The roles of organisations in providing health and social care services

Question 1

What are the 3 different types of sector?

Answer 1

Public
Private
Voluntary

Question 2

Give examples of services in the public sector?

Answer 2

– NHS Foundation Trusts, to include hospitals, mental health services and community
health services
– adult social care
– children’s services
– GP practices

Question 3

Explain how the public sector is funded

Answer 3

The public sector organisations that provide health and social care services are financed and directly managed by the government. For example, the National Health Service is a public sector service. It is primarily funded by taxation and a smaller proportion of funds come from National Insurance contributions. The majority of the services available are free to service users when they need them, but they do pay for them through their regular tax and National Insurance contributions.

Question 4

What are the 4 public sector health services in the UK?

Answer 4

National Health Service England (NHS England)
Health and Social Care in Northern Ireland
NHS Scotland
NHS Wales

They generally work independently of each other, but there is no discrimination when individuals/service users move from one part of the UK to another.

Question 5

What 3 services do National Health Services in the 4 countries (UK) provide?

Answer 5

Primary health care
Secondary health care
Tertiary health care

Question 6

What is primary health care?

Answer 6

It is provided by GPs, dentists, opticians and pharmacists. Primary health care services are normally accessed directly by the service user when needed.

Question 7

What is secondary health care?

Answer 7

Secondary health care includes most hospital services, mental health services and many of the community health services. These are normally accessed via the GP, who makes an appropriate referral to a consultant or other healthcare specialist, such as a hospital physiotherapist, a psychologist or community nurse, and requests an appointment for further examination or specialist treatment. Members of the public and the emergency services have direct access to the accident and emergency services of hospitals.

Question 8

What is tertiary health care?

Answer 8

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.

Question 9

In England, what are hospitals managed by?

Answer 9

NHS Foundation Trusts which were established in 2004.

Question 10

What are NHS Foundation Trusts?

Answer 10

health services, largely financed by government that manage the delivery of hospital services, many mental health services and community health services in England.

Question 11

What are the aims of the NHS foundation trusts?

Answer 11

The aim of the NHS Foundation Trust is to move decision-making from a centralised NHS to local communities, in order to respond to local needs and wishes.

Question 12

What are mental health foundation trusts?

Answer 12

The services provided by a Mental Health Foundation Trust include provision of psychological therapies, the support of psychiatric nurses and very specialist support for people with severe mental health problems. These trusts are managed by the community.

Question 13

What do Community Health Foundation Trusts do?

Answer 13

Community Health Foundation Trusts work with GPs and local authority social services departments to provide health and care support.

Question 14

What services might be provided by Community Health Foundation Trusts?

Answer 14

• adult and community nursing services
• health visiting and school nursing
• physiotherapy and occupational therapy and speech therapy services
• palliative/end of life care
• walk in/urgent care centres
• specialist services, such as managing diabetes, sexual health or contraceptive services.

Question 15

What is palliative care?

Answer 15

Specialist care for people with serious illnesses, which aims to provide relief from symptoms and to reduce stress for patients and their families.

Question 16

What is the aim of the Community health foundation trust?

Answer 16

The aim of the Community Health Foundation Trust is to provide care for service users that will enable them to live as independently as possible in the community, rather than in settings such as hospitals or residential care.

Question 17

What is adult social care provision?

Answer 17

Adult social care provision is for people over 18 years of age who have disabilities, mental health problems or who are otherwise frail, due to age or other circumstances and who are unable to support themselves without specific and planned assistance.

Question 18

Give some examples of support that can be provided by adult social care services

Answer 18

> care in the service user’s own home – such as help with cooking, cleaning, shopping and a wide range of other personal daily needs
day centres to provide care, stimulation and company
sheltered housing schemes
residential care for older people, people with disabilities and people suffering from mental illness
respite care or short-term residential care provided principally to give families caring at home a rest and a break from their responsibilities
training centres for adults with learning difficulties.

Question 19

What has been established in some parts of the country and what are they responsible for?

Answer 19

Care trusts.
They are responsible both for the NHS mental health services and the local authority provision for people with mental illnesses.
Primary care trusts (PCTs) were launched to provide better continuity of care between the NHS provision and the social care support necessary for people with mental health problems.

Question 20

Who is responsible for children’s services?

Answer 20

The local authority

Question 21

What are children’s services aims?

Answer 21

Their aim is to support and protect vulnerable children and young people, their families and also young carers. The local council’s children’s departments are required to work in close collaboration with other care providers, and crucially with the NHS and the education services.

Question 22

What can support for children and their families include?

Answer 22

• services to safeguard children who are at risk from abuse or significant harm, including sexual, physical, emotional harm or neglect
• day care for children under 5 years old, and after-school support for older children
• help for parents and carers with ‘parenting skills’
• practical help in the home
• support of a children’s centre
• arrangements for fostering and adoption

Question 23

What are GP practices?

Answer 23

often the first point of access to health and care provision. GPs have an extensive knowledge of medical conditions and offer preventative healthcare. GPs work in local communities.

Question 24

What is the role of GP practices?

Answer 24

• Their role is to make initial diagnoses and to refer individuals to a specialist for further investigation and treatment.
• However, GPs increasingly work as members of multi-disciplinary teams, which may include nurses, health visitors and healthcare assistants.
• They also work closely with other agencies, including the education services, local authority social services and also the police.
• The GP and their team aim to use a holistic approach to care.

Question 25

How are GP practices funded?

Answer 25

They are funded from central government as part of the National Health Service. They are funded according to their assessed workload from their patients.
This includes:
- the age of their patients
- their gender
- levels of morbidity and mortality in the area
- the number of people who live in residential or nursing homes – this generates a higher workload
- patient turnover – newer patients generate more work than established patients

Question 26

What does the “assessed workload from their patients” include?

Answer 26

This includes:
- the age of their patients
- their gender
- levels of morbidity and mortality in the area
- the number of people who live in residential or nursing homes – this generates a higher workload
- patient turnover – newer patients generate more work than established patients

Question 27

Why might GP practices receive further payments from the NHS?

Answer 27

• if they are deemed to give a high quality service
• for certain additional services they may provide, such as flu immunisations
• for seniority, based on a GP’s length of service
• to support the cost of suitable premises and other necessary equipment, such as computers
• to cover additional costs if the GP practice also dispenses medicines.

Question 28

Describe the voluntary sector

Answer 28

Voluntary sector organisations are often known as charities. Voluntary organisations vary enormously in their size, history and the services they provide.

Question 29

Give some examples of voluntary sector organisations

Answer 29

Shelter
the NSPCC
the Samaritans
and some very small organisations that are run solely by volunteers for specific needs or for a particular local community.

Question 30

How are organisations in the voluntary sector funded?

Answer 30

Voluntary groups often rely heavily on charitable donations for their survival but may also receive support from central or local government.

Question 31

How are social services provided by the voluntary sector?

Answer 31

They are managed independently from government, but government departments may sometimes pay charities to provide services on their behalf. Charities often provide services for the NHS, adult social services and children’s services.

Question 32

Give some examples of social services provided by the voluntary sector

Answer 32

• MENCAP provides residential care, day care and educational services for people with learning difficulties, and service users can use their personal funding to access these services.
• Nacro (the National Association for the Care and Resettlement of Offenders) receives government funding for their work with offenders.

Question 33

What are the key features of a voluntary organisation?

Answer 33

That they:
▸▸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
▸▸are managed independently of central government or local authorities.

Question 34

Who supports and promotes the work of the voluntary sector?

Answer 34

NCVO (the National Council for Voluntary Organisations) is the body that supports and promotes the work of the voluntary sector. They have over 12,000 members that range from the smallest community group to the largest of the very well-known charities.