Stewardship, the culture to save universal healthcare
The need and demand for healthcare is increasing faster than resources. The gap between demand and resources was widening before Covid and it is re-emerging now, aggravated by the new problems caused by the pandemic, ‘long Covid’, the effects of lockdown, increasing obesity and the reduction in the levels of ability of older people and by the backlog of elective operations.
There is general agreement that a new paradigm is needed. Amazing progress has been made in the last fifty years as a result of technical developments combined with new paradigms of thinking and decision making. With each new paradigm comes a particular culture that influences not only how people think, but what they feel to be the reality of the world in which they live and work.
We have seen the effectiveness paradigm, with Archie Cochrane’s classic book Effectiveness and Efficiency being published fifty years ago, then came the evidence-based paradigm and the cost effectiveness paradigm and in the last twenty years the quality and safety paradigm with, most recently an increasing focus on efficiency. However, none of these paradigms can close or even maintain the gap and what we need to ensure the sustainability of the healthcare is a new paradigm – value-based healthcare and this will have a new culture – the culture of stewardship. The White Paper Integration and Innovation provides all the policy enablers that are needed. Here is the Triple Aim as set out in the White Paper :
- to support better health and wellbeing for everyone,
- better quality of health services for all, and
- sustainable use of NHS resources.
It is now the job of leadership to bring about the paradigm shift and this first module of our course is designed to accelerate the shift to the new paradigm which focuses on stewardship.
Module 1 – Micromodules and Topics
- Micromodule 1.1 – A new paradigm: values, value and stewardship for universal healthcare
- Micromodule 1.2 – Measurement in the new paradigm: understanding resources, outcomes and value
- Micromodule 1.3 – Delivering the new paradigm: the need for population stewardship forums
- Micromodule 1.4 – The five tasks to save universal healthcare