Unit 7 – Meeting Individual needs and different Acts to support and help vulnerable individuals

1. Unit 7 – Meeting Individual needs and different Acts to support and help vulnerable individuals A description of why these acts are in place, and what role they play within the health and safety of people in the community including infants, children and adults. Also what provisions are in place and how they have improved the overall quality of health care in the UK. Public Sector Informal Care Voluntary Sector Private Sector PPT 1 -

2. Key concepts of care • Mixed economy of care – the provision of care will come from a range of service providers. The conservative party of the 1980’s decided that competition between services would improve the effectiveness and quality of services. • Providers of these could be the NHS trust, hospitals, private agencies or the voluntary sector. • Commissioners of services – these could be Primary Care Groups – later to become Primary Care Trusts (PCT’s) – and social services departments.

3. The Health Act 1999 • This Act reformed primary care, allowing the creation of Primary Care Trusts, and requiring all hospitals trusts to improve their services. The Act also allowed the introduction of: • Walk-in high street health centres • Increased use of day surgery in health centres • Health checks and advice sessions in new clinics • One-stop shops-varied health care services at one site • Wider partnerships, encouraging GPs to team up with pharmacists, counsellors and dentists to provide a range of services from one site.

4. How does the NHS work? • The NHS budget for England is planned to reach 105.6 billion. • Central taxation and National Insurance contributions provide 95 per cent of the funding, while patient charges account for only 2 percent funding. Because many of the buildings are old, much of the budget will go on IT and new buildings and equipment. • Parliament passes legislation for the health service in England and Wales, the other three are responsible for their own. • The secretary of the State of Health is a member of the Cabinet has overall responsibility for the work of the Department of Health. He or she will work directly with several ministers for health.

5. The structure of the provisions of services – this always come up in an exam * please learn the content

6. Sectors Funding, 1990. Mixed Economy of Care 1997, 1999 and 2000 framework diagram • Later in this unit will cover information surrounding the funding of social services in the UK and the Mixed Economy of Care from 1997, 1999 and later 2000.

7. NHS at the moment

8. National service frameworks (NSFs) and strategies set clear quality requirements for care. These are based on the best available evidence of what treatments and services work most effectively for patients Task 1 • Find out what the core principles of the NHS are; • The Department of health sets out standards for the NHS, for example the National Service Frameworks (NSFs). • Find out what main groups of people are included in the NSFs , and what can they expect to receive from the NSF? One of the main strengths of each strategy is that it is inclusive, having been developed in partnership with health professionals, patients, carers, health service managers, voluntary agencies and other experts.

9. Task - 2 & AfL will be a small presentation of what you have found out in a group • You are requested to find out what health services are available in your area. • Your local Primary Care Trust (PCT) should have information about these. Many PCT’s have their own websites giving details of the services they provide. • Using maps, addresses, leaflet advice and any other useful information put together a small field study presentation of this information

10. NHS Community Care Act 1990 • The Act states that it is a duty for local authorities to assess people for social care and support. This is to ensure that people who need community care services or other types of support get the services they are entitled to. Patients have their needs and circumstances assessed and the results determine whether or not care or social services will be provided. This also ensures that the people giving the care follow a certain set of rules called the ‘care value base’. • Local Authority resources can be taken into account during the assessment process, but if it is deemed that services are required, then those services must be provided ‘by law’: services can't be withdrawn at a later date if resources become limited. • The NHS and Community Care Act in 1990 split the role of health authorities and local authorities by changing their internal structure, so that local authority departments could: • Assess the needs of the local population and then purchase the necessary services from ‘providers’. • To become 'providers' in the internal market, health organisations became NHS trusts, competing with each other. This means encouraging the independent sector and private nursery or residential homes. • Community care ensures people in need of long-term care are now able to live either in their own home, with adequate support, or in a residential home setting for short stays as much as possible. • Introduced mixed economy of care • Ensured that the needs of carers was also taken into account, such as rest bite homes, day breaks, short holiday finance for both carer and client. • Clarified the roles of NHS and Social Services more clearly.

11. Department of Health The NHS is divided up into several sectors Strategic Health Authorities NHS Trusts Primary Care Trusts

14. www.nhs.uk/Livewell/Staywellover50/Pages/Intermediatecare.aspxwww.nhs.uk/Livewell/Staywellover50/Pages/Intermediatecare.aspx

15. www.nhs.uk/Livewell/Staywellover50/Pages/Intermediatecare.aspxwww.nhs.uk/Livewell/Staywellover50/Pages/Intermediatecare.aspx

19. Task 3 – AfL - QWC you will be assessed on the quality of your written understanding and use of research and key terms • Find out what services your local GP offers. • A practice booklet is often produced. • Decide if these services meet the needs of the local community in Pocklington. • Write up your own views, use prose and decide using up to date information why the NHS has reduced or increased certain provisions

20. Personal social services • There is no clear or coherent category of 'personal social services', which cover both social work and 'social care', services to people which fall outside the remit of health services. • In Britain, these departments have developed as a residual category of services not provided by other services. The categories include:

21. Acts of parliament have made central and local government in England and Wales responsible for the provision of the a wide range of social services

22. Task Case study • Social services and the case about Ryan • You are requested to read the case study notes and enter into a scenario of central government/local authority social services. • Answer these questions truefully from what you have read.

23. Ryan You can confidentially talk to us (Contact Us) or talk to one of the following independent organisations: Childline Bullying UK Kidscape The NSPCC • http://www.bbc.co.uk/news/uk-england-birmingham-13885392 • Guest speaker – child protection officer Beverley Wilkinson – working on child protection in the Metropolitan police London Task 4 - From this information can you write up a short newspaper report highlighting the failings of the system and who you think is partly to blame. AfL – you will be asked to assess each others report.

24. The review found that several agencies, including the police, council and National Probation Service, failed to intervene in the child's care. It criticised poor record keeping and said there was "no evidence of effective communication or liaison" between the agencies. Wrong priorities The report found that a front line worker took the decision not to take further action in Ryan's case, instead of a senior member of staff. It said that in future all such decisions should only be taken by supervisors or managers. About 60 recommendations were made, including that Wolverhampton City Council should review its child assessment procedures and ensure files from all agencies were checked for relevant family information on all children brought to its attention. It also said that potentially at-risk children must be physically seen by staff and all people providing support to a child's family must be adequately checked. Bill Anderson, chair of the Wolverhampton Safeguarding Children Board, said the agencies involved in Ryan's care had the wrong priorities. He said: "They were focusing on the adults they considered to be vulnerable but they didn't put the focus on that child." Case study • Fourteen agencies missed opportunities to save a three-year-old boy who was killed by a couple who were meant to be caring for him, a report has found. • Ryan Lovell-Hancox died on 24 December 2008 from a brain injury he received at Christopher Taylor and Kayley Boleyn's home in Bilston, near Wolverhampton. • They were jailed for murder and child cruelty in July 2010. • A serious case review by Wolverhampton Safeguarding Children Board said staff may have been "overburdened". • Ryan received more than 70 injuries from the defendants who blamed each other for his death. http://www.bbc.co.uk/news/uk-england-birmingham-13892076

25. What is meant by 'Safeguarding Children'? • protecting children from maltreatment • preventing the impairment of children's heath or development • ensuring that children are growing up in circumstances consistent with the provision of safe and effective care; and • undertaking that role so as to enable those children to have optimum life chances and enter adulthood successfully

26. Web-links • http://www.publications.parliament.uk/pa/cm200809/cmselect/cmwelaf/56/5605.htm • http://www.nhs.uk/NHSEngland/thenhs/about/Pages/authoritiesandtrusts.aspx • http://www.newstatesman.com/blogs/the-staggers/2011/03/nhs-spending-ifs-inflation