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37 Cards in this Set
- Front
- Back
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What is health policy? |
A decision-making process that affects many people - priorities and values underlying health resource allocation are determined |
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What are the 2 key types of policy? |
1) Allocative policy 2) Regulatory policy |
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What is allocative policy? |
Intended to provide funding and other resources to a distinct group or type of organisation in order to achieve some public objective. (eg/// increased funding for dementia care) |
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What is regulatory policy? |
Seeks to influence the action, behaviour and decisions of others through direct control of individuals or organisations. (eg/// legislation to promote tobacco control) |
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What are 2 different levels that policies can operate at? |
1) Broad health policies 2) Specific health policies |
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What are broad health policies? |
Improving efficiency in the NHS. Increasing choice |
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What are specific health policies? |
Flu immunisation for elderly and vulnerable groups. Tackling key health behaviours like tobacco and alcohol control. Reducing rates of self-harm in young people |
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What are 5 ways that may cause a new health policy to emerge? |
1) ideology - political beliefs 2) evidence - research findings 3) inspiration - learning from the places 4) bargaining - trade offs between key groups 5) panic - swine flu, ebola etc |
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Who said that health policies were not a clean, straightforward process? |
Chris Ham, 2009 |
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What are the 4 models/approaches to guide policy-making? |
1) rational decision-making (empiricism) 2) incrementalism (muddling through) 3) mixed scanning 4) garbage can (multiple streams) |
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Who described rational decision-making? |
Herbert Simon |
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What is rational decision-making? |
A method for systematically selecting among all possible choices/courses for action based on reason, facts and analysis |
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What body uses the principles of rational decision-making? |
NICE |
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What essentially is rational decision-making? |
A data driven process |
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What type of people does rational decision-making involve? |
Key experts (analysts) |
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Does rational decision-making involve continuos monitoring or not? |
Yes, continuous monitoring of consequences |
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What are cons of rational decision-making? |
Ignored complexity Dominated by experts Resource intensive - high costs Rarely used in practice |
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What is incrementalism? |
Where decision-makes refrain from making drastic changes to organisations/systems as they hold the view that drastic changes can lead to failure of the change being successfully implemented. |
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What is incrementalism opposite to? |
Rational-decision making |
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What does incrementalism involve? |
Taking one small bit of the problem and dealing with that first - focuses on gradual or smaller scale change |
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Why does incrementalism focus on small-stepped changes? |
As these can easily be remedied if things start to go wrong. |
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What are some pros of incrementalism? |
Eliminates the need for complete knowledge of all alternative options and consequences (don't need an expert committee. Needs less data therefore less costly Can be seen as realistic |
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What are some cons with incrementalism? |
Tinkering with the system can miss the big issue Rarely leads to innovation or transformation (just carry on as it has) |
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Who talked about incrementalism? |
Charles Lindblom |
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What is mixed scanning? |
A middle of the other 2 ways |
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Who talked about mixed scanning? |
Amitai Etzioni |
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What do mixed scanners do with the system? |
Break the whole system down into chunks and some of these components will be considered in greater detail |
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What is done with these small chunks? |
The radical changes that are wanted to happen - just makes it more manageable |
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What model of policy-making allows you to take advantage of sudden opportunities of data that come available? |
Mixed scanning |
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However, what can happen to small changes that isn't good? |
They can get lost in the system therefore don't make a big impact |
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What is the garbage can model? |
Policy decisions are the outcomes of 4 independent streams |
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What are the 4 independent streams? |
1) problems 2) potential solutions 3) participants or players in the system 4) windows of opportunities for change |
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What is the garbage can essentially? |
A response to real world events, messiness, personalities - the streams are stirred and what emerges in policy terms is affected by other factors In any situation, the precise garbage can mix varies. |
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Where did the garbage can emerge from? |
Political science (Kingdon) |
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What is most of the evidence in health policy on? |
What goes wrong |
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What are examples of what goes wrong? |
Lack of stakeholder 'buy-in' Over-ambitious timescales Lack of skills/training/resources Ill-defined roles/responsibilities Poor project management Poor contingency planning |
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Why does research have little influence on policy? |
Policymakers have goals other than clinical effectiveness Competing types of evidence Lack of translation |
