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.
CEBM, University of Oxford. April 2019

SUMMARY

‘Value’ is gaining prominence in healthcare systems facing increased demand for services with limited resources. However, value-based healthcare has not yet been embraced as part of the everyday language and business of the NHS in the way that evidence-based healthcare has.

The absence of an agreed definition of ‘value-based healthcare’ in the NHS, the 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.  A stakeholder workshop informs the report with patients and leaders across the NHS and value sector.

SEVEN KEY RECOMMENDATIONS 

For patients and professionals in the NHS who are interested in increasing value at a local or national level:

1. Adopt a common terminology so that every person involved in healthcare, including patients, has a shared understanding of what value-based healthcare is
2. Identify and communicate unwarranted variations in healthcare to every person, ensuring genuine transparency about why value-based healthcare is essential, and why realistic decisions based on the available resources are required
3. Recognize and develop strategies to overcome barriers to implementing value-based healthcare at the individual, team and organisational level
4. Build capacity and capability to translate and implement the best available research evidence into effective action to increase value.
5. Develop the necessary skills in value-based healthcare by training staff in how to measure outcomes, patient experience and resource use
6. Ensure programmes to increase value are monitored and evaluated to provide better evidence about what is and isn’t effective
7. Facilitate better communication and dissemination about what works in increasing value at a local and national level

How to cite: 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. 

The meeting was funded by an NIHR Senior Investigator Award to Carl Heneghan. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.