When starting to think about what healthcare is and how it works it is often helpful to break it down into its component parts: the various people, roles, organisations, and resources that deliver health care services for populations. These various interactions and connections are often referred as the healthcare systems

If we take the NHS as an example and think about its various connections we start to realise that healthcare systems are complex and can be difficult to understand. Have a look at this clip which shows how the NHS works. It shows the many layers, people and organisations working that make up the NHS system

Does this overview support or question how you think the NHS system works?

What do you think are the strengths and limitations of organising services in such a way?

Increasingly there is a recognition in the UK as well as in other countries that the way in which healthcare systems work need to change in order to better respond to societal needs and demands as well as respond to increasingly limited resources. A good summary of these issues can be found here:

This film identifies key challenges related to an ageing population, increasingly complex care needs, and diminishing financial resources. Existing solutions and established ways of working might not be able to cope with these trends therefore other solutions and ways of thinking about healthcare are needed.

Gaps in the system: thinking about mental and social care

Crucially, our current healthcare system is exposed to criticisms about the notable gaps in how it works. This is particularly the case when thinking about mental health and social care: crucial and fundamental aspects of healthcare systems that require greater integration into how we organise and delivery services.

Karen Newbigging

The above video by Karen Newbigging summarises the current situation and challenges facing those accessing mental health services, as well as an assessment of different ways to improve the situation.

Catherine Needham

The above video by Catherine Needham addresses the gaps and challenges within the current healthcare system and analyses social care in terms of what this is, the experiences of those involved, as well as reflecting on how the situation can be improved.

Changing the way we think about systems: is healthcare a factory or an ecosystem?

It is increasingly being acknowledged that a systems perspective is needed if we are going to make the necessary improvements to meet the needs of the population. However, the ways in which healthcare systems are characterised has been criticised. Braithwaite for example argues that to improve healthcare systems, policy makers are preoccupied with the use of top-down tools such as more regulation, restructuring, and introducing more stringent performance indicators at the expense of involving staff in the decisions and activities that affect them and paying greater attention to established improvement methods and ideas.

“We must move instead towards a learning system that applies more nuanced systems thinking and provides stronger feedback loops to nudge systems behaviour out of equilibrium, thereby building momentum for change”

Now that you’ve read this section, please test your knowledge by taking the following quiz: