Unit 7 – Meeting Individual needs and different Acts to support and

help vulnerable individuals A description of why these acts are in place, and what role they play within the health and safety of people in the community including infants, children and adults. Also what provisions are in place and how they have improved the overall quality of health care in the UK.

Public Sector

Informal Care

Voluntary Sector

Private Sector

PPT 1 -

Key concepts of care Mixed economy of care – the provision of care

will come from a range of service providers. The conservative party of the 1980’s decided that competition between services would improve the effectiveness and quality of services.

Providers of these could be the NHS trust, hospitals, private agencies or the voluntary sector.

Commissioners of services – these could be Primary Care Groups – later to become Primary Care Trusts (PCT’s) – and social services departments.

The Health Act 1999

This Act reformed primary care, allowing the creation of Primary Care Trusts, and requiring all hospitals trusts to improve their services. The Act also allowed the introduction of:› Walk-in high street health centres› Increased use of day surgery in health centres› Health checks and advice sessions in new clinics› One-stop shops-varied health care services at

one site› Wider partnerships, encouraging GPs to team up

with pharmacists, counsellors and dentists to provide a range of services from one site.

How does the NHS work?

The NHS budget for England is planned to reach 105.6 billion.

Central taxation and National Insurance contributions provide 95 per cent of the funding, while patient charges account for only 2 percent funding. Because many of the buildings are old, much of the budget will go on IT and new buildings and equipment.

Parliament passes legislation for the health service in England and Wales, the other three are responsible for their own.

The secretary of the State of Health is a member of the Cabinet has overall responsibility for the work of the Department of Health. He or she will work directly with several ministers for health.

The structure of the provisions of services – this always come up in an exam * please learn the content

Public sector - statutory

•A service that a person has a legal (statutory) right to receive•Funded by the government•Usually free to those who are eligible for services•Usually provided by a public care organisation

Example – •emergency care provided by an NHS Trust hospital•Social work services provided by a local authority

Voluntary sector

•A service that is available to people who meet eligibility requirements•Usually free or low cost to service users. Typically funded by voluntary donations or government grants•Usually provided by a not-for-profit, voluntary organisation

•MIND support groups for people with mental health problems•Age concern advice and support services for older people

Private sector

•A service available to anyone who can pay for it•Funded by direct client payment or by the client taking out health care insurance •Usually provided by a private practitioner or care business

•BUPA private hospital care for cosmetic surgery•Home help service provided by a care services agency.

Informal care

•Care interventions and support provided by a partner, relative or friend of a person in need of care•Typically practical, personal and non-technical forms of help and support

•Provided injections or prescribed medicine for a partner or relative•Going shopping and providing companionship for a friend or neighbour

Sectors Funding, 1990. Mixed Economy of Care 1997, 1999 and 2000 framework diagram

Later in this unit will cover information surrounding the funding of social services in the UK and the Mixed Economy of Care from 1997, 1999 and later 2000.

NHS at the moment

Task 1 Find out what the core

principles of the NHS are; The Department of health

sets out standards for the NHS, for example the National Service Frameworks (NSFs).

Find out what main groups of people are included in the NSFs , and what can they expect to receive from the NSF?

National service frameworks (NSFs) and strategies set clear quality requirements for care. These are based on the best available evidence of what treatments and services work most effectively for patientsOne of the main strengths of each strategy is that it is inclusive, having been developed in partnership with health professionals, patients, carers, health service managers, voluntary agencies and other experts.

Task - 2 & AfL will be a small presentation of what you have found out in a group

You are requested to find out what health services are available in your area.

Your local Primary Care Trust (PCT) should have information about these. Many PCT’s have their own websites giving details of the services they provide.

Using maps, addresses, leaflet advice and any other useful information put together a small field study presentation of this information

NHS Community Care Act 1990 The Act states that it is a duty for local authorities to assess people for social care

and support. This is to ensure that people who need community care services or other types of support get the services they are entitled to. Patients have their needs and circumstances assessed and the results determine whether or not care or social services will be provided. This also ensures that the people giving the care follow a certain set of rules called the ‘care value base’.

Local Authority resources can be taken into account during the assessment process, but if it is deemed that services are required, then those services must be provided ‘by law’: services can't be withdrawn at a later date if resources become limited.

The NHS and Community Care Act in 1990 split the role of health authorities and local authorities by changing their internal structure, so that local authority departments could:1. Assess the needs of the local population and then purchase the necessary services from

‘providers’.2. To become 'providers' in the internal market, health organisations became NHS trusts,

competing with each other. This means encouraging the independent sector and private nursery or residential homes.

3. Community care ensures people in need of long-term care are now able to live either in their own home, with adequate support, or in a residential home setting for short stays as much as possible.

4. Introduced mixed economy of care5. Ensured that the needs of carers was also taken into account, such as rest bite homes,

day breaks, short holiday finance for both carer and client. 6. Clarified the roles of NHS and Social Services more clearly.

Department of Health

Strategic Health Authorities

NHS TrustsPrimary Care

Trusts

The NHS is divided up into several sectors

Strategic health authorities

There are currently 28 in England each is responsible for the health of the population of the area. They develop strategies for health services and manage the NHS trusts

Special health authorities

These are specialist bodies which are part of the NHS; ambulances and the NHS Direct service are examples. They are accountable to the Department of Health and have to produce an annual report.

Secondary services – they were set up in 2004 following the Health and Social Care (community health and standards ) Act 2003

Secondary health care is the service that is generally provided in or by general hospitals. It is usually provided by a specialist following a referral from a GP or other primary care practitioner. Travelling distances increase for patients receiving secondary care as the more specialised the services, the further people usually need and are prepared to travel for treatment.

Primary care services - since 1999

Primary health care is the term used for the activity of a health care provider who acts as a first point of consultation for all patients. Examples include GP services, dentistry services, ophthalmic services and pharmacy services. About 90% of all patient contacts with the NHS occur in primary care.

Adults and Older people Babies and Young Children People with Mental Health problems

Hospital – Out patients, In patients

Maternity services Group therapy

Mental Health – community services (CPN)

Dental care Drop-in day centre

Health promotion – smoking, obesity, alcohol, sexual health, Drug team

Physiotherapy Secondary care – in-patients care, out patients care, community mental health team (CMHT)

Specialist services – stroke Hospital services - out patients and in patients

Therapists – music, art

Diagnostics tests – x-ray, blood tests

Child psychology Day hospital

Intermediate care – (jointly with social services)

Speech therapy Behavioural psychologists

Occupational therapy Eye services Psychotherapists

Physiotherapy Primary health services – GPs, practice nurse, school nurses, health visitors

Primary care – GPs ,CPN

Primary health care – district nurses, GPs, practice nurses, Pharmacists, Dentists,

Child protection services (jointly with education and social services)

Counselling

Podiatry NHS Direct on-lineNHS Walk in Centre

Self-carePharmacists

Rehabilitation

Family planning

Intermediate care services

Out-of-hours services

Intermediate can help you to stay independent, or regain your independence if you’ve recently been in hospital and are now back at home.

That might mean supporting you at home, or in a residential care home, so that you don't have to go to hospital. Or it may mean helping to get you home after a hospital stay. PCT’s and social services work together to provide this service.

The NHS pledges to provide services at a time that's convenient for you. Outside normal surgery hours you can still phone your GP surgery, but you'll usually be directed to an out-of-hours service. The out-of-hours period is from 6.30pm to 8.00am on weekdays and all day at weekends and on bank holidays.Alternatively, you can call NHS Direct on 0845 4647 (24 hours a day, seven days a week) for medical advice. Telephone consultations and triage (an assessment of how urgent your medical problem is) are an important part of all out-of-hours care.  Since 2004, GPs have been able to choose whether to provide 24-hour care for their patients or to transfer responsibility for out-of-hours services to primary care trusts (PCTs).

www.nhs.uk/Livewell/Staywellover50/Pages/Intermediatecare.aspx

NHS direct Walk in Centres

NHS Direct is here to make a difference to the lives of people in England, 24 hours a day, 365 days a year…We’re here for you whenever you have health worries and we have the knowledge and experience to give you real help and reassurance.If you want health advice and information, call us on 0845 4647.

NHS Direct's visionTo be the national healthline, providing expert health advice, information and reassurance, using our world class telephone service and website, and to be the NHS’ provider of choice for telephone and digitally delivered health services.

Walk-in centres NHS walk-in centres (WiCs) offer convenient access to a range of treatment. WiCs are managed by primary care trusts (PCTs). There are around 93 centres in England, dealing with minor illnesses and injurieThese include:•infection and rashes, •fractures and lacerations, •emergency contraception and advice, •stomach upsets, •cuts and bruises, and •burns and strains.

www.nhs.uk/Livewell/Staywellover50/Pages/Intermediatecare.aspx

Types of out-of-hours careOut-of-hours cover may include some or all of the services below:GPs working in A&E departments, NHS walk-in centres or minor injuries units (MIUs). Teams of healthcare professionals working in primary care centres, A&E departments, MIUs or NHS walk-in centres. Healthcare professionals (other than doctors) making home visits, following a detailed clinical assessment. Ambulance services moving patients to places where they can be seen by a doctor or nurse, to reduce the need for home visits.

Each PCT is also establishing new GP -led health centres that will offer both walk-in access and bookable appointments, regardless of where the patient is registered, from 8am to 8pm, seven days a week.

Task 3 – AfL - QWC you will be assessed on the quality of your written understanding and use of research and key terms

Find out what services your local GP offers.

A practice booklet is often produced. Decide if these services meet the

needs of the local community in Pocklington.

Write up your own views, use prose and decide using up to date information why the NHS has reduced or increased certain provisions

Personal social services There is no clear or coherent category

of 'personal social services', which cover both social work and 'social care', services to people which fall outside the remit of health services.

In Britain, these departments have developed as a residual category of services not provided by other services. The categories include:

Acts of parliament have made central and local government in England and Wales responsible for the provision of the a wide range of social services

Mentally ill people

Disabled people Education and children

Elderly people

1. Parliament have made central and local government responsible for the provisions of the wide range of social services.

2. Councils have a duty to keep certain records, for example they keep a register of sick and chronically disabled people who are in their area.

3. They have a duty to provide accommodation for certain groups such as mentally ill clients.

4. Councils also have powers to decided what level of service they will provide and the charges they will make for the services. Social services are monitored on performances and spending by central government by the Commission for Social Care Inspection. Some services related to education and children, such as child minding and nursery school provisions are monitored by the Office of standards in Education (OFSTED)

Task Case study Social services and the case about

Ryan

You are requested to read the case study notes and enter into a scenario of central government/local authority social services.

Answer these questions truefully from what you have read.

Ryan http://www.bbc.co.uk/

news/uk-england-birmingham-13885392

Guest speaker – child protection officer Beverley Wilkinson – working on child protection in the Metropolitan police London

You can confidentially talk to us (Contact Us) or talk to one of the following independent organisations:ChildlineBullying UKKidscapeThe NSPCC

Task 4 - From this information can you write up a short newspaper report highlighting the failings of the system and who you think is partly to blame.

AfL – you will be asked to assess each others report.

Case study Fourteen agencies missed opportunities

to save a three-year-old boy who was killed by a couple who were meant to be caring for him, a report has found.

Ryan Lovell-Hancox died on 24 December 2008 from a brain injury he received at Christopher Taylor and Kayley Boleyn's home in Bilston, near Wolverhampton.

They were jailed for murder and child cruelty in July 2010.

A serious case review by Wolverhampton Safeguarding Children Board said staff may have been "overburdened".

Ryan received more than 70 injuries from the defendants who blamed each other for his death.

The review found that several agencies, including the police, council and National Probation Service, failed to intervene in the child's care.It criticised poor record keeping and said there was "no evidence of effective communication or liaison" between the agencies.

Wrong priorities The report found that a front line worker took the decision not to take further action in Ryan's case, instead of a senior member of staff.It said that in future all such decisions should only be taken by supervisors or managers.About 60 recommendations were made, including that Wolverhampton City Council should review its child assessment procedures and ensure files from all agencies were checked for relevant family information on all children brought to its attention.It also said that potentially at-risk children must be physically seen by staff and all people providing support to a child's family must be adequately checked.

Bill Anderson, chair of the Wolverhampton Safeguarding Children Board, said the agencies involved in Ryan's care had the wrong priorities.He said: "They were focusing on the adults they considered to be vulnerable but they didn't put the focus on that child."http://www.bbc.co.uk/news/uk-england-birmingham-13892076

What is meant by 'Safeguarding Children'?

protecting children from maltreatment preventing the impairment of children's

heath or development ensuring that children are growing up in

circumstances consistent with the provision of safe and effective care; and

undertaking that role so as to enable those children to have optimum life chances and enter adulthood successfully

Web-links

http://www.publications.parliament.uk/pa/cm200809/cmselect/cmwelaf/56/5605.htm

http://www.nhs.uk/NHSEngland/thenhs/about/Pages/authoritiesandtrusts.aspx

http://www.newstatesman.com/blogs/the-staggers/2011/03/nhs-spending-ifs-inflation