Investment in health could be good for Europe's economies

The changing health needs of the UK population

The demographics of the UK population are changing and so is the need for health care. In this Health Policy, we explore the current health of the population, the changing health needs, and future threats to health. Relative to other high-income countries, the UK is lagging on many health outcomes, such as life expectancy and infant mortality, and there is a growing burden of mental illness. Successes exist, such as the striking improvements in oral health, but inequalities in health persist as well. The growth of the ageing population relative to the working-age population, the rise of multimorbidity, and persistent health inequalities, particularly for preventable illness, are all issues that the National Health Service (NHS) will face in the years to come. Meeting the challenges of the future will require an increased focus on health promotion and disease prevention, involving a more concerted effort to understand and tackle the multiple social, environmental, and economic factors that lie at the heart of health inequalities. The immediate priority of the NHS will be to mitigate the wider and long-term health consequences of the COVID-19 pandemic, but it must also strengthen its resilience to reduce the impact of other threats to health, such as the UK leaving the EU, climate change, and antimicrobial resistance.

The Impact of Staff Turnover and Staff Density on Treatment Quality in a Psychiatric Clinic

Intuition suggests that improving stability of the health workforce brings benefits to staff, the organization and, most importantly, the patients. Unfortunately, there is limited research available to support this, and how health workforce stability can contribute to reduced costs and better treatment outcomes. To help to rectify this situation, we investigated the effects of staff turnover and staff density (staff members per patient) on the treatment outcome of inpatients in a psychiatric clinic. Our data come from the standard assessment of 1429 patients who sought treatment in our clinic from January 2011 to August 2013. Correlation analysis shows no significant effect of raw staff turnover (the total number of psychiatrists, physicians and psychologists starting or quitting work per month) on treatment quality. However, we do find two significant beneficial effects: first, a higher staff consistency (time without staff turnover) and second, a higher staff density lead to an improvement of treatment quality. Our findings underline the dire need for an extended effort to achieve optimal staff retention, both to improve patient’s outcomes and to reduce health expenses.

Ageing in the European Union

The ageing of European populations presents health, long-term care, and welfare systems with new challenges. Although reports of ageing as a fundamental threat to the welfare state seem exaggerated, societies have to embrace various policy options to improve the robustness of health, long-term care, and welfare systems in Europe and to help people to stay healthy and active in old age. These policy options include prevention and health promotion, better self-care, increased coordination of care, improved management of hospital admissions and discharges, improved systems of long-term care, and new work and pension arrangements. Ageing of the health workforce is another challenge, and policies will need to be pursued that meet the particular needs of older workers (ie, those aged 50 years or older) while recruiting young practitioners.

Sustaining universal health coverage: the interaction of social, political, and economic sustainability

The sustainability of health care systems, particularly those supporting universal health care, is a matter of current discussion among policymakers and scholars. In this article, we summarize the controversies around the economic sustainability of health care. We attempt to extend the debate by including a more comprehensive conceptualization of sustainability in relation to health care systems and by examining the dimensions of social and political sustainability. In conclusion, we argue that policymakers when taking decisions around universal health care should carefully consider issues of social, political, and economic sustainability, their interaction, and often their inherent trade-offs.

Paid Work Increases and State Benefit Claims Decrease after Bariatric Surgery

BACKGROUND

Bariatric surgery is a clinically effective treatment for obesity and has been shown to be cost-effective. The impact of bariatric surgery on the subsequent ability to work and the uptake of state-funded benefits is not well documented.

METHODS

A consecutive series of 79 patients who had undergone laparoscopic Roux-en-Y gastric bypass (LRYGBP) or laparoscopic adjustable gastric banding (LAGB) were surveyed to assess changes in their ability to work and the number and type of state benefits claimed after surgery.

RESULTS

59 patients (75%) responded, median age 45, median follow-up 14 months. There was a 32% increase in the number of respondents in paid work after surgery (P<0.05). The mean weekly hours worked increased from 30.1 to 35.8 hours (P<0.01). Respondents also reported a decrease in obesity-related physical and emotional constraints on their ability to do work (P<0.01). Fewer patients claimed state benefits postoperatively (P<0.01).

CONCLUSION

More patients perform paid work after LRYGBP and LAGB than beforehand, and the number of weekly hours they work increases. After surgery, patients claim fewer state benefits.