What can the UK and US health systems learn from each other?

Opportunities for transAtlantic learning in health care

What the US might learn from Britain

1. The effectiveness and efficiency of ensuring health care without regard to ability to pay

2. Paying general practitioners for quality and outcomes

3. National Institute for Clinical Excellence—particularly its use of cost utility data to help decide which innovations should be introduced into the NHS, how it incorporates public values into its decisions, and how it is beginning to regulate surgical procedures

4. National Patient Safety Agency—one of few examples of a national programme to make healthcare safer

5. National Programme for Information Technology—how can you wire a whole health service

6. National Electronic Library for Health

7. Continuous professional development for doctors rather than drug company sponsored continuing medical education

8. Scottish Intercollegiate Guidelines Initiative—how the Scottish medical colleges took the lead in creating guidelines on common topics that are actually used in Scotland

9. British National Formulary—a guide not only to how to prescribe drugs but also which may be the best to use

What the UK might learn from the US

1. Institute of Medicine—how medicine can speak with one, highly respected and well informed voice

2. Building a network of high performance, low cost centres for complex healthcare procedures

3. Getting maximum value for money through knowing much more about the costs and benefits of different procedures

4. Management of patients with long term conditions

5. Integration of primary and secondary care as happens in the Kaiser system

6. The renaissance of the Veterans’ Administration healthcare system

7. Institute for Healthcare Improvement: Britain—mainly through the Modernisation Agency—has already learnt a lot from IHI, but there is probably more to learn, including creating a body like IHI outside government