It is very easy to enter a new environment and start to compare it to what you know, pointing out everything that is done differently. Instead, I want to acknowledge some parts of the UK’s healthcare system which are very similar to what we have encountered on our own soil.

David Waters, and adult ICU nurse, started our day with some very informational lectures about the structure of the National Health Service (NHS). Although the UK has a universal healthcare system which is funded through taxation, there are more similarities to the US than one would usually imagine. Despite the healthcare being free, the process requires patients to visit a general practitioner who will refer you to further specialists if needed. Life-threatening issues take priority, but non-life threatening issues are put on the backburner. This means that it can take 3 to 6 months for procedures such as orthopedic surgery, which may not be life threatening but do impact quality of life. In order to access faster care, some people with insurance do opt to utilize private healthcare. This system is usually faster but financially restrictive for many everyday people. Thinking about it, things work in a very similar way here in the US. Those who are on Medicare or Medicaid, government funded insurance, usually wait much longer times and receive a lower quality of care than those who pay for private insurance. In the structure of the NHS, there are clinical commissioning groups made of appointed physicians and other officials. These groups choose what services are covered by the NHS and what are not, very similarly to how procedures are filtered by insurance companies. Procedures such as hormone replacement therapy and gender confirmation surgery may be designated as unnecessary by CCGs, very similarly to how they are in the US. These groups dictate how much money out of pocket patients will have to pay to receive their care, and oftentimes contribute to the economic barriers that prevent citizens from receiving their desired care.

While Dee Robinson, an Operating Department Practitioner (ODP), was speaking about her role in the surgical theater, she mentioned that there had been many new roles such as Physicians Associate, Nurse Practitioner, and ODPs, all roles that were made to fill gaps due to the lack of doctors. These issues have also been occurring in the States, mostly due to workforce burnout by the pandemic. As pay becomes lower and education becomes more expensive, these gap roles have gained more and more prevalence in the world of healthcare, trying to help bridge the long wait times to receive care.

In one of our final lectures, Lisa, a nurse midwife, came to educate the group on the role of midwives on the health of babies and birthing people across the UK. She pointed out that in the most recent “Improving Mothers Lives Report” in 2020, which investigates the most common causes related to maternal morbidity and mortality, women from an Asian background are two times more likely to die during childbirth than White women, as well as women from the most deprived socioeconomic backgrounds, and Black women are four times more likely. We have the same racial health disparities in the US, where Black women are three times more likely to die. Despite location, there are still barriers to health childbearing which need to be addressed through education, prenatal health, and an increase in services to support vulnerable populations. In addition, David Waters pointed out that life expectancy across the UK is reduced in the northern and middle regions in comparison to the south, showing that factors such as health inequality, poverty, and culture are contributing to health disparities. In order to better the health of our citizens, we must work to identify and implement plans to combat these issues, not just through individual countries, but the world.