Healthcare resource allocation in the aftermath of the Covid-19 pandemic
The NHS is currently facing significant challenges. It must restore elective clinical activity that was lost due to the pandemic, reduce waiting lists that delay treatment and care for more than 7 million people. New NHS strategic guidance requires that work is done to improve outcomes in population health and healthcare, to explicitly tackle inequalities in healthcare outcomes, experience, and access. This in a context where enhancing productivity and value for money, as well as supporting broader social and economic development, is already expected. Finally, large-scale reorganisation of the mechanisms of commissioning is underway in the transition from Clinical Commissioning Groups (CCGs) to Integrated Care Boards (ICBs).
This array of challenges means that work must be done to reshape and renew the processes by which resource allocation and prioritisation decisions are made. These processes have and will continue to involve significant consideration of ethical and legal issues, captured in particular through the adoption of Ethical Frameworks. These frameworks help to provide clear answers to questions related to a ‘fair share of resources’ when patients from different population groups and with different medical needs are competing for treatment in limited resource settings.
In response to these challenges, Ethox researchers have formed a partnership with the NHS Thames Valley Priorities Committee. This partnership has arisen out of mutual interest in the future of the priority setting processes in the region and recognition of the relevance of the academic research being conducted by Sapfo Lignou and Mark Sheehan on these issues. The work of this partnership will enable academic research and expertise to engage with policy makers directly and relevantly in the act of shaping the future policy context.
This project builds on the extensive experience of the researchers and the policy partners, to renew the current Ethical Framework and decision-making processes by considering lessons learned from pandemic policy-making with a particular focus on healthcare inequalities and disadvantage, as well as focussing sharply on the challenges facing newly formed ICBs in efficiently and fairly managing patient waiting lists.
- To build a network combining ethical and legal expertise with detailed policy experience and responsibility
- To develop a robust, theoretically grounded understanding of the practical changes faced at regional level
- To help support the development of processes that are fair, efficient and adaptable to regional needs
- Sapfo Lignou (PI), Senior Researcher in Bioethics, Ethox Centre
- Mark Sheehan (COI), Associate Professor, Ethox Centre
- James Hart (Researcher), PhD Student, University of Reading
- David Clayton-Smith (Policy Partner), Thames Valley Priorities Committee, NHS England and NHS Improvement, South East; Kent Surrey & Sussex Academic Health Science Network
- Megan John (Policy Partner), General practitioner, Chair of NICE Health Technology Appraisal Committee, Frimley ICB
- Clinical Effectiveness Team, NHS South Central & West Commissioning Support Unit, (Policy Partner)
This project is funded by an Oxford Policy Engagement Network (OPEN) Seed Fund award.
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