Social values and health priority setting in England: “values” based decision making

Author:

Littlejohns Peter,Sharma Tarang,Jeong Kim

Abstract

PurposeThe purpose of this paper is to provide an overview of the organisational and procedural arrangements for priority setting in England and Wales. It describes the role of social values in the decision‐making process.Design/methodology/approachThe processes and content of decisions made by the National Institute for Health and Clinical Excellence are analysed using the framework developed by Clark and Weale for identifying social values in health priority‐setting.FindingsWhile countries are seeking to achieve similar outcomes from their health prioritisation processes, each country has established different systems that reflect the social and legal framework underpinning their health systems. England is somewhat unique in being explicit about assessing “value for money” and using formal cost‐effectiveness in developing policy.Originality/valueMany countries are now considering the use of formal health economic methodologies to assess the value and prioritise health care interventions. However there is increasing recognition of the importance of values other than efficiency (cost effectiveness) in making acceptable decisions. This is manifest in the range of potential new approaches being developed including multiple criteria decision analysis.

Publisher

Emerald

Subject

Health Policy,Business, Management and Accounting (miscellaneous)

Reference25 articles.

1. Clark, S. and Weale, A. (2012), “Social values in health priority setting: a conceptual framework”, Journal of Health Management and Organisation, Vol. 26 No. 3, pp. 293‐316.

2. Department of Health (2005), “Directions and Consolidating Directions to the National Institute for Health and Clinical Excellence 2005”, available at: www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsLegislation/DH_4109216 (accessed 5 September 2011).

3. Department of Health (2008), “Improving access to medicines for NHS patients: a report for the Secretary of State for Health by Professor Mike Richards CBE”, available at: www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_089952.pdf.

4. Faden, R.R. and Chalkidou, K. (2011), “Determining the value of drugs – the evolving British experience”, New England Journal of Medicine, Vol. 364 No. 14, pp. 1289‐91.

5. Garner, S. et al. (2012), “Reducing ineffective practice: challenges in identifying low‐value healthcare using systematic reviews”, The Journal of Health Services Research and Policy, in press.

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