Southcentral Foundation's Nuka system of care

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  • Posted:Thursday 20 March 2014

Rachael Addicott speaks to Katherine Gottlieb, President, CEO, Southcentral Foundation, about the Nuka system, which delivers care to an Alaskan Native American population.

Katherine relays the successes of this system, and the reasons for this success, including developing a shared vision, working in partnership with their patients and measuring the outcomes effectively. She also explains what's changed for the population as a result, and what inspiration community health providers in England could take from this system.


Harry Longman

Chief Executive,
Patient Access Ltd
Comment date
20 March 2014
This is interesting from the point of view of the long term vision (30 years) and the way they "measure everything" - well, particularly things that matter to their patients one hopes. We do have something to learn here, with constant tinkering over structure, and poor measurement in many cases. However, there are important differences with the US system and in fundamental ways the capitated, free at the point of use NHS is doing universally many of the things for which the Nuka system has to make a special effort - they talk about targetting populations. This would not be necessary if they had GPs and patient lists, which all of us enjoy in the UK.

I hear that a system modelled on the Nuka was tried in Fife, but given up after not very long. This is perhaps not surprising given the above. I wonder whether King's Fund would undertake more local analysis of things working well in the UK, which have more chance of spreading? The danger the exotic is that it stays "out there" and while we may learn something, it does not really challenge us to introspection and therefore change.

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