1.3. Analyse the impact of developments on the evolution of models and systems of health care

This guide will help you answer 1.3. Analyse the impact of developments on the evolution of models and systems of health care.

Health care systems and models continuously change in response to new challenges, societal needs, and advancements. These developments influence how services are funded, organised, and delivered to meet the needs of a growing and diverse population. Technical progress, policy changes, and social trends all play a role in shaping these systems.

Understanding how models and systems have evolved provides insight into the forces that affect the way health care is accessed and managed. This guide will explore key developments and analyse how they have impacted the structure of health care systems and models.

Advances in Medical Technology

Technological progress has played a key role in how health care systems function. Breakthroughs in diagnostics, treatment, and communication tools have transformed care delivery, while innovations continue to shape available services.

Examples of Key Developments

• Diagnostic Tools: Technologies like MRI scanners, CT imaging, and genetic testing speed up and improve diagnosis. This allows health professionals to treat illnesses earlier and with greater accuracy.
• Electronic Health Records: Computer-based patient records replace paper systems, improving data sharing and reducing errors.
• Telemedicine: Online consultations and remote monitoring give individuals faster access to services, particularly for those in rural areas or with mobility issues.

Impacts on Health Care Models

• Systems such as the Beveridge model (used in the UK) have adopted these technologies to improve efficiency and outcomes. For instance, the NHS uses centralised electronic systems to manage hospital referrals, reducing delays.
• Insurance-based models (such as the Bismarck system) have often led the way in funding high-cost technological innovations, which are later adopted by public models.

Impacts on Individuals

• Faster and more accurate diagnoses through technology mean patients receive more timely treatments. This improves survival rates and quality of life.
• Telemedicine makes care more accessible for those unable to travel to clinics or hospitals.

Impacts on Professionals

• The availability of advanced tools allows health professionals to perform more detailed tests and treatments, improving their efficiency.
• Training on new technology, however, places additional demands on staff and budgets, highlighting the need for ongoing workforce investment.

Public Health Policies and Legislation

Governments introduce health policies and laws to protect public health, respond to changing needs, and reduce health inequalities. These reforms shape the evolution of health systems.

Key Examples of Policy Impacts

• The NHS Act 1946: The establishment of the NHS in the UK revolutionised health care delivery by making services universally accessible and free at the point of use. The Beveridge model became central to public care in the UK.
• The Health and Social Care Act 2012: In England, this legislation shifted decision-making to local clinical commissioning groups (CCGs), allowing services to be tailored to local health priorities.
• Equal Access Policies: Anti-discrimination laws have improved access for marginalised groups like those with disabilities or from ethnic minority backgrounds.

Impacts on Health Care Models

• The introduction of universal health care under the Beveridge model made care equitable and free for all residents. This replaced earlier systems, such as reliance on charities and privately-funded care.
• Policy changes requiring private insurers (as seen in the Bismarck model) to include lower-income people broadened access to essential services. This created more fairness within insurance-based systems.

Impacts on Individuals

• Universal health care reduced catastrophic costs for individuals, ensuring that financial hardship was no longer a barrier to treatment.
• Policies targeting health equality, such as free prescriptions for vulnerable groups, have improved their access to care.

Impacts on Professionals

• Legislation supports safeguarding and professional standards. This builds trust between staff and service users.
• Some policy changes, such as stricter performance targets, have added pressure to health workers.

Changing Demographics

Demographic shifts, such as an ageing population and increased diversity, have impacted how health care systems operate. Systems have had to evolve to account for these changes.

Ageing Population

With life expectancy increasing, more individuals live with chronic conditions that require long-term care. This rise in demand is particularly evident in countries with universal health care systems like the NHS.

Migration and Diversity

Globalisation has brought people from diverse cultural and linguistic backgrounds into communities. Health care workers need to meet their varied needs.

Impacts on Health Care Models

• Universal systems have shifted resources towards geriatric (elderly) care and mental health services. This ensures that older individuals have access to specialised support.
• Mixed models now provide interpreter services and culturally appropriate care pathways to meet a wider variety of needs.
• Insurance-based systems in Europe have expanded to include migrants in national health insurance schemes, particularly where integration policies are in place.

Impacts on Individuals

• Older adults living with conditions like Alzheimer’s benefit from dementia-friendly care services in primary and specialist settings.
• Language barriers are reduced through initiatives like translator support, improving access for non-native speakers.

Impacts on Professionals

• Professionals must complete additional training to manage complex needs associated with ageing and cultural diversity. This ensures care is sensitive and person-centred.
• Workforce shortages due to higher demand for care place greater strain on staff, especially in underfunded systems.

Economic Factors

Economic conditions affect how much funding is available to health care systems. Governments or private providers make decisions to expand or restrict services depending on available resources.

Examples of Economic Impacts

• Austerity: Budget cuts after the 2008 financial crisis affected public systems like the NHS. Staff reductions and resource shortages created longer waiting times.
• Growth of the Private Sector: In mixed systems, individuals increasingly turn to private providers when public funding doesn’t meet demand.

Impacts on Health Care Models

• Systems based on taxation (e.g., Beveridge) struggle during economic downturns. Funding cuts mean reductions in staffing and services.
• In private insurance models, economic growth enables investment in cutting-edge treatments. However, recessions make it harder for individuals to pay their premiums.

Impacts on Individuals

• When public budgets are reduced, people face longer waiting times and fewer specialists.
• In private insurance systems, economic recessions result in people losing their insurance or being unable to afford higher premiums.

Impacts on Professionals

• Declining funding creates stress for health professionals. They are expected to do more with fewer resources.
• The private sector often benefits in tough economic times, attracting more professionals with better salaries or working conditions.

Scientific Research and Evidence-Based Practice

Health systems increasingly use scientific research to improve care quality and outcomes. Evidence-based practice means decisions are made using proven methods and outcomes.

Impacts on Health Care Models

• Research-led practices are central to public systems like the NHS, ensuring resources are directed towards effective treatments.
• Mixed systems introduce more transparency. Providers (public and private) are compared and monitored to ensure they follow evidence-based protocols.

Impacts on Individuals

• Access to safer and more reliable treatments improves individuals’ recovery rates.
• Public awareness campaigns informed by scientific research help people understand how to prevent illnesses, encouraging healthier lifestyles.

Impacts on Professionals

• Staff gain access to training and resources backed by research. This helps them stay up-to-date with modern practices.
• However, increased scrutiny based on measurable outcomes, such as patient satisfaction surveys or waiting times, may add stress for professionals.

Social Trends and Expectations

Changes in society influence what people expect from health care services. Increasing demand for mental health support, holistic care, and self-management tools has shaped how systems evolve.

Impacts on Health Care Models

• Universal systems now promote mental health services on par with physical health treatment.
• Telehealth tools in mixed systems allow individuals to manage their own conditions through smartphone apps, blood sugar monitors, or wearable devices.

Impacts on Individuals

• Services that focus on mental well-being ensure individuals feel supported across all aspects of their health.
• Self-management tools give people more control over their conditions and reduce the need for frequent appointments.

Impacts on Professionals

• Staff working with new systems, such as mental health first aiders, are better equipped to support service users holistically.
• Increased public expectations around access and quality place pressure on teams to balance competing demands.

Closing Thoughts

Developments such as technology, policy reforms, changing demographics, and economic challenges have reshaped health care systems and models. These changes directly affect individuals, families, health professionals, and wider society. By analysing these developments, we better understand how models like the NHS or hybrid systems evolve to meet new demands and deliver effective care across all sections of the population. This ensures that health systems remain effective and responsive over time.