Part 1
In April 1999 The National Institute for Health and Clinical Excellence (NICE) was built as a Special Health Authority to advocate and further the clinical quality and effectiveness of the resources in the NHS. NICE is an independent organization in charge for stipulating national guidance on the advocacy for good health, prevention and medication of illnesses (Chidgey, Leng, & Lacey, 2010). NICE has given a set of guides for the users of National Health Services to follow. The responsibility of NICE is to improve outcomes for people utilizing NHS and other public health services (NICE, 2013). The coverage of the organizations functions are making evidence based guidance and advice for health, developing criteria or standards and performance for people who are giving and authorizing social care services, health, and public health, giving various informational services for practitioners, manager, and commissioners among the range of social and health care (NICE, 2013).
Five (5) Areas by NICE
1. Dementia, disability and frailty in later life – mid-life an approach to prevention – This guideline gives recommendations on approaches in mid-life to prevent or deter dementia, disability and frailty (NICE, 2014). Its goal is to improve the lives of older people who can healthy, active and independent lives through decreasing occurrence of behaviors that contribute to dementia, disability and frailty, delaying the development of dementia, disability and frailty for those who are experiencing it and decreasing other chronic non-communicable conditions in the elders that are risks factors to disability and frailty like cardiovascular diseases, diabetes, chronic pulmonary diseases and some cancers (NICE, 2014).
2. Maintaining a healthy weight and preventing excess weight gain among children and adults – This guideline gives advice on modifications of adults and children can make to their behavior that may sustain the safeguarding of a healthy weight or deter more gain weight if the person is already overweight (NICE, 2014). The purpose of this guide is to lessen the risk of illnesses connected with excess weight which are liver diseases, coronary heart disease, hypertension, stroke, osteoarthritis, type 2 diabetes, and some cancers such as colon, breast, kidney and cancer (NICE, 2014).
3. Older people: independence and mental wellbeing – This guideline will give advice on first-rate practice according to the best available proof of effectiveness like cost effectiveness. This guideline is intended for the managers, practitioners and commissioners in public health as a part of their obligation (NICE, 2014). The said responsible people could be dealing or working with local authorities, NHS, community sectors, private, public and voluntary organizations. This will be interesting to older people, carers, friends, family, community and other members of the public.
4. Oral health: local authority oral health improvement strategies – This guide provides suggestions on oral health needs evaluation, making a local strategy on oral health and disseminating community-based interventions and activities (NICE, 2014). The purpose of these guidelines are the following: (1) promoting and protecting oral condition by enhancing diet and lessening consumption of alcohol and tobacco, sugary foods and drinks; (2) improving oral hygiene; (3) increasing the availability of fluoride; (4) encouraging people to go to the dentist regularly; and (5) increasing access to dental services (NICE, 2014).
5. Domestic violence and abuse – This guidance is for local authority and other commissioners, General Practitioners, specialist domestic violence and abuse staff and those involved in the health, social care, community, voluntary, and private sectors who can be directly involved with people who experienced or committed abuse or violence (NICE, 2014). The recommendations comprise service delivery, inquiring about domestic violence and abuse, training, mental health, commissioning, information sharing, equality and diversity, perpetrator programmes and advocacy (NICE, 2014).
Among the areas provided by NICE the oral health and oral health improvement will be discussed thoroughly in the following sections of the paper. It is important to have a regular check-up with a dentist. Oral health and ways of taking care one’s teeth is very important. Tooth decay is caused by a lot of things. In medical jargon cavities are called caries, which is triggered by prolonged harmful forces acting on teeth such as enamel and the inner dentin of the tooth (Cavities and Tooth Decay, n.d.).
The causes of tooth decay are frequent exposure to foods with a lot of carbohydrates and sugar. The common foods that cause tooth decay are candy, ice cream, soda, and milk (Cavities and Tooth Decay, n.d.). Without a regular tooth brushing and flossing, materials will breakdown and making the bacteria form detrimental, colorless substance called plaque (Cavities and Tooth Decay, n.d.). The plaque will then destroy enamel and other tooth structures together with the leftover particles in your mouth. If cavities will not be treated early, it can cause more serious problems which may require treatments like root canal therapy (Cavities and Tooth Decay, n.d.).
The World Health Organization says that oral health is important overall health and wellbeing of a person. A good oral health allows a person to eat properly, speak, and socialize without discomfort or awkwardness (The State of Children’s Oral Health in England, 2015). WHO reiterated a number of effects of tooth decay on children which are the following:
1. Pain and infection like dental abscesses or gum disease which may lead to difficulties in eating, sleeping and speaking.
2. Fluoride varnish, fillings, and dental extraction may be required.
3. Tooth decay may be a cause of tardiness or absences.
4. If a child had developed caries they are more likely to develop more problems like tooth decay in permanent teeth.
5. When there is a tooth extraction and it was experienced at a young age and several times, children are more likely to have orthodontics problem such as premature loss of teeth and misalignment of permanent teeth.
Since 1970’s oral health has improved because of the awareness of people of the importance of oral health care and the availability of fluoride. Although there was an improvement, one third of five year-olds are still suffering from tooth decay (The Prevalence of Tooth Decay in England, 2015).
The Role of NICE on Developing the Guidelines
Public Health Advisory Committee (PHAC) agreed for the purposes of the guideline provided by NICE, there are group of people who are at danger of poor health could be described as susceptible to oral infections (NICE, 2014). The members of PHAC also agreed that it was integral to determine common factors that steer them to be susceptible. The factors comprised of socioeconomic deprivation, cultural factors which covers the English as a first language and physical disability.
The result of sugar on oral health is influenced by when and how frequent it is eaten, as well as the quantity a person consumed. The level of acidity in the diet was also noted by PHAC which affects the oral health (NICE, 2014).
In determining the evidence several archives both in libraries and web-based libraries were searched in May 2013 for papers issued since May 1993 which were pertinent to the effectiveness of programs and interventions about the promotion, improvement and maintenance of oral health of a local community. The reviews taken from the researches were summarized and utilized as the basis for the evidence statements for questions formulated by NICE (NICE, 2014).
The collaboration of NICE and PHAC steered the advancement of suggestions about the strategies of local authorities on oral health improvement. When PHAC adopted a ‘life course’ approach, it examined the evidence on oral health for a distinct series of events that people are expected to undergo from birth to death (NICE, 2014). The purpose of this is to study the efficiency of community-based oral health interventions at key ‘life course’ stages determined by age, common life events and social changes that influence people.
The PHAC said that deprived oral health and failure to give access to dental services for children, adult and young people is seen as a form of neglect (NICE, 2014). The PHAC suggested that when the NICE guideline was developed about looked after children and young people is updated, it should add evidence on preventing and responding to poor oral health (NICE, 2014).
After all the revisions and steps undertaken by PHAC and NICE, recommendation were published in the website for commissioners, consultants in public health and frontline practitioners, social care and education, health and wellbeing boards and directors of public health (NICE, 2014).
The Name and Role of Any Other Organizations in Producing the Guidance
There were only two groups or organizations which are directly involved in the guidance for oral health: PHAC and NICE. The recommendations were directed to the local authorities who somehow have indirect involvement in the strategies used for the improvement of oral health guidelines.
NICE has organized several Public Health Committees who serve as standing committees in considering the evidence and develop public health guides. The members of the committee include academics, topic experts, public health practitioners and members of the public (NICE, 2014).
NHS England which was the NHS Commissioning Board are collaborating with Public Health England and local authorities to deliver and develop oral health improvement strategies and providing plans in oral health strategies and commissioning certain plans for the necessity of local populations (NICE, 2014).
Processes Involved in Making the Guidelines
The stages NICE had undergone in developing the guidance for oral health are the following: (1) scope and outline released for the consultation; (2) remarks of the stakeholders were used to modify the draft; (3) answers to comments and final version were shown in the website; (4) economic modeling and reviews on evidence submitted and commenced to PHAC; (5) draft recommendations were produced by PHAC; (6) evidence and draft guideline were released for consultation and fieldwork; (7) the recommendations were amended by PHAC; (8) final draft was published in the website; and (9) comments on the response were published in the website (NICE, 2014).
Evaluate the Social, Political, Economic, and Environmental Contexts Facilitating the Public Health Guidance
Social Context
Oral healthcare in social context includes the economic status of the people living in the area. In Australia, despite the country’s high standards of living enjoyed by its citizens, there was a significant difference among the spread of the status of oral health among social groups in Australia (Social Determinants of Social Health, 2015. PDF. file). Normally, adults who experience immense financial constraint have more oral illnesses which are untreated like more missing teeth compared to more advantaged adults. In the study, social factors were discovered as changeable societal conditions that affect life opportunities, affect access to resources, and shape patterns of behaviour that influence the oral health of people. Moreover, adulthood’s oral health is influenced by exposure to various social conditions that are linked to socioeconomic position (Social Determinants of Social Health, 2015. PDF. file). These resources change the exposure to detrimental social conditions are likely to affect people’s response to emphasize in ways that have consequences for oral health. The research provided alternative ways to approach population oral health, not merely by access to dental care alone, as well as by changing the broader social environment in which citizens in which people work, live and seek dental care (Social Determinants of Social Health, 2015. PDF. file).
Another study connected to social context of oral health is from Mellner, Biterman, and Celeste. According to the study of Mellner et al., (2015), caries during has been connected to the occurrence both acute and medical conditions in life. Past studies links social living conditions to both showing up or not at a routine dental check-up and oral health among children and adolescents. Furthermore, there is substantial proof that social inequality in oral health among children and adolescents exist between social groups and classes (Mellner, et al., 2015).
Political Context
Advocacies for dental and oral health care are promoted to ensure that equal distribution of information and services about oral health is provided. According to Doig (2013), Canadian Dental Association intends to affect the resource allocation and public policy resource allocation decisions within political, economic and social systems of institutions that have direct impact on people’s lives. CDA is involved in different levels of oral health in Canada. At the local area, CDA aids dentists in efforts to influence local policy initiatives by giving resources and assistance (Doig, 2013). At the local area, CDC gives forums and discussions with provincial dental directors and facilitates the development of strategies to enhance strategies for problems at the provincial level (Doig, 2013). Government relations, media relations, and public education are the things CDC is involved with in the national level for oral health (Doig, 2013). CDC has a direct impact on the international level through its efforts at the FDI World Dental Federation (Doig, 2013).
NHS dental services also provided recommendations for policy makers of what they have to do about the oral health care which are the following: NHS dental services should address children’s access to oral and dental services; improve oral health education; raise awareness of the impact of sugar to tooth decay; ensure adequate priority for pediatric dentistry; and promote water fluoridation scheme (The State of Children’s Oral Health in England, 2015).
Economic Context
An allotted budget for promoting oral healthcare among the citizens of a country to prevent costly expenses in curing diseased related to oral health. According to Sheiham (2015), in other countries, oral diseases are the fourth most expensive diseases to treat. It was estimated that treating caries, that it costs US$ 3513 per 1000 children and would exceed the total budget for oral health for low income families (Sheiham, 2015). Even if it a pervasive illness in countries, developing countries do not allocate budget for this problem (More Oral Health Care Needed for Ageing Populations, 2005).
Environmental Context
Poor oral health affects people of all ages. Sheiham (2015) explained that oral health alters people psychologically and physical and affects they grow, enjoy life, speak, look, chew, socialize and taste food and their feelings of social well-being. Terrible caries caused excruciating pain, discomfort, acute and chronic infections and sleeping and eating disruptions to kids. The impact of toothache or poor health condition in teenagers is also recognized. In Brazil, 335 of the teenagers reported to be distressed which leads to school absence (Sheiham, 2015).
The Guidance Identified as Cost-effective Compared to Previous or Existing Guidance for the Same Health Program
For the cost-effectiveness, the guidance was made by reviewing the strategies read and analyzed from the studies and researches gathered. Initially the economic modeling includes only oral cancer, periodontal disease and dental caries however; it only focused on the effect of interventions on dental caries (NICE, 2014). There were 5 input key parameters for the analysis of which are intervention costs, baseline risk of dental caries, intervention effectiveness, loss in quality-adjusted life years (QALYs), and cost of treating each one (NICE, 2014). The values were the following: intervention cost per person: £20, £40, £60, £80 and £100; baseline risk of dental caries: 10%, 20%, and 50%; intervention effectiveness: 0%, 10%, 20%, 30% and 40%; QALY loss from dental caries: -0.025, -0.05 and -0. 1; and cost of treating dental caries: £75, £100 and £125 (NICE, 2014).
References
Anon., (2015). Social determinants of oral health. [pdf] Available at:
< https://www.adelaide.edu.au/oral-health-promotion/publications/theses/pdf_files/AnneSander_Abstract.pdf> [Accessed 13 June 2015]
Cavities and Tooth Decays. (2015). What is tooth decay? [online] Available at:
<http://www.jallendmd.net/library/28/CavitiesandToothDecay.html> [Accessed 13 June 2015]
Chidgey, J., Leng, G., and Lacey, T., 2007. Implementing NICE guidance. Journal of Royal Society Medicine, 100 (10), pp. 448-452.
Doig, P., 2013. CDA advocacy: Making a difference in oral healthcare. [online] Available at:
<http://www.jcda.ca/article/d119> [Accessed 13 June 2015]
NICE. (2013). What We Do. [online] Availabel at: <http://www.nice.org.uk/about/what-we-do> [Accessed 13 June 2015]
NICE. (2014). Dementia, disability and frailty in later life – mid-life approaches to prevention. [online] Available at: <https://www.nice.org.uk/guidance/gid-phg64/documents/disability-dementia-and-frailty-in-later-life-midlife-approaches-to-prevention-draft-guidance2> [Accessed 13 June 2015]
NICE. (2014). Domestic violence and abuse. [online] Available at: <https://www.nice.org.uk/guidance/ph50/documents/domestic-violence-and-abuse-identification-and-prevention-draft-guidance2> [Accessed 13 June 2015]
NICE. (2014). Maintaining a healthy weight and preventing excess weight gain among children and adults. [online] Available at: <http://www.nice.org.uk/guidance/gid-phg78/documents/maintaining-a-healthy-weight-and-preventing-excess-weight-gain-among-children-and-adults-draft-guideline2> [Accessed 13 June 2015]
NICE. (2014). Membership of the public health advisory committee and the NICE project team. [online] Available at: <http://www.nice.org.uk/guidance/ph55/chapter/12-Membership-of-the-Public-Health-Advisory-Committee-and-the-NICE-project-team> [Accessed 13 June 2015]
NICE. (2014). Older people: independence and mental wellbeing. [online] Available at: <http://www.nice.org.uk/guidance/gid-phg65/documents/older-people-independence-and-mental-wellbeing-final-scope2> [Accessed 13 June 2015]
NICE. (2014). Oral health: Approaches for local authorities and their partners to improve the oral health of their communities. [online] Available at: < . http://www.nice.org.uk/guidance/ph55> [Accessed 13 June 2015]
NICE (2014). Summary of methods used to develop the guideline. [online] Available at: <https://www.nice.org.uk/guidance/ph55/chapter/9-Summary-of-the-methods-used-to-develop-this-guideline> [Accessed 13 June 2015]
Mellner, C., Biterman, D. and Celeste, R., 2015. Living conditions and neighborhood effects on dental health care visits and oral health among children and adolescents: A Swedish register-based study. [online] Available at: <http://www.researchgate.net/publication/268672452_Living_conditions_and_neighborhood_effects_on_dental_health_care_visits_and_oral_health_among_children_and_adolescents_A_Swedish_register-based_study> [Accessed 13 June 2015]
Public Health England. 2014. Local authorities improving oral health: commissioning better oral health for children and young people An evidence-informed toolkit for local authorities. [online] Available at: <https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/321503/CBOHMaindocumentJUNE2014.pdf> [Accessed 13 June 2015]
RCS Faculty of Dental Health. (2015). The state of children’s oral health in England. [online]
Available at: <https://www.rcseng.ac.uk/fds/policy/documents/fds-report-on-the-state-of-childrens-oral-health> [Accessed 13 June 2015]
Sheiham, A.,2015. Oral health, general health and quality of life. [online] Available at: <
http://www.who.int/bulletin/volumes/83/9/editorial30905html/en/> [Accessed 13 June 2015]
World Health Organization. 2005. Moral oral health care needed for ageing populations. [online]
Available at: <http://www.who.int/bulletin/volumes/83/9/infocus0905/en/> [Accessed 13 June 2015]
Part 2
The second part of this paper will give an in-depth discussion of National Health Services in United Kingdom about the principles related to distribution of health, finance, and supply, and to different health care systems, describe the different economic techniques as a tool for allocating resources and analyze economic principles which shows effective allocation of scarce resources.
National Health Service in England was established in 1948. The organization was developed because of the ideal that good healthcare should be accessible to all regardless of their socio-economic status which is a principle that remains at its core (NHS, 2015). NHS almost gives everything in free except prescription and optical and dental services for citizens of United Kingdom. NHS accommodates around 64.1 million people in United Kingdom and 53.9 million in England. NHS in has over 1 million patients every 36 hours which includes antenatal screening to routine screenings like NHS Health Check and treatments for long-term conditions, emergency treatment, transplants, and end-of-life care (NHS, 2015).
NHS’s primary role is to improve people’s health in England. Its purposes are the following: to provide national leadership for enhancing results and futhering up the quality of care; to oversee the operation of clinical commissioning groups; to allocate resources to CCGs; and to commission primary care and specialist services (NHS, 2015).
Last 2014, the Commonwealth Fund reported that compared to healthcare systems of ten countries like Australia, Canada, France, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland and the US the NHS is considered the most remarkable among all the ten countries (NHS, 2015). It was rated as best system in terms of efficiency, safe care, effectiveness of care, coordinated care, patient-centered case and cost related problems. For equity, the NHS ranked second.
Finance
The fund of NHS comes from general taxation and National Insurance contributions. Patient charges from services provided by NHS contribute also to the organization’s fund. The Department of Health is in charge of the amount of money given to NHS England which is a part of Spending Round process (How the NHS is Funded, 2015). Most of the funds of NHS, 80 percent comes from the general taxes which are allocated to general practice, dentists and opticians (Glennerster, 2009).
Source
OHE Guide to UK Health and Health Care Statistics
How NHS is Funded, 2015
General taxation is generally regarded as being a highly efficient way of financing healthcare. This means that the government has a full control on incentive and control costs (The NHS Handbook, 2009). As taxations draws more revenue from a variety of points it aids in minimizing disfigurement in specific sectors of economy (The NHS Handbook, 2009).
For patient charges, NHS charges a minimal amount for prescriptions, dental and optical services. These out of pocket payments account for almost 2 percent of NHS funding. However, glasses and contact lenses can only be paid for those who can afford it. With the help of safety net people who can’t afford them will not pay for it and will be discouraged to seek advice and treatment (The NHS Handbook, 2009). A number of exceptions applied in these kind of cases which includes young and old people, unemployed and with low income (The NHS Handbook, 2009).
Canada’s version of NHS is called medicare which publicly financed but privately run which gives universal coverage and care is free at the point of use (Irvine, Ferguson, and Cackett, 2005. PDF. file). The Canadian Healthcare system is funded generally by tax dollars. The federal government makes cash transfers to the provinces, but the provinces may levy their own taxes to help cover the costs of healthcare services (Irvine, et. al, 2005. PDF.file). Alberta and British Columbia require a health insurance premium, and other provinces have instituted employer payroll taxes (Irvine, et. al, 2005. PDF. file).
Likewise with NHS of United Kingdom, Canada’s healthcare is funded by taxes from people. However, it s unclear whether they also have services which can contribute to additional fund such as prescriptions, dental and optical services like that of NHS of United Kingdom.
Supply
The number of services provided by NHS also depends on the number qualified staff they have. Referrals from General Practitioners also account for the increase of number of demands in NHS. Under the NHS Choose and Book scheme, a patient can choose the hospital or clinic where a patient can get the treatment as long as the GP feels that a person needs to see a specialist to receive proper treatment (How Do I Get a Referral to NHS Specialist, 2015).
The reforms made by the government greatly influenced the demand and supply of healthcare services in NHS UK. In NHS has developed it market dominated government policies over two periods: 1989-1997 (Brereton and Vasoodaven, 2010. PDF. file). These reforms aimed at three objectives: demand-side reform; supply-side reform; and payment system reform.
The reforms included the separation of the functions of care purchasing and care provisions, which were previously directed to the Department of Health (Brereton and Vasoodaven, 2010. PDF. file). Major demand side covers the development of General Practitioner Fundholding (GP Fundholding), where GP’s are assisted to take on budgets for purchasing elective (planned) care hospitals and a new responsibility for purchasing other healthcare services given on regional administrative bodies, which are called Health Authorities or HAs (Brereton and Vasooden, 2010. PDF. file). Supply-side reforms cover the development of self-governing healthcare groups called NHS trusts, which makes HAs relieved from day to day management of hospitals.
The following effects on the reforms were noted: GPs fundholding decreased in the first two years but increased thereafter, leaving the policies impact on costs inconclusively; GP fundholding was associated to decreased in patient waiting times; it may have led to different imbalance in patient care; and patients of fundholders reported lower overall satisfaction with care but with a higher satisfaction on additional medical services provided by the practitioners ( Brereton and Vasooden, 2010. PDF. file).
For the demand of healthcare services in Canada, according to the study of Murray, Gilbert and Wong (2002), there is a serious growth on the demand of healthcare in Canada. The recent growth of the demand for healthcare services can be imputed to varied demographic and socio-economic trends and the multiplying number of technologically advanced genetics, precision instruments, robotics and micro-processing (Murral et, al. 2002).
One of the drivers of the demand of healthcare is the physicians. Physician spending has been among the fastest- growing health categories these past years (Murral et, al. 2002). The salary that the doctors receive increased faster than a regular wage. There was a 6.8 percent increased per year from 1998 to2008 of the number of patients which can be attributed to physician fee schedules.
NHS UK and Canada have the same dilemma when it comes to the supply and demand of the healthcare services they provide. It will still depend on the needs of the patients and the appropriate services given to them.
Distribution
Since the core value of NHS is to provide accessible healthcare to all regardless of someone’s economic status. To ensure that the healthcare services are properly distributed NHS has established bodies to give services to patients (Understanding the New NHS, 2014. PDF. file.). Commissioning organizations aim to improve national leadership for improving outcomes and driving up the quality of care; overseeing the operation of clinical commissioning groups (CCGs); allocating resources to clinical commissioning groups; commissioning primary care and directly commissioned services such as specialized services, offender healthcare, and military healthcare (Understanding the New NHS, 2014. PDF. file.).
NHS England has responsibility for commissioning are primary care, specialized healthcare services, health services for serving personnel and families in the armed forces, and health services for people who are in prison or other secure accommodation, and for victims of sexual assault (Understanding the New NHS, 2014. PDF. file). The Health and Social Care of 2012 replaced the previous system of primary care trusts with 211 clinical commissioning groups (CCGs) each serving a median population size of around 250,000 people. Its advantage is that CCGs are clinically led by local organizations that know the area in which they are working, and so able to give services that are specifically required by the population it serve (Understanding the New NHS, 2014. PDF. file.). Clinical commissioning groups can commission services from various providers which include the voluntary and private sectors. Any organization that gives services must be registered with a regulating body. Provider organizations are predominantly known as trusts, which can be classified as NHS foundation trusts or NHS trusts. The services given by these trusts are primary care services, acute trusts, ambulance trusts, mental health trusts, and community health services (Understanding the New NHS, 2014. PDF. file.).
Allocation of Scarce Resources
It is very important to ration properly the budget for healthcare services provided by NHS. Priorities on resource allocations should be taken into consideration. The population of UK is becoming older and the existence of different illnesses comes with it that needs more sources for fund. The cost of treatment given to people should be weighed properly to increase the cost-effectiveness of the treatment (Resource Allocation, 2015).
NICE use QALYs or Quality Adjusted Life Years as a measure of health-related outcomes in relationship to cost-effectiveness. QALY tries to quantify the length and quality of life gained through an intervention. However, there are two factors that NICE should consider which are utilitarian and libertarian (Resource Allocation, 2015). Utilitarian means that doing the greatest good for many people would favor public health initiatives while libertarian means that people in UK do not have the right to treatment, but rich can have private healthcare since they can pay for it.
However, NHS UK has a budget enough to deliver the mandated services for the citizens of United Kingdom. NHS has £65.6 billion which is allocated to local health commissioners which CCGs and local authorities (NHS Allocations, 2014). The part of the fund which is £25.4 is allocated to NHS UK’s commissioning of specialized healthcare, primary care and military, offender services (NHS Allocations, 2014).
Economic Evaluations
The reason behind economic evaluation to know the cost effectiveness and cost benefit analysis, which are used to address the questions of whether a program or a project or intervention gives a good value of money (O’Brien, 1993. PDF. file.). The two main reasons why economic evaluation is needed are cited by O’Brien. First, the market for health care is unlike that of other commodities where supply and demand are brought together through a price mechanism (O’Brien, 1993. PDF. file.). The lack of a functioning market, government intercedes to deliver or finance healthcare. Second, faced with a finite pool of scarce resources and the lack of market price signals of what consumers value, how should a government or other decision making bodies allocate healthcare resources between the many competing demands (O’ Brien, 1993. PDF. file.). It is important that there should be a concept of the cost implementing of healthcare program has also the same health benefits of another healthcare program which cannot be pursued (O’ Brien, 1993. PDF. file.). In other words, the healthcare body or NHS should weigh the outcomes of healthcare program if they wanted to improve or make a new healthcare program in relation to its cost.
Another benefit of economic evaluations is to provide decision makers with information in resource cost and public health benefits involved in choosing one intervention over the other (Economic Evaluations for Global Health Programs, 2015. PDF. file). Economic evaluations together with research on safety, efficacy, and effectiveness are crucial parts for evaluating health technologies and interventions for use in low resource settings (Economic Evaluations for Global Health Programs, 2015. PDF. file).
Main Approaches to Economic Evaluations
The most common type of economic evaluation is cost-effectiveness analysis or CEA. Cost-effectiveness analysis compares the cost and outcomes of two or more alternatives or compares a new intervention or treatment with the status quo (Global Health Programs, 2015. PDF. file.). The net cost includes the cost of delivering a specific health intervention to prevent an illness or unwanted health result minus the treatment and other costs not earned because of the beneficial effects of the intervention (Global Health Programs, 2015. PDF. file).
Another approach is the cost-benefit analysis which an evaluation wherein the benefits of the health intervention are expressed in monetary terms that is a dollar value or its equivalent is placed on the life years gained; hence, a ratio of benefit to costs less than one would imply that the intervention was not worth undertaking at all (Global Health Program, 2015.PDF. file.). On the other hand, a benefit to cost ratio greater than one would indicate that the intervention is a good investment.
Cost Utility Analysis measures the QALYs or quality-adjusted life years, in which the gain in expected lifespan resulting to a medical intervention is weighted by the quality of that life, evaluated through some type of systematic of the affected population (Global Health Programs, 2015. PDF. file.).
Evaluating the Implications of the Guidance for Public Health
The guidance developed by NICE is significant to local authorities in improving their strategies in preventing oral diseases. The oral health to communities is important for their general health and quality of life. The recommendations provided by NICE is adopted by communities and showed evidenced-based programs and preventions for oral health (NICE, 2014). The local authorities’ aim is to improve people’s diet which includes the reduction of sugar in take and its frequency of consumption; oral hygiene; access to fluoride products; and access to dentists (NICE, 2014).
The government made a commitment with a purpose to improve oral health of the population specifically children, introduce a new NHS primary dental care contract, increase access to primary care dental services (Public Health England, 2014. PDF. file). Since the guidance specifically are aimed to the primary oral healthcare it is important that they will understand and do their best to provide the best oral health services for their people (Public Health England, 2014. PDF. file).
Understanding of National Institute for Health and Excellence
The National Institute for Health and Excellence gives national guidance and advice to enhance health and social care. It was initially established in 1999 which served as a special health authority to lessen the variations in the availability and quality of NHS treatments and care (NICE, 2014). In 2005, it merged with the Health Development Authority and started developing national guidance to deter diseases and endorse healthier lifestyles. Because of the Health and Social Act of 2012, NICE became Non Departmental Public Body (NDPB). They are now more responsible than ever to provide guidelines to national levels according to their independent committees.
The government believed that the creation of NICE will help expedite the good value treatments used across NHS which is also a way of promotion and encouragement for successful innovation on the part of clinicians, pharmaceutical companies and medical devices company (NICE, 2014).
NICE was a certified quality provider of health and social care information which demonstrated the needed processes and systems to make sure that information are well-kept. NICE is an independent organization that provides healthcare services guidance that patients or citizens can get based on their national guidelines.
References
Anon.,2015. How do I get a referral to a specialist. [online] Available at: <http://www.nhs.uk/chq/pages/1094.aspx?categoryid=68&subcategoryid=153> [Accessed 14 June 2015]
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Brereton, L. and Vasoodaven, V., 2010. The impact of the NHS market An overview of the literature. [pdf] Available at: <http://www.civitas.org.uk/nhs/download/Civitas_LiteratureReview_NHS_market_Feb10.pdf> [Accessed 14 June 2015]
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