Professor Cam Donaldson
Decisions about how to allocate health and social care resources fairly and efficiently are increasingly difficult for healthcare providers, particularly with competing claims on budgets that could benefit different groups of patients, clients and the public.
New Scottish Government legislation to implement health and social care integration came into force last year, bringing together NHS and local council care services under one partnership arrangement for each area. In total 31 local Health and Social Care Partnerships (HSCPs) have been set up across Scotland to manage almost £8 billion of health and social care resources.
As a result, there is a greater emphasis on provision for people in their own homes or local communities, whilst considering cost, quality and the value of services provided for local populations. The need to shift the balance of care from acute to community services, and re-prioritise spending, has since been reinforced by the Scottish Government in ‘A Plan for Scotland’.
In a ground-breaking project, researchers from Glasgow Caledonian University (GCU) will develop the first framework for making difficult healthcare decisions which integrates economics, decision-analysis, ethics and law to be applied in this new context of shifting the balance of care.
With £244,000 funding from the Chief Scientist Office (CSO), the research team will develop, test and implement the new framework in four HSCPs to establish barriers and facilitators to its use, but also draw comparisons with all other HSCPs to assess what difference it makes to priority setting processes in practice and to evidence-based shifts in the allocation of health and social care resources.
Led by GCU’s Professor Cam Donaldson, the team will comprise researchers from the University of Strathclyde, Cardiff University, the University of Liverpool and the Scottish Government.
Professor Donaldson has been newly appointed GCU’s Vice-Principal and Pro Vice-Chancellor Research and Enterprise. He is one of the world’s foremost health economists and joined the University in 2010 from the Institute of Health and Society at Newcastle University.
Professor Donaldson will work with colleagues Professor Rachel Baker, Marissa Collins and Dr Micaela Mazzei in GCU’s Yunus Centre for Social Business and Health, a unique, interdisciplinary centre of excellence which hosts GCU’s health economists, internationally recognised for their work across boundaries of care, including partnerships between the NHS, social care and the third sector.
Professor Donaldson said: “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. Practically, with little or no increases in global budgets, frameworks need to facilitate resource shifts involving disinvestment from low-value services to move resources to higher-value services in areas of most need. This requires transparent and justifiable processes that consider costs and outcomes, the needs and values of local populations and a range of ethical, economic and legal arguments.
“Any new framework has to be practically and ethically robust to ensure that it is acceptable to stakeholders and to uphold the underpinning principles of healthcare provision. 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.”