Med School Interviews: How the UK Health System Works | PostGradMedic

hi everyone oli here welcome back to the channel once again in this video we're going to be discussing how healthcare in the UK actually works [Music] now it might seem like a bit of a weird thing to talk about but when you go to your medical interviews it's reasonable for them to assume that you have some knowledge of how the UK medical system works it's actually more complicated than you might think particularly for those of you who I know are applying for medical school from outside the UK and your own systems might be very different so this is aimed at those people as well as you know those people in the UK that maybe haven't dealt that much with the healthcare system or aren't familiar with how every level of it actually works and how its organized so this is just gonna be a rough overview of how our system works so as I'm sure many of you know we have what's called the National Health Service that in theory is meant to provide free health care to anyone who needs it at the time when they need it and the NHS gets its money because it's a government organisation it has to be funded by the government from two major sources the vast bulk of this money comes from taxation of the working populace and then a smaller supplementary amount comes from what's called the National Insurance contribution exactly how much money the NHS receives every year as a percentage of GDP is determined by the government during what's called the spending review so for a given year it will be decided exactly how much money is going to be sent to the NHS and because that doesn't cover quite everything there's a couple of other ways that the NHS can get its money the first is by charging for prescription items so the current prescription charge is about nine pounds and between this uncharged is for some dental services this makes up about one percent of the NHS is income every year and because the NHS is devolved into kind of geographical Trust's which all act a little bit autonomously if they want to bring money in in other ways they can do that for example by charging for parking and in hospital car parks they might sell off any land they have or just assets that they generally hold to shareholders which in turn can bring private money in and some trusts can also choose to treat patients privately to boost their funds as well so now the NHS has its money it exists how do we use it well if you or I were to suddenly become ill we might make an appointment with our general Tichenor our GP although it's a bit of a paradoxical term these are specialist doctors who are trained as generalists and they have to be familiar with a very wide range of conditions because anything can obviously come through the door and the key thing is that they can spot when something really serious is wrong GPS from the medical wing of what is called primary care that is the part of the NHS that a patient first deals with when they notice that they have a problem and it includes other services such as dental practices pharmacists optometrists usually the community setting in which you will receive your health care but then a GP will either provide the advice if it needs advice or any medical treatment that the patient can receive in their own practice or if the situation needs it they might refer you on to a specialist service and any drugs that a patient needs whether it's antibiotics or antihypertensives diabetes medications whatever are provided by a prescription so it's a signed piece of paper from the doctor saying you know my patient needs this and give it to them which they then take to the pharmacy a pharmacist then has a look they use their own knowledge to check that everything's kind of in order and the prescription makes sense and is safe and then all being well they will dispense that medication and the patient can go off and take it in the primary care setting you might also be seen by maybe a nurse in the community or maybe a community physiotherapist basically if someone can deal with you safely in the community that's usually preferable at this stage however in emergencies such as cardiac arrest or stroke more serious things that might kill you it's more appropriate for someone to ring 999 call an ambulance and you will be taken immediately to hospital you'll go to the A&E or accident and emergency department and all the staff here are trained in very acute life-threatening presentations this level of the NHS because we're now in a hospital kind of very well-equipped setting this is known as secondary care and hospitals unlike community settings can provide a very wide range of staff with a huge range of specialist skills with a lot more advanced equipment than would be available for example in your average GP practice just because they have more space more money more staff and secondary care is best represented by your local can a district General Hospital not the huge whopping ones but the one that you might find attached to a reasonably sized town while you're in hospital a doctor will be placed in charge of your care and will ultimately decide what treatment it is you're gonna receive and while you're there you'll be looked after by nurses health care assistants again physiotherapists pharmacists many many different types of health professional that you would find in the average Hospital then the final organizational level of the NHS is what are known as tertiary centers so we've gone primary secondary tertiary and these are the largest big expensive modern hospitals these units usually haul marked by their ability to provide very specialist and niche services such as cancer therapy organ transplants plastic surgery to use these centers patients might have to travel quite a long way waiting lists can be very very long for access to these services and you will almost always require a referral from your GP to use these settings for those of you coming to med school it's very very likely that you will spend some time at a tertiary center because they have access to virtually every specialty that exists in medicine and the biggest teaching hospitals tend to be tertiary centers so where I'm based University Hospital Coventry and Warwickshire is the big teaching hospital for the region although of course we have learning in the other hospitals as well examples of these big centres include places like Great Ormond Street Hospital in London and the Royal Victoria infirmary in newcastle upon tyne now I know I said that was the last one there is another small group of centres you might find it purely interesting to know about and these are called the major trauma centers or MTC's there are only 31 of these hospitals across all of England and Scotland and the point of these is to provide immediate life-saving therapy for the most dangerous and life-threatening conditions basically traumatic injury that's gonna kill someone pretty soon if we don't do something as you might have guessed every single one of these units is based in a tertiary centre and they have things like surgical theaters and CT scanners permanently active and open ready to go at the drop of a hat because a case might come in at literally any time of the day or night so those are different of hospital and now we're very briefly going to go through what might happen if you need to be admitted to one of these hospitals so if a patient is severely unwell and they're told that they need to stay in hospital they will check in and become Watsa known as an inpatient that means they're going to receive a bed on a hospital ward and be assigned a consultant specialist doctor who is going to look after their medical management how long they stay is simply determined by quite how sick they are when they come in and the nature of the treatment that they require because some things are a lot more complicated than others as well as how quickly they recover once they've had it something like a broken bone you might be looking at you know three days and you could be in and out to have that fixed but a really severe pneumonia or other kind of infection can take weeks and weeks and weeks to clear and quite simply once they're managing doctor decides that they're well enough to go home they are discharged and someone can come get them or they can go themselves or perhaps they might simply be discharged to a district General or a less specialist hospital when they don't need that level of care anymore and then that bed can be freed up and someone else can take it now something it's really important to note is the in line with patient autonomy patients can actually self discharge from hospital at any time even if this flies in the face of every bit of medical advice they've been given if they've got capacity they don't have to consent to treatment and even if it's certain that they're gonna die if they're kind of mentally fit to make that decision no one can stop them going home so let's say you've been into hospital you've come out your condition has resolved some patients will still need monitoring just to check how they're doing this just prevents any remission to where they were before or further injury that they might acquire and this is often done during daytime hospital appointments where these specialist services can be accessed without having to stay in the hospital overnight and depending on what type of doctor you're talking to about this they might be referred to as day cases in the name of surgery there are day surgical units or perhaps outpatients if you're just going to see your medical consultant about your blood pressure asthma just anything that needs checking up so you're still a patient but you're outside the hospital you are an outpatient so a surgical day case for comparison might mean something like remove a breast lump or maybe removal of a suspicious-looking skin lesion and in these cases the patient can just come in you know have the operation under local anaesthetic get it done go home but just something to be aware of the last common instance in which a patient might want to interact with a doctor might be to receive something called a fit note which obviously was previously known as a sick note but we don't use that terminology anymore if a person requires significant time off work which is used if a person would require significant time off work for medical reasons which is usually seven or more days then their employer will ask them to bring in a fit note from their doctor just to confirm why they can't work and what arrangements need to be made now this is a matter of judgment for the doctor if you as a doctor provide a fit note to an employer there is nothing an employer can do about it legally and it can be quite wide-ranging it might suggest that the person needs you know complete time off work to rest and get better but it could also take the form of a compromise you know if the person wants to go back to work and the employer wants them back at work it might suggest things like reducing their hours or maybe altering their duties at work if they were doing heavy lifting or something they might not want to do that while their injuries are healing or simply a gradual phased return to work just so the person is properly rested and isn't going to further damage themselves so thank you so much guys for watching this has been quite a highly requested topic just going through each level of how our UK health system works as I say for those of you wanting to come and study here from outside the UK I hope that was useful if like me you maybe didn't have the best understanding of how our system works when applying to med school from within the UK I'd barely set foot in a hospital before going to med school I hope that was equally useful thanks very much for watching guys if you'd like to support the channel there are three things you can do the first thing is like share comment and subscribe you can buy me a coffee using my cofee link in the description below or you can save 10% of your first year or you can save 10% off your first year subscription to complete anatomy 2020 from 3d for medical my favorite 3d Anatomy learning tool take care guys and I'll see you next time

Channel: Ollie Burton

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Length: 11min 19sec (679 seconds)

Published: Sat Jan 11 2020