NHS and social care Flashcards
When and by who was the NHS founded?
1948
Aneurin Bevin
Where does the funding for the NHS come from?
- Largely comes from general taxation
- Income tax
- National Insurance contributions
What are the aims of the department of health?
Improving the health and wellbeing of people in England
Set overall strategic direction of the NHS
Set national standards to improve quality of services
Securing sufficient funds from overall gov spending
Working with key partners to deliver the best quality care
Describe NHS England
- Led by a board of exec and non-exec members
- Headed by Chief Exec, Simon Stevens (stepping down to become a Lord)
- Replaced by Amanda Pritchard
- NHS England oversees the budget, planning, delivery and running of the NHS
- Has now effectively merged with NHS Improvement
- Commissions most services via Clinical Commissioning Group
Describe Clinical Commissioning Groups
- Responsible for 2/3 of NHS England budget- £73.6m
- Assess local health needs and commission services from providers- hospitals, pharmacists, dentists, physio, mental health care and other
- Providers can be NHS Trusts, charities or private sector organisations such as Virgin Care
- Made up of GP doctor surgeries
- Led by an elected governing body made up of GPs, other clinicians including a nurse and a secondary care consultant, and lay members
- Independent, and accountable to the Sec of State for Health through NHS England
- Responsible for the health of populations ranging from under 100,000-900,000, although their average population is about a quarter of a million people
What are hospitals like at a local level?
- Managed by NHS Trust (acute trusts)
- Run by board of directors responsible for running of hospital, ensuring quality and efficiency
- Some have special status as Foundation Trusts with greater autonomy and are accountable to local people through the election of board members
- Trust also run other services including ambulances and mental health care
Describe the National Institute for Health Protection (NIHP)
-Shake up public health as a result of Covid pandemic
-Public Health England abolished
-NIHP takes on UK wide responsibilities for health protection from PHE and NHS Test and Trace
-Aims to tackle the challenges posed by domestic and global threats to health
-Works with local health protection teams to deal with infections and other threats and provides support and resources for local authorities to manage local outbreaks
-Handles emergency response and preparedness to deal with the most severe incidents at
national and local level
Describe the Directors of Public Health
-Each local authority has a Director of Public Health
-Provides leadership, expertise and advice on issues, from outbreaks of disease and emergency preparedness through to improving the local people’s health and access to health services
Provides public with expert, objective advice on heath matters
Works with directors of children’s services, adult social services, and with NHS colleagues; contributes to health sector planning to protect the local population from risks to its health
Describe the National Institute for Clinical Experience (NICE)
- Set up by the Labour gov in 1999
- Responsible for deciding which drugs and treatments should be available to patients on the NHS
- Draws up guidelines for doctors
- Aims to eliminate the ‘postcode lottery’ in medical care
- Decisions by NICE only apply in England and Wales- sometimes adopted in NI and Scotland
Describe the Care Quality Commission
-Watchdog body which combines functions of-
Healthcare Commission
Mental Health Act Commission
Commission for Social Care Inspection
-Inspects hospitals, health centres, dentists, GPs, mental health services, care homes, homecare services-
Rates services from outstanding to inadequate- requiring special measures
Inspection reports published on CQC website
-Carries out annual assessment on state of NHS nationally
Describe Healthwatch England
- National independent consumer champion for health and social care, working with a network of 152 local Healthwatch offices
- Patients can have their say about NHS
Describe the health and well-being boards
- Formed by all 152 local authorities to bring together all commissioners of health and social care in each area
- Along with local reps of Healthwatch to promote integrated approaches to improving health
- Boards include elected councillors and directors and public health
What are some of the issues facing the NHS?
Funding Pay Waiting times Staffing Impact of Covid- lack of PPE and compulsory vaccinations Social care
Describe adult social care
- Aids range of personal social services
- Close collaboration with the local housing authority and the with the NHS, through joint planning and join funding arrangements
Describe Community Care
- National Health Service and Community Care Act 1990
- New system of community care- major new responsibilities on local social services authorities
- Allow people to continue living in the community in their own home rather than in institutions
- Applies to elderly and people with physical and mental disabilities
- Criticised in early years because of lack of support in community
- High profile stories of isolated cases of mentally ill patients attacking members of the public
What does the state provide when it comes to social care?
-Social services assess the needs of a person requiring care
-Make arrangements to provide suitable services
-Within the limit of the resources available
-Every “client” has care plan to meet needs:
Holidays
Home modifications
Aids for daily living
Employment doe disabled people in sheltered workshops
Day centres
Domiciliary care
Describe domiciliary care
- Help ranging from visits to washing dressing and putting to bed etc.
- Mostly provided by agencies
- Commissioned and monitored by social services
- Client may have to contribute financially
- Attendance allowance
Describe residential care
- Care homes
- Nursing homes
- Need assessed by key worker
- Residents make contribution to care
- Income also taken into account- leaves resident with approx. £23/week
What are some of the issues faced by the social care sector?
-Finance cuts and rising charges for care
-Standards of home care
-Quality of care in care homes and hospitals
Inspections by CQC
-Closure of care homes due to financial pressure
Southern Cross
-Pressures of aging population and higher rates of dementia- COVID lowered average age a lot
In a two-tier council or a unitary authority, what would a county council provide when it comes to education and children’s services?
-Provides support for children and families
-Families assigned key social worker
-Identifies need to provide support
Respite care
Holidays
Parenting class
What would a local authority provide when it comes to education and children’s services?
-Children’s services sometimes called the “Cinderella service”
-Criticism of social workers-
Inadequately trained
Hard to recruit
Under-resourced
What is the Children Act 1989?
-When matters come to court the paramount consideration is the child’s welfare and that courts should only make orders if doing so would be better for the child than making no order at all
-Courts can make 4 types of orders:
Residence- settling with whom the child should live
Contact- allowing visits or contact with a named person
Specific issue- e.g, attending a specific school
Prohibited steps- forbidding specified actions by the parent in relation to the child
-Local services authorities must provide accommodation for any child who needs it
What are court supervision orders?
- Aimed at keeping child in family home
- Enables social services to supervise parents or guardian closely
- If child is likely to suffer significant harm from receiving care of a standard below that which would be given by a reasonable parent
- The child is beyond parental control
What are care orders?
- Authority assumes parental responsibility
- Must allow parents reasonable access unless it is explicitly prohibited by the courts
- Local Authority has the power to determine the degree of contact
What are emergency protection orders?
-Fast track order-
Gives the parent’s responsibilities to another person, usually the social services authority
If child is in immediate danger
If child is likely to suffer considerable harm
Limited to 8 days but can be extended for a further 7 days
What are secure accommodation orders?
- SAO can restrict the liberty of a child in their care by placing them in secure accommodation
- Limited life
- Not more than 3 months
- Renewed by the court
What is fostering?
- Temporary care by foster parents
- Adoption is permanent
What are local education authorities in unitary authorities (like Liverpool) responsible for?
Children’s services
What are the local education authorities in a two-tier system (county council or district) responsible for?
Education Development Plan Building of new schools and closures School Transport School Meals Can step in to run schools directly in crisis
What are LEA maintained schools?
-Funding developed directly to schools but channelled though local authorities
-Dedicated School Grants
-Local management-
Power to control budget devolved to school
Some schools employ bursars to run budgets
What is a national curriculum?
- Nationwide curriculum for primary and secondary state schools
- Independent and free schools exempt
- Academies can deviate from the National Curriculum
What does a school governor do?
-The day-to-day running- governing body-
Extent of powers vary according to type of school
Can consist of businesspeople, staff, parents (elected) and reps from local authority
Appoints teachers
Controls the school budget
What is a community school?
Maintained by local authorities- teachers employed by local authorities and building owned by them as well
What is a voluntary controlled school?
Maintained by local authorities but with involvement of other e.g faith groups
What are specialist schools?
Provide specialist services for students with particular needs
What are grammar schools?
State or independent schools which select based on ability
What are academy schools?
State schools outside of local authorities
What are free schools?
Newly created schools outside of local authority control
What are academies-State-maintained schools?
-State-maintained schools
-Outside of LA control
-Get funding direct from central gov
-Aim was to tackle failing secondary schools
-Gov has now extended option to all schools
-Schools become company with charitable status
-Some schools can have sponsors
Critics say this amounts to privatisation
-Free to determine their own rates of pay and conditions for staff
-Aren’t bound by the national curriculum
-Can determine their own spending
-Can change length of school say and terms
What is a traditional academy?
Former poorly performing schools
Set up by providers- unis, FE colleges education charities, businesses
Group must form a charity and not make a profit
Held accountable through their funding agreement with the gov
What are converter academies?
Usually high performing schools which opt out of LA Set up by existing state schools Run by governing body Outstanding schools fast tracked All schools can apply
What is OFSTED?
-Inspects all state schools and some independent schools
-Reports rate the standard of school and can put in school in “special measures”
-Also inspects-
Early year services
Childminders
Prison education
Institutions caring for vulnerable young people
