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The NHS can learn from working with international partners

Nora Colton
By Professor Nora Colton, Director at the UCL Global Business School for Health
3 May 2024

Health systems around the world are coming under greater strain than ever before. Ageing populations, a rise in non-communicable diseases, mental health, and the impact of climate change are all presenting increasing global public health risks. While many countries face similar challenges, there is particular  concern in the UK that our healthcare system is not set up to adequately tackle these challenges, and that we are lurching from crisis to crisis.

The public wants to see change in how we tackle healthcare challenges in the UK. For example, polling has shown just 29% overall satisfaction across all ages, socio-economic groups, political parties, and genders with the NHS in 2022, falling from 36% in 2021. With Health Secretary Victoria Atkins MP in post since November and the public wanting to have a proper discussion as to the future of our NHS ahead of the next general election, seeking expertise from international examples is a useful policy tool that we should make more of in improving our own healthcare infrastructure.

That’s why it has been great to see this prioritised in the UK Government’s Department for Business and Trade’s (DBT’s) initiative to develop and expand partnerships between the UK and Philippines heath sectors. I joined DBT in meeting with partners to not only sign a twinning partnership between Pasig City in the Philippines and West Yorkshire to support each other’s development of healthcare research and innovation, but also to meet with leaders from public and private healthcare groups in the Philippines to share what innovations are helping us tackle our respective challenges.

I joined the delegation as a representative from UCL’s Global Business School for Health (GBSH), where we too believe that learning from other systems around the world is one of the most effective ways to improve our own system in the UK. We recently partnered with the Dr Sulaiman Al Habib Medical Group (HMG), the leading provider of healthcare in the Middle East, training the next generation of senior healthcare leaders. We’ve set up bespoke courses for our HMG students to facilitate cross-cultural learning, with education split between sites here in London, and with partner institutions across the Middle East.

Reflecting on the trip and thinking about the specific considerations for ICB’s, there are a five tips to consider when working with international partners:

  1. Ensure that any partnership aligns with your integrated care strategy – when going overseas for partnerships, there is a need to resist the excitement of getting an agreement versus alignment.  There is always a degree of compromise that must take place when dealing with other organisations, especially those in different country settings, and you must understand how far they are willing to bend to secure an agreement so that they don’t find themselves with an agreement that is not actionable.
  2. Develop a criteria for partnerships that is realistic. This is so you can identify who you will and, more importantly, won’t partner with so that the opportunity cost of forging these relationships is a win-win for both organisations.
  3. Understand the legal and data sharing issues at the start of the journey when looking for partners in certain markets, and always do your due diligence regardless of how highly recommended the partner might be.
  4. Ensure that the partnership is a collaboration and that there is value for both organisations to learn and grow in the relationship
  5. Always start with a quick win so that you build trust in delivering with the other organisation, and then build up to bigger projects that may span years to deliver.

It’s great to see that the healthcare policy community is increasingly being given a platform to facilitate this cross cultural learning. It is my hope that with this increased approach we can continue to learn international health policy lessons that I have long been familiar with as a health economist and Director of GBSH. For example, learning from Singapore’s approach to prioritising community care settings when possible, ensuring it can allocate hospital beds and clinical staff to cases which are most urgently in need of support and urgent attention.

Another policy challenge that we can look outwards for international examples is funding. It’s no secret that health systems need adequate funding to effectively treat populations – and how we pay for our health system in the UK is under constant scrutiny. In Germany, the oldest social health system in the world, patients see 0.9% more of GDP invested into their health system than we do in the UK – with Germany spending the most on health in Europe. Everyone has to have health insurance, paid for through a social security contribution – equally split between employee and employer and with a cap at €365 (£312) a month for the individual. This system has resulted in Germany having a higher life expectancy than the EU average and high numbers of doctors and nurses with its health system not having to regularly fight for a greater slice of the budgetary pie.

The rapid development and uptake of medical innovations will be a key feature of the most effective health systems in the years to come. The Danish medtech sector now accounts for more than 7% of Danish business and, despite being a primarily free-to-access healthcare system, the Danish health system has proactively prioritised healthcare innovation. Patients across the country benefit by having access to the foremost cutting-edge developments in medicine, while in the UK, we have not been as quick to adapt to new developments in healthcare. The UK should be proactive in replacing outdated equipment and integrating new tech, such as AI diagnostics; it’s an area we have previously lagged behind our international counterparts in modernising.

The scale, complexity and unpredictability of managing the change needed to improve the supply and demand dynamic of access to healthcare in the UK means that more minds are better than just the one. I look forward to seeing how international partnership learning will evolve and support the health leaders of the future to be the best equipped to tackle the challenges we will face in the years to come, and deliver better health outcomes across the country.

By Professor Nora Colton, Director of UCL Global Business School for Health

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