Secretary agreed that it was unacceptable that patients could be missing out on potentially lifesaving early diagnosis, and decided to hold doctors and clinicians to account. When the Healthcare Secretary approached the body of doctors and clinicians responsible for detecting bowel cancer in patients, they fought back. They argued that staff shortages are directly impacting their ability to diagnose more patients at an early stage. The lack of radiographers, radiologists and endoscopists meant that they couldn’t keep up with the number of patients being referred for tests.

Skip to 1 minute and 51 seconds The doctors and clinicians blame the policy for causing the rise of undiagnosed cases. Clinicians need more time and funding, but the government policy is aimed at trying to save money wherever it can. Waiting times go up, lives are lost, and lobbyist groups form to hold those responsible to account. While this is happening, people fall through the cracks, further increasing the risk of patient harm. Within healthcare there is always a tradeoff. What policy issues are affecting the country where you live and how could they be solved?

A new week

Let’s return to the story of Sally, a patient of the British public healthcare system, the National Health Service (NHS).

Last week, we defined healthcare policy and looked at healthcare policy in the context of global and national politics.

This week, we’ll focus on the process of healthcare policy development. We’ll identify the key features of the processes of policy identification, formulation, and implementation.

The development of healthcare policy is inherently complex and often does not occur in a vacuum. It involves the complex interaction of ethical, financial, political, social and ethical considerations under the influence of multiple stakeholders. On a practical level, the activities involved in policy development do not just overlap but are often intertwined with multiple feedback loops. This complexity makes it seem too large or too difficult a topic to successfully deal with.

This week, we aim to give structure to the issue of healthcare policy development. Policy development here is presented as a series of discrete phases. In the real world, these phases may not follow a logical flow and may be subject to multiple interruptions. Nevertheless, there is a good reason for conceptualising healthcare policy development in this way, it represents a basic model for which the development process in the real world can be patterned after.

Your task

What does the case of Sally and the NHS suggest to you about the complexities involved in the healthcare policy implementation and evaluation process?

Share your thoughts in the comments area.

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This video is from the free online course:

Policy Formulation and Analysis in Healthcare

Coventry University