1. Alice Taylor BMedSci (Hons) Final Year Student Nottingham Medical School Professor Harold Ellis Medical Student Prize for Surgery 2010

2. NHS?

3. “No longer will wealth be an advantage nor poverty a disadvantage. Healthcare will be provided free of charge based on clinical need and not on ability to pay.”

4. NHS Expensive conditions Expensive treatment Patient expectations Demand for quality Funding tight

5. Looking to the future...  Evidence-based outcome measures  Foundation Trusts  Removing cap on private income  Pro-market approach

6.  Independent surgeons and teams  Many purchasers: Department of Health Private insurance companies Patients  Contracts based on quality and efficiency How does Surgery fit in?

7. Monitoring and audit  Participation in audit  Robust monitoring and benchmarking outcomes  Specialty agreed quality measures  Some will not ‘make the cut’

8.  Pooling of patients  Subspecialisation  High throughput centres  basic procedures  Specialised centres  maintain quality  Greater team integration

9. What will this mean for patients?  Greater choice of team  Informed decisions  Ensured quality care

11. Alice Taylor