care practice and provision

Unit 10-Charlottes work

A01

Care, practice and provision

Services, which the PCT’s provide depend on what the general publics needs, are. The service Organisations such as NHS and Social services use information from national targets and priorities such as the new smoking ban and also from local population needs, gathered from demographics from that area. That information is then weighed up taking into consideration where the information has come from so as they can determine what services to buy. A plan is then made to organise services, set local targets and to buy services with the money provided by Tax.

The people who produce the plan are the called the stakeholders, these are statutory government funded organisations such as the NHS and the social services. There are four types of services, these being;

Public

This is statutory and owned by the public e.g. NHS

Private

This is privately owned and is out to make a profit e.g. Nurseries

Voluntary

This is where people will voluntarily work for health and social care organisations e.g. charities

Informal

Informal services will be those who are not paid e.g. families who look after ill relatives.

They will then use the information collected by the local population demographics, determined through categories such as age, disability, unemployment, single parent, elderly or youth related needs E.g. in a local population of high disability will buy services to provide for that need such as equipment needed for paralyzed service users like a wheelchair. These are statistics of the local population collected by either the local county or the national 10-year census. The other place information is collected from is the national targets such as the smoking ban in 2007 and the high increase in teenage pregnancy’s. Members of parliament, which is then used to determine the needs of the country/population, set the national targets.

The NHS is funded by the government, which is funded by tax, the NHS then give the PCT’s all the money they need to be able to distribute the money out to various hospitals and GP surgeries. The PCT’s (Primary care trusts) are then responsible for all the money, all the people, all health issues, planning how the money is used and finally uses the money to buy services and equipment. The services are brought from the Acute trusts which are primarily hospitals so are then used to treat and look after patients.

Local demographics; Elderly and youth related care according to the demographics of an area.

Local demographics in the Taunton Deane area show that 6.3% of the population are 15 to 19 years old (teenagers) and 19% of the population are retired (over 65 years). These figures will determine what facilities and services are available in the Taunton Deane area. There are two types of services that both age groups will use. These being the large health care organisations i.e. hospitals and the smaller organisations such as transport services.

There are currently just over 3 times as many elderly people than teenagers in the Taunton Deane area. ()

As there is a huge amount of retired people in the area, all services will need to accommodate this. Firstly older people are more likely to need the larger services.

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As there is a huge amount of retired people in the area, all services will need to accommodate this. Firstly older people are more likely to need the larger services.

Hospitals- Elderly bodies are less able to heal than younger bodies; this is why more hospital beds and staff will be needed. There are many diseases and illnesses caused by age, which is why public services need to take the demographics into consideration when choosing what types of wards hospitals in that area need, what type of equipment and which members of staff are more likely to be needed, due to the populations age. Elderly are more likely to break bones that will not heal, so equipment needed to transport people to get to the toilet and to get washed will be needed i.e. a wheelchair or a hoist. The ratio of elderly wards to children’s wards will be compared to the ratio of elderly to young age demographics. In the Taunton Deane area there is more likely to be more elderly wards. The staff needed at hospitals where the elderly population is greater than the youth, will include;

Doctors- General health related problems
Nurses- Basic needs
Care workers- 24/7 care
Geriatrician- Specialises in elderly care
Physiotherapists- Muscle problems
Occupational therapists- Help with everyday life (aids that help the disabled)
Chiropractor/osteopath- Bone problems

Care Homes- These are specifically for elderly patients who need constant care, they will ‘live’ with other patients, and many of them will have age related diseases such as dementia or Alzheimer’s. They will be privately owned so will gain profit from their business. There can be many different types of elderly care homes, specific to different needs.

Day care centres- this service will provide clubs for all types of ages. Elderly can attend clubs such as the ‘stoke’ club. These are very helpful with elderly people keeping in contact with other people in a similar situation to them. They can enjoy the teaching/activities the club sets out for them to do as well as the social side.

G.P surgery’s- Elderly people will often be very vulnerable, they like to see familiar faces when in need, G.P’s help with discussing the needs of a patient but also in getting to know a patient and talking to them about anything. Elderly people are much more inclined to need someone to talk to-they maybe lonely (if widowed) or depressed and need a familiar face to help calm them. Health care assistants also work in G.P surgeries, they are also there to comfort and reassure elderly patients about any aspect of life.

However there are also smaller organisations/services that are specifically designed for elderly people. These are not necessarily health related but can help to prevent health problems occurring in elderly. Services that help transport elderly in wheelchairs or elderly who are disabled are extremely useful in ensuring people get out in the fresh air and see friends, go shopping and do normal everyday activities. Their maybe clubs available, which are specifically designed for elderly people to attend to stop them becoming depressed and lonely such as chess club or solitaire club. This doesn’t necessarily mean that only old people attend, just that elderly are more likely to join as it maybe something they are interested in taking up. Other small services include making sure O.A.P’s receive concession rates, bus passes are provided free of charge for elderly or simply cinema nights devoted to older people who generally enjoy older films.

Even though in the Taunton Deane area there are more people aged 64+ that 15-19 years, there still needs to be services provided for teenagers. Just like the elderly, there will be large services that will need to be provided for youth and the smaller services. The large services will include;

Hospitals- Unlike elderly diseases and illnesses it isn’t easy to predict what health related problems, teenagers will face. It is more likely teenagers will get sexually transmitted diseases; it is also likely that the more youth in an area the more drink problems will occur. The hospital may provide more equipment to deal with drink or drug related illness.
Day care centres- these can be useful for disabled teenagers, who want to socialise like others but are nervous of what people may think about their disability. Day care centres will provide clubs and fun activities for disabled teenagers to go and socialise with others who are in similar situations to them.
Orphanages- Orphanage take all children up to the age of 18. Orphanages are for children who have been abandoned by their parents or their parents have died. They offer a home for the children, support, finance and food.
Children’s care homes- Child care homes are similar to orphanages as in they provide food, support, security, warmth and love. However care homes are there as a temporary home for children. They work at finding the perfect family for the child in need. The child then moves in with that family on a potentially permanent basis. Care workers will work in these environments; they will work as the children’s temporary parents/guardians.
G.P surgeries- every person will have a G.P, general practioners will mainly deal with any pain the patient is experiencing. They will prescribe drugs/medicine to relieve pain and try to cure illness. They will also work with other practioners to help combat any further pain issues.
Nurseries in colleges/work- these are here to allow teenage mothers to continue with study once they have a child. This service is growing dramatically, proving extremely useful to teenage families.
Family planning clinics- Family planning clinics help to give teenage men and women advice as to planning and making a family. They will also provide free contraception to any person who asks.
Sexual health clinics- Sexual health clinics will provide advice related to sexual health, they will explain the uses of contraception and how they work. They may give teenagers options as to what they want to use. They will also ensure they maintain confidentiality, which especially young pregnant teenagers need. People who are specialised in sexual health will work in these clinics to provide safe and accurate advice to clients.
Colleges/schools- Teenagers will attend school and college to gain an education to be able to go and seek occupations that will suit their abilities and needs. Teachers, school nurses, supply teachers and teaching assistants will all work in schools to provide a useful service for children and teenagers. With a growing number of teenagers in a population a larger amount of schools and colleges will be needed.

The smaller services that most teenagers are likely to use are those of sport related. Clubs such as netball, hockey, rugby and basketball will all help towards keeping teenagers fit and healthy. By keeping them fit, they are often less likely to pick up illnesses and diseases. Doing sport also helps a persons self esteem rise; they are less likely to become withdrawn and depressed while doing regular exercise.

These figures have come from the demographics of Taunton Deane area. However, when services look at statistics to choose what services they need they will perform a lot of research. The researchers will look at national figures/statistics, possibly from the national census and other quantitive data that has been collected.

This graph shows a national census of England and Wales age population. This graph shows that in England and Wales roughly 6% of the population is ages 15-19years and roughly 15% of the population is 65 years+. As national figures these will not affect the service decision is Taunton Deane as much as local demographics will; however they still do have a part to play.

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The NHS

The NHS is one of the largest organisations in the world, and identified as one of the best organisations in the world. It was founded in 1948 and continues to develop through the 20th and 21st century.

PALS (Patient advice and liaison service) are very important in patient involvement in the NHS. PALS officers are there to help, support and advise patients, they are 100% necessary in the organisation of the NHS. They will also liaise with patient’s family and carers to discuss health related matters of either the patient or even them selves. They will confidentiality listen to any queries of problems the patient has or the carers/family of the patient have about the care and needs of the patient. If the patient has a complaint to make the PALS officer will be there to listen to the complaint or explain how the NHS complaint process if organised. The PALS officers are there to listen and advise patients and their families/carers.

The second part of the NHS process is called patient choice. If any changes need to be made in the care plan, i.e. a patient needs some more treatment that requires a specialist, the patient can choose where and when from a list of clinics they want the appointment to be made for. ‘This will include several local hospitals, NHS Foundation Trust hospitals across the country and a growing number of independent sector treatment centers and hospitals which have been contracted from the private sector to provide services to NHS patients’.

Patient and public involvement forums (PPIF’s). These make sure patients and the public has a say in day-to-day services in the NHS. They are very important to the NHS and are used in every single trust. They are specifically designed to monitor and review services in their area, search for views and opinions of the public about the services available and make appropriate suggestions as to the improvement of these services.

The final part of the NHS is the NHS foundation trusts. Whereas old trusts would be primarily owned and controlled by the government the foundation trusts are replacing the NHS for patients, public and staff. This will help in ensuring the best facilities and services are available for that specific community. The public can make a huge impact on the way the trust operates, to do this they will become a member or governor of the trust. Any member of the public or staff of the NHS can become a member, the members will then vote on a representative of that trust.

The second service that are used in care provision are the social services, these work in different ways to the NHS.

The local government structure is arranged in two different ways in England, Scotland and Wales. The first is a ‘single tier authorities’; this is where one council is responsible for all local authority functions throughout England, Wales and Scotland. The second way is through the ‘two-tier system’. This is where the rest of England uses separate councils, so they can divide the responsibility between districts and county councils. The ‘single tier’ authorities are split into categories throughout England, Scotland and Wales, these are; 47 English Shire Unitary Authorities (including Isles of Scilly), 33 London Boroughs (London also has the Greater London Authority), 22 Unitary Authorities (Wales) and 36 Metropolitan Authorities (England), Whereas the ‘two-tier system’ is split into three councils-district, county and local authorities. Local authorities will be funded in many different ways. The council tax only raise 25% of the total local authority therefore other funds is made from central government grants of which 48% of funding come from. The rest comes from non-domestic rate is a charge to business, which is set buy central government which raises 25% of funds.

The local government has changed throughout the 90’s. In England this change became a subject of debate. The independent local government commission (LGC) was formed, to look at the case for replacing the existing two-tier system. However the London and metropolitan England did not form part of the review. Although none of this actually happened, it was decided that all decisions were to be made according to the needs of the local area. The LGC then concluded after much debate a mixed system should be created. In some parts of the country the new system was put in place however it was decided that the existing two-tier system should be kept in some areas. The government accepted the commission’s recommendations. Due to new reviews taking place, the LGC recommended the creation of an additional eight unitary authorities; therefore the many changes were as follows;

Elimination of three new counties (Avon, Cleveland and Humberside) created in 1974 and their replacement with four unitary authorities in each case.
Elimination of the Royal county of Berkshire and its replacement with six unitary authorities.
The creation of 46 new unitary authorities in 22 counties, mostly with large towns and cities such as Bournemouth, Milton Keynes and Derby.

However Wales had a system of unitary government established by the passing of local government (Wales) Act 1994.