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Rural Health System Resources


Defining Value-Based Healthcare in the NHS


Hurst L, Mahtani K, Pluddemann A, Lewis S, Harvey K, Briggs A, Boylan A-M, Bajwa R, Haire K, Entwistle A, Handa A and Heneghan C


The paper examines the concept of ‘Value Based Care’, a principle that has been widely adopted in Australia and which underpins the rationalisation and centralisation of health care. It is a way of managing health services in the context of a system facing increased demand for services with limited resources. However, the authors note that there is an absence of an agreed definition of ‘value-based healthcare’ in the UK National Health Service, and a lack of skills required to deliver value-based healthcare and a clear understanding of the barriers to effective development and implementation inhibits the health system in addressing problems such as overdiagnosis, too much medicine, poor allocation of resources and the introduction of inadequately evidenced technologies This report sets out a route to defining value-based healthcare in the NHS, an assessment of the barriers to its development, and an understanding of what skills and training would support implementation.

Why is this useful for rural and remote people?

Policies like ‘value based healthcare’ have been adopted across the Australian health system. It incorporates concepts like ‘patient-centred care’, reducing unnecessary costs and procedures, and improving outcomes. But what does this actually mean in practice, and when we talk about ‘value based care’ is everyone talking about the same thing. The authors of this paper from Oxford University discuss the different ways that ‘value based healthcare’ is understood and propose a new people-centred definition. This has big implications for rural and remote people and the services they receive. For example, when we talk about ‘improving outcomes’ in value-based health care policies, are we talking about improving health outcomes for people, or improving budget outcomes for health systems? Over the last 2 decades, services for rural and remote people have declined, the health of rural people has gone backwards and more health investment has gone into cities despite ‘value-based healthcare’ being a guiding policy framework for decision-making. Health system policies inform every decision made, including the types of services rural and remote people can expect, what type of resourcing will be allocated to rural and remote towns, and how outcomes will be measured. The report can be used by rural and remote people to argue for greater clarity in the meaning of policies like “value based healthcare”, “patient centred care”, “evidence based medicine” etc to ensure that these policies are driving good quality decisions that do not adversely impact the health of rural and remote people.

Suggested Citation

Hurst L, Mahtani K, Pluddemann A, Lewis S, Harvey K, Briggs A, Boylan A-M, Bajwa R, Haire K, Entwistle A, Handa A and Heneghan C. Defining Value-based Healthcare in the NHS: CEBM report May 2019.


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