After the lectures today, I have definitely noticed the major differences between the UK and US healthcare systems, but there are also many similarities. To begin, David discussed how NHS is promoting a move towards “integrated care.” He explained how primary, secondary, and social care each have different funding processes, organizations, and services. This can lead to a lack of communication, duplication of services, and high costs of services leading to poor patient outcomes. Some NHS trusts are just hospital or community based, so they have different policies. However, now, NHS is working on getting trusts that cover both community and hospital care to have the teams communicating and working together. The community team works to keep patients out of the hospital, but at the same time they are communicating to the hospital that the patient may need to be brought in which allows for a smoother transition from community to hospital care if necessary.

This shift towards integrated care is also seen in the US. In my intro to diversity equity and inclusion in healthcare class last semester I talked to a nurse working at Magee Women’s hospital, specifically with breast cancer patients, for a project. She explained to me how there are many disparities in breast cancer treatment because individuals of lower socio-economic status cannot afford transportation or to take time off from work to go seek care or go for a routine exam. She then explained how important it is to bring care from the hospital out into the community. She told me about one of her colleagues who goes out into poor areas in Pittsburgh and provides breast cancer screenings for women and hands out pamphlets to educate them on how to perform self breast exams. She explained how important it is to bring this care out into the community because if it just stays at the hospital, the people who do not have access to the hospital will never receive this information and end up with poor health outcomes. Related, both the US and UK have electronic patient records that are accessible throughout the system and can be accessed by any healthcare professional seeing that patient.

Furthermore, something that is the consistent throughout the US and UK are health disparities. Even though the UK has a universal healthcare system and everyone is guaranteed free healthcare, health disparities are still a large issue. Lisa, woking in maternity services, explained how Asian women are 2 times more likely and black women are 4 times more likely to die in pregnancy, labor, and post natal care than white women. Furthermore, David was explaining how there are serious class issues within receiving access to care. He said there is reduced life expectancy in the Northern and Middle UK having to do with poverty. Of course, similar inequalities are present in the US for several reasons such as lack of access to care or lack of health insurance.

One major difference that was discussed today is the role of a school nurse in the US and UK. In the UK, school nurses play an important role in supporting children with special educational needs and disabilities. In the UK, when there is a child with a disability, the school nurse is responsible for assessing the child and requesting an Education Health Care assessment. Then, once the child starts to receive support, the school nurse will stay in touch with the child’s pediatrician to see if any of the school services need to be changed, remain a point of contact for the family, and work alongside the SendCo. In the US, the school nurse does not have the same role. I believe the child study team in the US would perform a similar role as the school nurse in the UK. The child study team evaluates the student and develops plans for students in terms of additional academic or social-emotional services. The student would then be passed to a physical therapist, occupational therapist, speech therapist, etc. who would each perform their own evaluation and determine if the student needs their services. Then they would develop their own plan of care for the student. The school nurse might be involved if the student needs a shot or medication administered throughout the school day, but their role is all medically based.

Also, I absolutely loved the Birmingham Botanical Garden we visited today!!!