Webinar - Supporting Carers wellbeing

We have a further update on our project Informal Carers Well-Being Enhanced (ICWE) – Improve the conditions of ICs in their role as caretakers (icwe-project.eu) 

Join us on 27th November at 12.30 UK for a focused half hour when we will to a quick deep dive into some key tools to enable self care for carers REGISTER HERE

 Best Wishes 

c/o CEmPaC

Pandemic Bonds: Beware perverse incentives and instruments?

individual - self

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INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

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group- population

Geography Number of Countries Number of fatalities Instruments: Legal, Science, Social, Policy, Financial ... ?

"On Wednesday [24 July], the World bank said it  would give $300m in grants and loans to DRC to step up its aid response. But funding connected to the World Bank's pandemic bonds, issued in 2017 have been less forthcoming. One relatively small slice - the so-called "cash" element - has delivered $31.4m to help with the crisis." Ebola's latest resurgence in central Africa has led to more than 1,700 fatalities. But for the insurance element of the bonds to pay out, the disease must cross an international border and there must be at least 20 fatalities in the second country. The total possible insurance payout for Ebola is $150m and comes in three tranches: when 250, 750 and 2,500 people have died across at least two countries, $45m, $45m and $60m, respectively, will be disbursed."

Pandemic Bonds World Bank: Pandemic Emergency Financing Facility DRC - Rwanda border

My source: Asgari, N. (2019) World Bank pandemic bonds spark Ebola anger, FT Weekend, 27-28 July, p.17.

Photograph - adapted from original by The Independent.

"One-size-fits-all" Assurance of Insurance needed?

individual

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INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group

mental health problems affect Self-employed, single No previous history of MH problems PURPOSE# Psychology - Counselling	12.5 million adults - 1 in 4 PROCESSES (automated?)* 'Life cover' Insurer access to GP record - deemed high-risk 500,000 people affected by
Untimely death of a parent Mother killed by drug-using driver Refused IVF treatment PRACTICE	insurance company POLICIES driver jailed Voided application for life cover (figures) suggest insurers reject up to 625,000 people a year By law ins. companies cannot discriminate

*Need to discuss an application with a person, fill in 'gaps' then less likely to become subjected to an algorithm and an automated rejection.

^# What were the reasons for referral to psychology and counselling?

My source:
Miller, L. (2018) My fight to get life cover after mental health trauma, The Daily Telegraph, Money, 22 September, pp.1-2.

See also: https://www.telegraph.co.uk/insurance/life/get-life-insurance-mental-health-problem/

Technology can, will and is helping to 'disrupt' the insurance market.

EHR Individual - Group: Aggregator

People probably look at Hodges' model and see something that is simplistic. There is a great power, however, in the scenarios that the structure of Hodges' model can readily encompass. Not just in the hospital, but across all care contexts.

"Where is the great value promised by the transition to EHR [Electronic Health Record]? Where is the huge surplus from all those lives saved? Without an actor who can find it, and deploy it to shift the doctors into surplus, nothing will happen. 

If the ecosystem* includes just the five traditional players, EHR will remain an academic dream. The answer, then, requires introducing a new player - an aggregator. Because the odds of mistakes are so low, the benefits of EHR are invisible to the individual patient. They become material only when we aggregate outcomes over a large enough number of patients. We need to find an actor whose surplus is affected by patients not as individuals but as a group, and who is able to both capture and distribute this benefit; insurers, health-care systems, and governments all fit the bill. And the larger the group, the larger the surplus." p.130.

*The ecosystem illustrated by Adner is simplified and includes:
Payer/ Insurer, IT Provider, Hospital Administration, Hospital Department, Doctor, Nurse, Patient
(I have added Nurse)

Adner, R. (2012). The Wide Lens: A New Strategy for Innovation. London: Portfolio/Penguin.

Navigating health and models: c/o HSJ

individual

INTERPERSONAL : SCIENCES

humanistic ------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

group

Geisinger's Proven Health Navigator communicate and share decision making  patient - person focus patient access to records birthday cards, follow up benefits, outcomes purposes of integration	population management data gathered and applied preventive medicine referral reduction to hospitals early intervention case management of complex and chronic diseases
a "medical neighbourhood" offering care in the most appropriate setting - community care health promotion culture change1	Geisinger Health Systems (not for profit) health insurance, budgets care commissioning values based reimbursement system accountable, leadership culture change2

My source:
Moore A. (2014) Show you can navigate integration, Health Service Journal, 28 November: 124, 6425, pp. 20-23.

"A wise person once explained to me that delivering integrated care successfully was 

"more sociological than technical"".

 Prof. Chris Ham, On 'bilingual' clinical leaders. p.22.

Memo to America's Right

Please do not treat the UK's NHS as a
political football and yes I mean 'football'
(there's enough of that o'er here without
you sticking your ten cents worth in!).

Do not underestimate the -
knowledge, skills, creativity and dedication -
of NHS staff, or how it is perceived, valued and loved by the People.

Yes, the NHS is not without its faults (it is also true we are not all Angels), but amid the signs of wear, the aged splinters -

we do not forget the middle,
the constant called change,
or the challenges that beckon in the 21st century.

Image source: Allproducts.com

Additional links:

BBC News Bloggers debate British healthcare

New York Times 2008 Paying Patients Test British Health Care System

Health Affairs blog - MENTAL HEALTH PARITY: researchers stress importance of out-of-network benefits

There is an interesting insight into US mental health provision/funding and what can be hidden factors posted by Chris Fleming at the Health Affairs Blog.