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Scoring system devised to 'ration' health services developed by economists
The Herald Scotland, by Jody Harrison 
05.04.17
 
A Scoring system to help health bosses prioritize spending in hospitals and social care is being developed by economists.
 
The framework, similar to that used by prescription drugs watchdogs, will help new care boards and councils decide where to direct spending cuts to investment.
 
Scotland’s new care boards, which manage both community NHS and social care services, could use the system to weigh up controversial decisions, such as whether to maintain a local hospital service or instead create a “hospital at home” team taking more treatment to people’s homes.
 
The rationing system is intended to work in the same way as the Scottish Medicines Consortium in Scotland and the National Institute for Health and Care Excellence (Nice) in England, which make judgments on which drugs are to be made available to patients on the NHS.
 
Professor Cam Donaldson, a health economist at Glasgow Caledonian University, is leading the team,
 
He said that said difficult decisions needed to be made. In any system that was free, “the needs outstrip the amount of resources available” he added.
 
He said: “What we really need to put in place are more robust processes to help health and social care partnerships to manage scarcity,” he added. “Difficult decisions will need to be made in Scotland about which services to fund and to what extent, and which existing services to scale back.”
 
With little or no increases in global budgets, frameworks need to help shift resources “from low-value services . . . to higher-value services in areas of most need”.
 
The £250,000 initiative, is supported by the Chief Scientist Office and is part of the drive to shift spending away from hospitals into the community
 
Nice and the SMC evaluate new drugs to decide which the NHS should buy based on the amount of extra quality of life they offer for the price. Professor Donaldson added: “A study of this nature has never been undertaken before and would place Scotland at the forefront of this important field of social and economic policy.”

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