On July 28th 2016, Francis Ruiz of the Global Health and Development group (GHD, formerly NICE International), participated in the launch of a UK supported Prosperity Fund project in Qingdao, China. The project, led by the China National Health Development Research Centre (CNHDRC), GHD’s key Chinese partner in an ongoing collaboration on health technology assessment (HTA), focuses on chronic disease management and integrated care, key issues for decision makers not only in China but across the world. In the control and management of chronic disease, it is possible to identify two key challenges: the first relates to risk factor control, and the second concerns the effective management of those diagnosed with a chronic disease, including the implementation of evidence-informed guidance. This CNHDRC led project focuses on the latter.
The Prosperity Fund is one element of the UK’s total overseas development commitment, and in China it is focussed on promoting economic reform and growth while supporting the delivery of China’s 13th Five Year Plan (2016-20).
At the official launch meeting there were opening speeches by Wei Fu (Deputy Director of CNHDRC) and Rachel Ainley (Senior Policy Officer, Health and Social Care, British Embassy) to an audience of over 40 people, including representatives from the National Health and Family Planning Commission (NHFPC) and the British Embassy in Beijing. Representatives from Huangdao and Xiamen – the two pilot sites in the project – described their experiences to date in improving the management of patients with chronic diseases such as diabetes and hypertension, with an emphasis on using IT systems to support integration between hospitals and community health centres, and in developing criteria for patient referral and outcome assessment. Deputy Director General Wei, which can be found here, and Deputy Director General Hong, which can be found here, of the Health and Family Planning Commission of Qingdao and Xiamen respectively, set out the strategy and aims of their integrated care initiatives in the pilot areas including the objective of reducing unnecessary hospitalisation, presenting some initial findings where quality and efficiency have improved.
Prof Kun Zhao of the CHNDRC provided background to the project, noting that a key aim of this work is to develop a standardised approach to developing clinical guidelines and any derived quality measures in China, and applying it to existing care pathways and guidelines on hypertension and diabetes currently in use in Xiamen and Qingdao. Her presentation can be found here. Francis Ruiz from GHD, presented on international experience in explicit priority setting and health technology assessment, stressing how HTAs and clinical guidelines can be used to improve frontline practice through the development of targeted quality measures linked when appropriate to financial incentives. His presentation is here.
The launch concluded with a presentation from Dr Charles Young, Chief Medical Officer of Capita Healthcare Decisions, who along with GHD are involved in the activities associated with this Prosperity Fund project. Dr Young described Capita’s work in decision management, particularly their expertise in nurse-led telephone triage and clinical record management. Implementation of Capita’s decision support system has contributed to reduced primary care referrals and savings of over £213 million to the UK NHS. The previous day Capita delivered a detailed workshop on their decision management system including a demonstration of their software to an audience of policy makers, clinical professionals and IT specialists. This highlighted the potential benefits of clinical IT systems linked with algorithms based on evidence of best practice, to effectively triage patients and support better referral decisions. Attendees at this workshop included representation from Ping An Health Insurance, who also provided support for the event. They have a strong interest in the role of clinical guidelines and decision support tools in supporting the services they provide both within and outside China. Chinese coverage of this event can be found here.