Unit 7: Meeting Individual Needs
7.1: Structure and provision of services
Four sectors for the provision of health and social care services:
- The public (statutory) sector
- The private sector
- The voluntary sector
- The informal sector
The public (statutory) sector
Includes the NHS – provides services in hospitals and in the community.
The NHS was set up in the UK in 1948, and is paid for through taxation and insurance.
Most services are free at the point of delivery.
Some services, such as dental services, prescriptions and eye tests, are charged for.
NHS and Community Care Act (1990)
Developed from two White Papers.
As a result of this act, several changes were made:
Social Services (SS) took the lead role for community care services
SS and social work departments had to produce care plans for their area
Department of social security stopped paying board and lodging for people in residential homes
Care managers were appointed by SS to assess people’s needs
Originally, services were just provided mainly by the statutory health and social care services. After the 1990s Act, services were provided by a range of agencies, such as voluntary and private care. This is the mixed economy of care.
Following the 1990s Act, inspections were introduced, provided by the council.
The Health Act (1999)
Primary Care Trusts were introduced.
Also allowed the introduction of:
Walk-in health centres
Increased use of day surgeries in health centres
Advice sessions in clinics
Wider partnerships, encouraging GPs to team up with pharmacists, counsellors and dentists to provide a range of services from one site
The NHS Plan (2000).
A ten-year NHS plan.
It set out a vision of health service designed around the patient.
The targets included:
7 000 extra beds in hospitals and intermediate care
Over 100 new hospitals
Clean wards overseen by modern matrons
Provision of better food
7 500 more consultants
2 000 more GPs
20 000 more nurses and therapists
Child care support services for NHS staff
100 on-site nurseries
As a result of these changes, waiting times for treatments should be reduced and long waits in A&E departments ended.
Structure of the NHS
The NHS is divided up into several sectors.
Strategic health authorities
28 strategic health authorities in England
Each authority is responsible for the health of the population in their area
They develop strategies for health services
Also, they manage the NHS Trusts in their area
Special health authorities
Specialist bodies are part of the NHS
Ambulance services and NHS Direct Service are examples
They are accountable to the DoH
Provided in or by hospitals, NHS Trusts
Trusts – created in 1991 under NHS reforms to provide hospital care, mental health care and specialist services
Some Trusts act as regional centres for specialist services, such as cancer
NHS Trusts are self-governing bodies with their own board of directors
They receive funding from the DoH and PCTs, who send patients to them
Secondary care is also provided by NHS Foundation Trusts (NHS…