LO B Flashcards
Define a Public Sector organization?
The Public Sector organisations are financed and directly managed by government. The public sector health services and systems of organisation in the four countries that make up the UK generally work independently of each other, but there is no discrimination when individuals/service users move from one part of the UK to another. These four services are – National Health Service England (NHS), NHS Scotland, NHS Wales, Health and Social Care in Northern Ireland
Who provides Primary Health Care?
Primary Health Care is provided by GP’s, Dentists, opticians, pharmacists etc. The are services normally accessed directly by the service user as the need arises
What is Tertiary Health Care?
Tertiary Health Care provides specialist, and normally complex, services. For example specialist spinal injury units or hospice support. Referral to these services is by health professionals who have identified the need
What services are regarded as Secondary Health care?
Secondary Health Care includes most hospital services, mental health services and many of the community health services. These are normally accessed via the GP using referral. However, members of the public and emergency services have direct access to accident and emergency services of hospitals.
Who finances the NHS?
Who Manages an NHS trust?
NHS Foundation Trusts – established in 2004. Independent health services, largely financed by government, that manage the delivery of hospital services, mental health services and community health services in England.
They are managed by a board of governors, which may include patients, staff, members of the public, partner organisations.
The aim is to move decision making from a centralised NHS to local communities.
What do Mental Health foundation trusts do?
Mental Health Foundation Trusts provide specialist support and are managed by the community including people who use mental health services. Patients, families, friends. Local organisations and local residents can become members of the foundation. Members then elect governors who have responsibilities for a range of care.
The services provided include psychological therapies, support of psychiatric nurses and specialist support for people with severe mental health problems
What do Community Health Foundation Trusts do?
What services do they provide?
Community Health Foundation Trusts work with GPs and local authority social services departments to provide health and care support.
The services provided by the trust may include;
Adult and community nursing services
Health visiting and school nursing
Physiotherapy, occupational therapy, speech therapy
Palliative/end of life care
Walk in/urgent care centres
Specialist services eg diabetes management, sexual health
What services does Adult Social care provide?
Adult Social Care is the responsibility of local authority social service departments. It is provision for people over 18 who have disabilities, mental health problems who are otherwise frail and unable to support themselves without specific and planned assistance.
The support provided can include;
Care in service users home e.g. cooking, cleaning, shopping etc
Day centres to provide care, stimulation and company
Sheltered housing schemes
Residential care
Respite care
Training centres for adults with learning disabilities
Who is responsible for Childrens services?
What do they do?
Children Services are the responsibility of local authorities. They are to support and protect vulnerable children and young people, their families and young carers. This requires multidisciplinary work.
Support can include; Services to safeguard children Day care for children under 5 and after-school support for older children Help with parenting skills Practical help in the home Support of a children’s centre Arrangements for fostering/adoption
Who funds GP practices?
What impacts the amount of funding the GP receives?
GP Practices are funded by central government as part of the National Health Service according to their assessed workload from their patients. Funding looks at age of patients, gender, levels of morbidity and mortality in the area, number of people in residential or nursing homes, patient turnover.
Additional funding can be granted by the NHS for high quality service, providing additional services e.g. flu jab, GPs length of service, support the cost of premises and equipment, cover additional costs if the GP practice also dispenses medicine.
This is often the first point of access whose role is to make initial diagnosis and refer to specialists if necessary. The GP and their team use holistic approach and multidisciplinary teams
What are Voluntary Sector organisations also known as?
Who can they support?
Voluntary Sector is often known as charities. Voluntary organisations vary greatly in size, history and the services they provide. There are the well-known groups – Shelter, NSPCC, Samaritans and some very small organisations that are run purely by volunteers for a specific need or particular local community.
Voluntary groups often rely on donations but may also receive support from central or localised government.
The services are managed independently from government, but government departments may sometimes pay charities to provide local services on their behalf for example NACRO (the National Association for the Care and Resettlement of Offenders) receives government funding for their work with offenders.
The key features of a voluntary organisation are;
Not run for personal profit, any surplus income is used to develop their services
Usually use volunteers for at least some of their services
Managed independently of central government or local authorities
NCVO (the National Council for Voluntary Organisations) is the body that supports and promotes the work of the voluntary sector
How is Private Health care funded?
What services can they supply?
Private Sector health and care provision is managed by commercial companies. These are organisations that need to make a profit to stay in business. Private care providers work in all sectors, including the provision of;
Private schools
Nursery and pre-school services
Hospitals
Domiciliary day care services
Residential and nursing homes for older people
Mental health services
Private sector companies often provide services for central government and local authorities
They are funded by;
Fees paid directly by service users
Payments from health insurance companies e.g. Bupa
Grants and other payments from central and local government for services provided on their behalf
What sort of services can a hospital provide?
Hospitals provide inpatient and outpatient services. Outpatient – regular clinics, day surgery, specialist daytime care. Inpatient – treatment which needs 24 hour specialist support.
When a service user is referred to a hospital for specialist care, they have a right to choose which hospital they wish to attend as well as the consultant they would like to see. In hospitals, clinical departments are organised according to medical speciality
What types of clients can be supported by Daycare Services?
Day care centres/units are normally provided for specific client groups. In most places there will be day centres for older people, for people with disabilities, learning difficulties, mental health problems and specific conditions such as dementia or visual impairment. The provision is designed to provide a friendly, stimulating and supportive environment for people who otherwise would be socially isolated. They normally offer educational facilities to help with employment. They can be run by statutory, voluntary or private providers.
What sort of clients does Hospice care support?
Hospice Care aims to improve the quality of life for people who have an incurable illnesses. Care may be available from the moment of diagnosis through to the end of life. Hospice care is holistic focusing on PIES and the practical needs of the individual, their family, and carers. Care may be extended to support during the bereavement period
What sort of service is provided by Domically Care?
Domiciliary Care is provided in the client’s home. The care can be short-term, for example after coming out of the hospital or a family with a new baby or long-term, for example, for a service user with a disability or a frail older person.
This support can vary from a drop-in visit a day to 24-hour care, providing support with domestic tasks and intimate personal care. It looks to ensure service users are able to live as independently as possible in their own homes.
What is Residential Care?
Residential Care is the long-term care of adults or children needing 24-hour care that can not be adequately or appropriately provided in their own home. They are usually specialist units providing care for specific client groups e.g. mental health, learning difficulties, elderly. There are two types of care homes – Residential care homes providing help with personal care e.g. washing, taking medication, and Nursing homes which provide personal care but also 24-hour nursing care by a qualified nurse, who may contribute to a care planning cycle
What sort of care is provided by the Workplace?
The workplace – Occupational health services aim to keep the workforce fit and healthy so they can carry out the roles they are employed for. These services are normally provided by the employer and can include access to nurses in the workplace, and referrals to counselors for work-related stress or physiotherapists if there are issues with posture or repetitive strain injury caused by the job.
What is self referral?
Self-referral – when a person contacts a care provider personally. Access to primary healthcare services such as doctors, dentists, and opticians is normally through self-referral.
Third-party referral – when a friend, neighbour or relative contacts a health or care service e.g. a neighbour may contact social services on behalf of a frail elderly neighbour. These referrals are usually to services that are accessible through self-referral.
Professional referral – when a health or care professional contacts another service provider to request support for service users e.g. headteacher referring a child to an educational psychologist or GP to a hospital consultant
Who should be carrying out assessments if somebody is finding it hard to look after themselves?
Assessment;
Local Authorities have a duty to carry out a community care assessment for anyone finding it difficult to look after themselves independently, usually by the adult services department. This is when there is a professional assessment of care needs to provide help and advice in accessing necessary services.
If there are informal carers involved they are also entitled to a carers assessment to address what support they need.
What is included in a needs assessment? (what areas of life?)
In order to decide entitlement of support from the local authority an assessment is carried out by a social services department assessor. In order to get support they must have a physical/mental impairment/illness and an inability to achieve two of the following;
Prepare and eat food, wash themselves/clothes, manage toilet needs, dress appropriately, move around home with ease, keep their home clean and safe, avoid social isolation, access work, training or education, use local facilities e.g. shops, carry out caring responsibilities e.g. caring for children.
Social Care is not usually free and a financial assessment is carried out to decide if and how much the individual has to contribute to the care.
Who is able to represent a client’s views or interests?
Charities and Patient Groups – Many represent services users when they need to contact and liaise with official agencies e.g. Shelter represent people with housing problems and will represent them when applying for housing benefits or negotiating with landlords.
They can also act as pressure groups and campaign on behalf of the individuals they represent e.g. NSPCC campaigns to encourage the government to introduce policies and laws that support the protection of children
What is a whistleblowing policy used for and why?
Whistleblowing Policies - are organizations are required to have a whistleblowing policy. This provides protection for staff who tell the press or other organizations outside of the setting that the quality of care is dangerously poor.
These procedures can be a form of protection for all staff. If the quality of care is poor, and this is going unchecked, whistleblowing will protect service users, staff and sometimes the provision itself as poor practice damages the reputation of the sector.
It may lead to investigation, inspection and in extreme cases the police being involved. Poor practice should be checked and remedied by the organisation through its policies and practices
What does an advocate do?
Advocacy – If a client has a serious communication problem, an advocate may speak on their behalf.
In health and care settings advocates are usually volunteers. They work with individuals getting to know them and building a trusting relationship so they can accurately represent them.
What is the role of a complaints procedure?
Complaints Policies - All care settings must have formal complaints procedures. The settings have a responsibility to ensure understanding of how to use and access the complaints procedure. The procedure and outcomes of any complaints will be checked whenever the setting is inspected.
If a service user complains, they have a right to;
Have a com[plaint dealt with efficiently and in a timely way,
Have their complaint formally investigated,
Be told the outcome of their complaint.
What is the role of CQC?
It is responsible for monitoring and inspecting health services and adult social care services in England. It aims to ensure high-quality provision that is delivered safely, effectively, and compassionately. It monitors and inspects; NHS and independent hospitals GP Provision Clinics (family planning, slimming, etc) Dentists Residential Care Homes/Nursing Homes Domiciliary Community Care Provision Mental Health Provision Accommodation for people requiring treatment for substance misuse
All providers of these services must register with the CQC
How are inspections carried by CQC?
How regulations and inspections are carried out;
When a service provider applies for registration checks are carried out to ensure it meets safety standards, has the resources to ensure high standards of care. Once registered they are continually monitored.
Inspectors are drawn from a range of backgrounds and make judgements supported by robust evidence on the quality of provision, where care provision is safe, it is effective, well-managed and well-led.
Evidence for this can include;
Feedback from service users, relatives, friends and staff,
Written reports of care practice and procedures,
Records of complaints,
Observations
How do people respond to inspections by CQC?
Response to regulation and inspection;
Inspections are stressful and can identify weaknesses managers were not aware of. They can cause feelings of vulnerability, anger, and inadequacy.
To support providers clear guidance that outlines what they expect to see is published. The CQC publishes the outcomes of each inspection with a grade according to the quality of care provided
What changes in working practice can be required by inspection?
Changes in working practice required by inspection;
Following an inspection when practice does not meet the required standards, the regulator can enforce change which may include
Requiring/recommending improvements to policy and practice in specific respects e.g. sharing good practice
Issuing a requirement notice or warning notice
Limiting the range of care they are allowed to provide
Criminal prosecution in extreme cases.
Who are NICE?
The National Institute for Health and Care Excellence (NICE)
NICE is responsible for providing guidance on current best practice in health and social care. it publishes guidance and advice that aims to control and improve health and social care provision. It provides;
Guidance on the most appropriate treatments for specific conditions,
Evaluations of whether procedures are safe and effective enough to be used,
Guidance about the use of specific health technologies and procedures
Assessment of cost and effectiveness
Recommendations about best practices based on most recent research
Support for health promotion campaigns and healthy living advice
Smooth transition for service users moving from health care providers to social care provision
Who are PHE?
Public Health England (PHE)
PHE aims to protect or improve the health of a community or population, for example flu vaccination programmes. It undertakes measures such as;
Health promotion programmes/campaigns e.g. ‘Be Clear on Cancer
Research projects to improve knowledge and generate strategies
Take measures to protect nations health when there is a public health concern e.g. an epidemic or a new virus
Who are OFSTED?
The Office for Standards in Education, Children’s Services and Skills (Ofsted)
Regulates and inspects services that educate children, young people and adults or care for children. They inspect state funded schools and colleges, adult education providers, initial teacher education, private agencies that provide training e.g. apprenticeships, education provision in prisons and the armed forces, nurseries, pre-schools, childminders, fostering and adoption agencies, residential care settings for children.
They make judgements relating to;
Effectiveness of leadership and management
Quality of teaching, learning and assessment,
Personal development, behaviour and welfare
Outcomes for children and learners
Following an inspection Ofsted publish a report with an overall judgement of 1-4 and recommendations for improvements before the next inspection
Who are the NMC?
The Nursing and Midwifery Council (NMC) is responsible for regulating the standard of professional practice of all nurses and midwives in the UK whether they are in paid employment or volunteering. It sets high standards for;
Initial education and training,
Continuing professional development
Standards of professional practice
Standards of personal conduct, both at work and in private life
Nurses and midwives have to provide evidence of CPD to remain on the register.
The NMC investigates allegations of those not meeting the standards and they have the right to restrict their practice (e.g. can only work under supervision) or can remove them from the register meaning they are no longer permitted to practice
Who are the RCN?
The Royal College of Nursing (RCN) is not an inspectorate or regulator of nursing practice, it is the worlds largest union and professional body representing the nursing profession. It aims to maintain a high standard in nursing by providing education and research activities
Who are the HPCP?
The Health and Care Professions Council (HCPC) exists to promote good practice and protect the public from poor standards of care. It regulates 16 professions including physiotherapists, speech therapists, social workers and paramedics.
To register and become an approved practitioner you must;
Have the relevant qualifications
Meet the standards of professional practice and personal behaviour required by the council
It investigates complaints of misconduct and can suspend or permanently remove people from the register.
Who are the GMC?
The General Medical Council (GMC) registers and regulates doctors. It is responsible for;
UK medical education and training
Deciding which doctors are qualified to work in this country
Setting standards to be met in professional practice
Taking action to address shortfalls that put patient’s safety at risk or brings the medical professions into disrepute
When serious concerns are raised, they are investigated and if upheld the GMC can restrict their practice or remove them from the register.
What must organisations do according the Health and Social Care act 2008?
Implementing the Organisation’s Code of Practice
The Health and Social Care Act (2008) require that registered providers of care services must ensure they have a sufficient number of appropriately qualified staff to meet the needs of their service users at all times. They must also provide support, training and professional development to ensure staff can carry out their role.
In social care settings new staff are required to complete an induction programme to meet Common Induction Standards (2010) within 12 months of starting.
What are the National Occupational Standards?
Meeting National Occupational Standards (NOS) describe best practice that is to be met in the UK health and social care sector.
NOS underpins the code of practice in care settings and the curriculum for the training of practitioners and cover the standards that are also included in the codes of practice for professional bodies.
What is CPD?
Undertaking Continuing Professional Development (CPD)
To retain the high standards required of the sector practitioners need to continually update their skills. This will ensure that they are following the best practice and most up-to-date procedures, based on recent research. All members of the GMC, NMC and HCP are required to complete regular professional training to remain registered.
It is the responsibility of care managers to ensure that support staff who are not members of the professional organisations regularly update and extend their skills
Why do organisations have a complaints procedure?
All Care organisations are required by their regulators to have a formal procedure to address complaints. Where allegations of poor practice are made, this will normally be initially addressed through the organisations internal disciplinary systems. However in more serious instances the regulatory body e.g. GMC may be involved. In extreme circumstances e.g. death caused by negligence the police will be involved.
What is the role of trade unions and professional associations in HSC?
Membership of trade unions/professional associations
The role of these is to support practitioners who stand accused of professional misconduct or are in conflict in other ways with their employer. Some examples are;
British Medical Association (BMA) – Doctors
Royal College Nursing (RCM
UNISON – Social Workers
Why should staff follow the professional standards set by the regulatory bodies?
Following protocols of regulatory bodies
Protocols are accepted codes of practice and behaviour required of professionals by their regulatory bodies. These bodies also provide protection for employees by ensuring that the standards expected of them are clear and transparent. As part of their induction and ongoing training health and care practitioners must fully understand their professional responsibilities and the protocols by which they must practice.
