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Essay: The provision and structure of health care and social care in the United Kingdom

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This essay is to critically analysis the provision and structure of health care and social care in the United Kingdom and the implications for multidisciplinary and multiagency working in managing care NHS England it will also compare and contrast with the Ghana National Heath Insurance scheme . It will also look further at the various structures and new reforms within the two health system after its establishment and its benefit and weakness towards quality health care delivery. It will also examine the role of the independent sector in these two health systems.

The National Health system of England was officially launched in 1948 by Aneurin Bevan (a Labor Minister of Health) on 5th July 1948 after 2nd world war. It was formed on the basis that good and quality health care should; be made available to the residents irrespective of wealth, health care be should on clinical needs and not ability to pay and also it should meet the needs of everyone.(NHS Choices 2015). The NHS has been one of British major accomplishment and is the backbone of British health . It was quite surprising such a great achievement was opposed during its establishment. Unlike the NHS England, Alfers (2013)the National health insurance scheme is a National insurance system which was established by the President Kuffours administration Ghana in 2003.The Nhis Ghana has a similar goal and principle like that of the NHS England it is younger in terms of existence. Like any other social intervention, the NHIS Ghana was however not exempted from criticism during its formation by government opposition. The ideal of the Nhis Ghana has been described as innovative and it has attracted a lot of researchers

According to King’s Funds (2016), about 98.8% of the NHS funding comes from general taxation and National insurance contribution. The remaining 1.2% comes from patient charges like optical care, prescription and dental care. The expenditure of the NHS is however decided by the Department of health under the influence by parliament. Like the NHS England, the NHIS Ghana also gets the majority of its funding from 2.5% of the National Insurance Level which forms about 70% of the total expenditure, 2.5% of its funding also comes from Social contribution from formal workers. However NHIS Ghana gets a sum of its funding through donor countries which makes it a bit difference from the NHS England. (GHS Report, 2008)

On account of the NHS UK 2016, the secretary of state continue to supervise the activities of the Department of Health (D H). The Department of Health is responsible for the leadership and funding within the health and social care. The NHS in England is responsible for overseeing the activities of the Clinical Commission Group, whose main responsibility is to plan and commission health for their locality. The C.C.G is made up of clinicians, Nurses and consultants. However, the quality of services in which they commission should be in-accordance with the National institute for Health and Care Excellence (NICE) guideline and Care Quality Commission (C Q C) data on service. Ham, Alderwick (2017) also supported that, the service of the commission group should be strategic and integrated. They also established that, there should be a Scare commission expertise, process in the activities of the Clinical Commission Group. The Public Health, England and the Wellbeing Board under the supervision the of the Local Authority to ensure that there is a quality delivery of care. Like the secretary of state of the NHS England, the NHIS Ghana is also headed by the National Health Authority, which was established under National HEALTH Insurance Act of 650. The president of Ghana appoints chairperson of National Health Insurance Authority . The Secretary General of the Trade Union acts as representative of both formal and informal labor. Each district in Ghana is headed by the DWMHI, the various district head function just like the Clinical Commission Group of the NHS England. However, the various District heads of the NHIS Ghana are more of administrative managers rather clinical managers.

The major goal of the social care Act (2012) was to ensure quality health care is made available to the public. The Act also stipulated that the local Authority is responsible for social care service funding for everybody irrespective of how it will be financed. The authority does this by accessing the need of the individual. The service can be delivered by independent sources as well as the voluntary sector. According to the social care Act (2015), individuals are entitled to a carer’s assessment, where their needs are assessed. However an individual will be entitled to support if their needs meet the national eligibility criteria. Since April 2015, the local authorities have arranged for organizations such as volunteers or private companies to carry out assessments. A response from a survey which was conducted by the UK Carers 2016, criticize that carriers have to wait for longer time before they are being assessed. Knapton (2017), also supported that about 5% of the hospital beds within the NHS are still covered by people should have been in the care home but are still are still at the hospital due to lack of social care. The local Authority assessed an individual Financially, this assessment shows whether the local authority contributes towards your care or the individual themselves have bare the entire cost. However the local authority does not contribute towards an individual care if they have more than ”23,250 savings and property. Gheera , (2010) critise that, the new Act has been biased to those who have saved for their old age, whilst those who couldn’t save much are eligible for state-funded care. Under the new Act, most people can cater for their own care through ‘deferred payment’ when they have not saved a lot for their care and they own a property. The local Authority will temporarily finance for the cost of care until the property is sold. Alternative, an equity release scheme with a financial entity can be arranged for your finances of on care corresponding to the valve of the property. Tony Blair (2010), expresses his displeasure on on deferred payment of care under the Care Act whereby the local Authority requires individuals to sell their property for long term care.. It is estimated about 41% of care home residents pay for their care services meaning a lot of people may have to save or get their properties sold. On the other hands, individuals whose capital fall below”14,250 may receive financial assistance from their local council through direct payment or indirect payment to their various care homes depending on their needs. However an individual can asses charity fund and other support to meet their needs

Social care in Ghana has formed part of the responsibility of the Department of social Welfare rather the NHIS Ghana. Although NHIS Ghana takes some role in social care, the greater part of it is done by Social Welfare Department through NGO’s and separate individual as well as volunteers. However the Department of Social Welfare doesn’t form part of the structure of the NHIS Ghana. Social care in Ghana is focused on the children because children are more vulnerable, owing to their immaturity and dependence on adult as part of the NHIS role in social care responsibility ensures that all vulnerable children and pregnant woman are excepted from the premium payment.

According to Socialist Health Association, the NHS, wouldn’t have survived without the role of the private sector. The private sectors plays a role in the equipment, building of hospitals and also the manufacturing of drugs. In 2000, the secretary of state of health supported that, the private sector shouldn’t be limited in role in providing health care to people.(Health Policy Monitor 2003).

The clinical commission group or the local Authority may give a contract to a an organization or a private sector to provide care services.

According to the BBC (3RD June 2006), about 10%of non emergency surgeries carries on by the private hospitals They also carried out minor surgical procedures. The introduction of the Independent sector treatment Centre (I S T Cs) has reduced the rate at which patient has to wait for planned operation and diagnostic test.

Easton (2010), also the introduction of the independent sector has led to the delivery of quality care service. Because once they perform below the standard of their service delivery, they are likely to lose their contract. Just like NHS UK, NHIS Ghana is also supported by the private sector and the Christian Health Association to help its goal of reaching quality health to the people. Unlike the UK NHS were NHS own hospitals, hospitals in Ghana are owned by either government or independent bodies which could private or CAG hospital. All government hospitals are automatically accredited by the NHIS whiles CAG and the private hospital hospital are accredited. The ministry of health, has a board which assesses the services of the provider just like the Clinical commission group of the UK NHS. Makinen et (2011), most of the plans of the private sector have not put into practice since it sated operation. They went on further by saying that, most of the activities of the private sector in health are not documented.

MULTIDISCIPLINARY TEAM WORKING

Multidisciplinary team work is a major concept use in the Health care system. This essay will deal with the effect it has on the members within the team as well as on health care delivery.

A multidisciplinary team is made up various occupation group within the team working towards a common goal or objectives. (Hogston and Marjoram, 2007). NHS England 2015, also explain multidisciplinary and multi agency team working as simply using skills and ideas from various disciplines to meet comprehensive patient needs. A multidisciplinary team consists of different health care disciplines. In an Acute Medical Unit, the team consists of General practitioner, nurses, medical assistant, nurse assistance, community health nurses and physiotherapist. This team works together to ensure that quality health care is delivered to the patient. Working together as in multidisciplinary positive and negative effect on team members.

Health and Social (2014) emphasized that, multidisciplinary team work has a positive effect on both the patient and the health professionals within the team. These comprise of creating an excellent health results and also it ensues job satisfaction due to the maximum use individual skills. However, it stated members can achieve such benefits when they are respectful and are willing to mix their skills without team members. NHS (2016) also supported the above stated benefits. The above stated benefit has been critically analysis and seen as useful in my role as a team member in an an acute medical unit

According to Atwal and Caldwell (2006), patients are likely to get a negative impact on their care when the team is not working towards the same goal or when a team member fail to complete their required work role. They went on further by saying that team work delays decision making since team members have to be consulted before decision are taking. In an acute medical unit where I have been working, some health professionals like the General practitioner always see the other professions as below them and hence develop lesser confidences in the team. Also, in leaders in a multidisciplinary team may sometimes not be respected by some team members since each member in the team is seen as unique and have a particular skill to play as well as quality health care delivery is concerned

REFERENCES

  • The NHS: A Difficult Beginning. (2011). [film] Rick B. Acessed 12 March 2017.
  • Nhs.uk. (2016). The structure of the NHS in England – NHS Choices. [online] Available at: http://www.nhs.uk/NHSEngland/thenhs/about/Pages/nhsstructure.aspx [Accessed 13 Mar. 2017].
  • Ham, Alderwick, C. (2017).”Place-based system of care: A way forward for the NHS in England. 1st ed. [ebook] London: The King’s Fund. Available at: https://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/Place-based-systems-of-care-Kings-Fund-Nov-2015_0.pdf [Accessed 13 Mar. 2017].
  • “Private Sector Roles: NHS plans for PFI and PPP”. Health Policy Monitor, 01. Available at <http://www.hpm.org/survey/uk/a1/5>
  • Leggat, S. (2007) Effective healthcare teams require effective team members: defining teamwork competencies. BMC Health Services Research.” 7: 17.
  • Atwal, A, Caldwell, K, (2006), ‘Nurses’ perceptions of multidisciplinary teamwork in acute healthcare’, International Journal of Nursing Practice, 12, pp.359-365
  • Health Policy Monitor,(2003) ,Private Sector Role, NHS plan for PFI and PPP, United Kingdom
  • Aritzeta, A; Swailes, S; Senior, B. (2007) Journal of Management Studies 44: 1 (96-118)
  • Alfer L.( 2013), ;The Ghana National Health Insurance scheme; Barrier to Acess for Informal worker, Women in formal Employment Globalization and Organization USA
  • Department of health, The NHS constitution of England(2015). https://www.gov.uk/government/publications/the-nhs-constitution-for-england/the-nhs-constitution-for-england. Accessed: 15March 2017
  • Slasbery C, Beresford. P(2015), Disability &Society ;Building on the original strength of direct payment to create a better future for social care, page 479-483(5)
  • Munro A J and S. Swartzman(2017), What is Virtual Multidisciplinary team(VMDT);British Journal of Cancer. Accessed: 20th march 2017.
  • Unicef Ghana(2009), Opportunities and Challenges in Ghana; Social Protection and Children. Page 116-120

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