The Mission of the Outcomes Value
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CREATING VALUE-BASED HEALTHCARE
The NHS 10 Year Plan sets out the strategic direction of travel, but how are three paradigm shifts to be achieved using the "value-based approach" which is cited 8 times in the Plan, and need to "ensure the financial sustainability of the NHS...for future generations" which is emphasised three times? The bureaucratic structure is set out clearly, but healthcare is too complex to be delivered by bureaucracies, or indeed by bureaucracies and markets working together, as Oliver Williamson, joint winner of the 2008 Nobel Prize for Economics, clearly described. What is needed for complex challenges are systems, complex adaptive systems to be precise and a system is defined by having a single set of objectives and being delivered by networks.
Bureaucracies are essential for linear tasks like recruitment and employment of staff, the procurement of imaging equipment or the organisation of theatre services, and markets are essential for the development of new drugs and technology. But to achieve a strategic aim such as increasing value through a value-based approach, a system is essential with the following objectives:
This network has been developed to allow the various professional groups to work together to agree the terms and language that need to be used, the data which need to be collected and the information which needs to be produced to achieve these objectives. the Glossary will be equally relevant for both commissioning and providing healthcare , and for working with other agencies to improve population health.
A term like 'value', or its counterpart 'waste' can of course be defined in words however, another way of defining the meaning of a term is through data. In his 1934 book 'Language, Truth and Logic' A J Ayer, introduced the Verification Principle,
We say that a sentence is factually significant to any given person if, and only if, he knows how to
verify the proposition which it purports to express – that is, if he knows what observations will lead him, under certain conditions, to accept the proposition as being true, or reject it as being false.’
We would now express this as ‘what data would you wish to collect' to accept the proposition that respiratory service for population 'A' gives greater value than respiratory service for population 'B'.
Bureaucracies are essential for linear tasks like recruitment and employment of staff, the procurement of imaging equipment or the organisation of theatre services, and markets are essential for the development of new drugs and technology. But to achieve a strategic aim such as increasing value through a value-based approach, a system is essential with the following objectives:
- To measure outcomes in addition to process
- To increase value, and reduce waste
- To minimise or mitigate inequity
- To create a culture of stewardship
- To improve the health of the population by tackling the social determinants
This network has been developed to allow the various professional groups to work together to agree the terms and language that need to be used, the data which need to be collected and the information which needs to be produced to achieve these objectives. the Glossary will be equally relevant for both commissioning and providing healthcare , and for working with other agencies to improve population health.
A term like 'value', or its counterpart 'waste' can of course be defined in words however, another way of defining the meaning of a term is through data. In his 1934 book 'Language, Truth and Logic' A J Ayer, introduced the Verification Principle,
We say that a sentence is factually significant to any given person if, and only if, he knows how to
verify the proposition which it purports to express – that is, if he knows what observations will lead him, under certain conditions, to accept the proposition as being true, or reject it as being false.’
We would now express this as ‘what data would you wish to collect' to accept the proposition that respiratory service for population 'A' gives greater value than respiratory service for population 'B'.