Accessing new learning from abroad

Once we acknowledge what we have in common with overseas healthcare providers, we can access a new world of learning – sometimes from unexpected quarters, writes Jo Bibby, Director of Strategy at the Health Foundation.

The context for healthcare varies around the world, but different health systems are increasingly facing similar problems: long-term conditions and co-morbidities, rising costs and the challenges of supporting an older population. Of course, the details of healthcare differ from one location to the next – from organisational structures to funding models. But overall, people providing healthcare on a day-to-day basis have more in common than we may realise.

As an organisation constantly looking for new ideas to improve healthcare, we at the Health Foundation think that looking outside the UK is essential. One way we do this is by providing funding for the International Partnership for Innovative Healthcare Delivery (IPIHD), which helps innovators spread high-quality cost-effective healthcare solutions. These global innovations can be informative and useful for developing and developed healthcare systems alike.

One such project is Operation Asha – an initiative working to address tuberculosis (TB) in India and Cambodia, through low-cost local centres that TB patients can reach within 10 minutes to receive their daily medication. Technology alerts caregivers to any missed medication, enabling quick follow up and targeted counselling.

Another example, VisionSpring, works in Bangladesh, India, El Salvador and South Africa, training up community members as ‘vision entrepreneurs’ who screen for eye problems, sell glasses or refer people to eye clinics for further treatment. Both these examples offer valuable learning that can be harnessed by healthcare providers anywhere in the world.

The most obvious benefit of looking for learning from abroad is to avoid spending unnecessary time and effort if a model has already been implemented and evaluated elsewhere. Northern Ireland’s South Eastern Health and Social Care Trust discovered this when it began working with the Basque government.

Learning from new and emerging healthcare systems also provides a valuable opportunity to take a fresh look at how care can be provided. We in the UK are lucky to have a long-established healthcare infrastructure. But there are drawbacks, with providers constrained by previous models of care, ingrained professional roles and expectations from public and staff.

Some emerging countries are now starting to rapidly develop their healthcare systems, without being limited by notions of ‘the way we’ve always done things round here’. This gives them the chance to come up with new ways of doing things. One example is salaUno – a Mexican social enterprise breaking new ground by providing low-price cataract operations through an ambitious business model.

The growing interest in drawing on international learning runs parallel to an increasingly global healthcare workforce – especially within the European Union, with its free flow of labour. This development presents an opportunity for faster transfer of good ideas. A scheme from the European Union Network for Patient Safety and Quality of Care is working to support and embed this exchange of good practice, in order to share learning and raise standards.

Comparing improvements from countries with different health systems does present challenges too. We must always be mindful of how far it is possible to directly transfer an approach or model of care. Workforce regulation, payment systems and societal expectations can be important deciding factors in the success or otherwise of a model, so they need to be taken into account. But often, the fundamental principles behind the learning will still pertain.

The important thing is to strike the balance between being open to other possibilities without being naive about some of the factors that could get ‘lost in translation’.