How to Improve Health and Social Care: A Vision for Preventative Service

Restructuring of health and social care is forcing many services to close or become streamlined and managers have had to find new ways to ensure they get financial support to continue services’ delivery. In the current climate of rationing services, preventative care should be re-in fenced to minimise accidents and service users’ health deterioration at home. The measure is intended to save health and social care money in the long run. By contrast, due to drastic cuts across the public sector organisations, unfortunately preventative services are often the first to be axed. This actually tantamount to negligence at core, which later challenges the existence of our prime services – to manage complex situations such as the critical and substantial care needs. Therefore, what is the rationale behind this policy decisions (Ugwumadu 2011).

Nonetheless, it could be argued that such decisions are accredited to the tunnel vision of some senior managers. In hindsight, some of them can only see within the parameters of their corporate responsibilities that is “to save money”. In reality, it is only the older people and the other vulnerable groups in society that would suffer the consequences of such irrational decision-making. Thus, the aims of this article is to illuminate how the managers could make the case for continuing care delivery in a changing economic environment in relation to; demographic change and linear family units in the 21st Century and beyond.

On reflection, best practice would suggest that in a time of economic and budgetary constraints, collaboration with the local primary care trusts, community organisations and the third sector institutions would prevail. This would ensure that the vulnerable service users will be supported adequately to become more independent in their homes. Partnership working between agencies has the propensity for sharing resources such as, staff, information technology, offices, intelligence etc. If we are to emulate the private sector, mutualisation would help in reducing unmet needs and service breakdowns in the community. Sharing responsibilities would also promote health and psychosocial well-being among service users as well as reducing the need for admissions into nursing homes or hospital admissions.

Managing community services require organisational cultures and political change, which would give rise to the sharing of intelligence between the collaborated organisations who are working for the benefits of service users (older people, learning disabilities or mental health). This approach is intended to provide opportunities in reducing services’ duplications, costs and antagonistic relationships between agencies. Whilst capitalising on intelligence sharing, a lot of soft evidences could turn to hard evidences, this coming directly from community health practitioners such as community nurses and social workers. This data would show for example, figures on how many older people or the other vulnerable groups that were admitted to hospital after a fall or care breakdowns and what these cost the NHS and social services in after-care (Cameron 2010).

Looking at the frequency of falls and care breakdowns among the service users in a given period, the estimated figure would provide a relative forecast for the number of incidents that could lead to hospital admissions in future, costs to local primary trust and cost of care packages to social services. These results would be instrumental to future planning for community base services and implementation of strategies appropriate in reducing falls or care breakdowns at home. The projected cost savings could be reinvested to preventative services in line with continuing safe environments, where older people and other service users could be rehabilitated to minimise falls.

In practice, good risk assessments provide the opportunity for service users to be assisted in a safe environments, this could be in their own home or in a residential setting. These should be incorporated into day-to-day operations and will often run alongside equality monitoring of services. This is about getting the balance right between planning, delivery of services and managing information. This approach should be robust and prudent as to ensure cost recovery and quality care management for service users and their informal caregivers. Information gathering and monitoring of services would intensify support for community services while users are able to make choices and control of their support networks.

Another important source of evidence is feedback and “quotes from service users”. This adds to the richness of evidence. Hence, the service users know what they want and the standards they are used to, rather than the professionals prescribing for them. This signals the process for change and how services could be delivered in future. The service users and their families should be part of the new thinking in a modernising health and social care sectors and they have rights like any other citizen of the state to make informed decisions and choices.

For health and social services to remain in the premier league of services delivery within the wider welfare and universal service frameworks, it is imperative that investment in research and development is forthcoming. This provides an apparatus for good evidence based practice, where data could be shared, analysed and put to action as a mechanism in maintaining safety net. In the light of this, there is every indication that unless mutualisation is considered each of the organisations would not be able to meet the increasing needs of the growing service users now and in the future.

Inevitably, advancement in technology is changing our world and the methods of working. Thus, capturing quality practice based evidence from service users and their families could be made simple by developing and implementing scorecard systems so that individuals who come to the service can tell us things. This could be on a scale of one to five for example, telling us how depressed they feel about their care; how they feel about their health; how many falls they had in the last one month and how to improve services further. These questions or survey could be repeated every three to six months in order to compare and contrast findings. The information gathered would help determine investment in human resources and hospital avoidance strategies necessary to support older people and the other vulnerable groups to be cared for in the community for as long as possible.

All things being equal, Data Protection Act (1998) and Freedom of Information Act (2005) could constrain sharing and flow of information between agencies and this would influence services delivery in the community. If that is the case, duplication of services would continue to be present coupled with poor information sharing between agencies. In practice, duplication of services and assessment works against the best interest of the service users, hence this can create anxiety, repetition of information and exacerbation of stress amongst the users. Equally, duplication of services could lead to costs escalations between agencies and these defies the objects for cost effectiveness and strategies for recovery and business turnaround (Ugwumadu 2011).

The Ailing Welfare Service: Reforms of Health and Social Care Needs Proper Scrutiny

Change is part of a humans’ existence therefore, it is unavoidable and timeless. This concept is interrelated and insensitive to current occurrences within the wider welfare institutions in the UK’s health and social care sectors in particular. At present, health and social services are yet again undergoing a painstaking restructuring that is creating psychological and physical stresses to the entire workforce and consumers. This trajectory is building uncertain future due to continuous re-organizations, change of emphasis and redirections of care delivery to the general public. Ironically, people are not sure where their future and loyalty lies as changes in the system is triggering great worries to all concerned.

On reflection, health and social services went through a huge conscientious change in 1990s (The NHS and Community Care Act), that reconfigured the welfare systems to what many practitioners and managers thought would be a modern establishment. However, the New Labour government in 1997 to 2010 changed the prospect and redesigned it to new approaches such as personalization of services (Direct payments, Cash for Care and Personal Budgets) that transformed services delivery within the sectors. Change can make or break staff commitment, maximization of services, profitability or industrial disputes between the management and employees, this owing to mishaps within industrial relations’ policies and protocols.

Changing organizational cultures as well as philosophy and employee’s terms of reference requires effective governance and scrutiny in order to ensure health and social care reforms work for the benefits of all. The key to making the reforms work as planned would be to safeguard effective analysis of all new policy directives and structures. It is now questionable whether the “New Ways of Working” is capable of changing the fabrics and structures of the welfare services in the UK. The main themes of the overhauls are to reduce costs/budgets, staffing and improving quality and standards of services.

Decision making in some departments or services are proving to be irrational because costs are escalating, standards declining and waiting lists for assessment increasing across many social services departments. Most quality newspapers affirm that the coalition may have done everything they could to start implementing health and social care modifications before being properly examined. But, without careful considerations and good governance the plans would be an unmitigated disaster. That notwithstanding, the speed of restructuring and reallocation of services have produced an unsettling atmosphere for most health/social care workers and managers. The government’ itinerary to continue with reforms and their failure to allow time for study or to win the professional’s backing for these radical plans have been challenging to the wider community of experts and the public at large.

Considering the clamor amongst practitioners and clinicians, the question is, would the governments’ defiant be regarded as democratic or dictetorism? In contrast, it is believed that democracy means “government for the people and by the people”. If that is the case, the coalition would have itself to be blamed for any criticisms regarding their actions. The dismantling of the (PCT) Primary Care Trusts throughout the country in the next two or three years could be termed as political vandalism of tax payer’s money and good governance.

Similarly, most strategic health and local government authorities have expressed concerns regarding cutbacks on their budget, which could have huge ramifications to services for older people and other vulnerable groups such as people with disabilities and mental health. This has also been widely highlighted by a large proportion of the professional bodies such as the Nursing and Midwifery Council, British Medical Association and BBC 2 News Night in particular. The criticisms of the government is now without seasoning because health and social care organizations needs to double their expected cuts in order to remain afloat.

The growth of older people and their increasing demand for care is now unprecedented and becoming a threat to the welfare service and public services. This is despite extraordinary support from informal caregivers who are believed to have saved the government over eleven (£11bn) billion pounds a year. That notwithstanding, change is needed to reduce duplications within the system therefore, what is desirable now is a long term strategic alliance between all stakeholders (the national and local governments, health and social care and family members etc.). This would guarantee and strengthen collaborative services and minimization of costs and wastage within the sectors involved. Yet, judging from the current state of the economy both the macro and micro variable, it is certain that change is foreseeable in order to meet the challenges presented by the turmoil in the financial market and escalation of cost to maintain health and social care.

However, the difficulty in planning, management and administration of the ageing universal service in the UK has been made a lot harder as a result of disproportionately deep cuts to local authorities. The Big Society agenda indicated that the government should devolve responsibilities to the community, individuals, families and the third sector. By all assumptions, this would ensure that service users’ care would continue while restructuring is in progress. In hindsight, the key to making the reforms work would be to safeguard effective control and scrutiny of all the workflow patterns and services delivery. Practically, this has proved overwhelming for the organizations and management as details of the shake-up is superficial in terms of economics and socio-politics in line with social policy in the UK.

Presently, the government seems unconcerned and flustered regarding the “House of Common’s” health select committee’s proposal that councillors should be appointed to have seats on the boards of GPs consortia. On reflection, the quality and capacity of the representatives of some voluntary bodies such as: patients/service user’s liaison body and the local involvement network agencies could be inconsistent and lacking because of clinical and financial expertise. Thus, as a scrutiny committee, it would in practice be problematic to work closely with Health Watch, as well as with the health and wellbeing boards.

Different Career Paths in the Health and Social Care Industry

Health and social care relates to services which involves helping and assisting those who need extra care and support due to disability, old age, illness and poverty. Local authorities and private organisations with an aim to help them lead a normal life and keep their independence and dignity provide these services.

There are a range of vocational and academic courses like GNVQ, A-Level and S/NVQ, which can be pursued to qualify as a care provider. Subjects involved in health and social care studies are sociology, biology, law, ethics and nutrition that cover every aspect of issues that carers deal with. Those who pursue this line of study get hands on experience through work placements alongside their studies in nurseries; care homes, hospitals and other related establishments.

Various jobs in the health and social care industry are categorised into:

Care Assistant Jobs – Varies according to the nature of the job and is further classified into-

Personal Care Assistant or PCA – Assist people with disability and illness in their day-to-day activities within or outside their homes.

Emergency Care Assistant or ECA – Assist qualified paramedics and medical technicians in accidents and emergency’s. Responds to emergency calls and usually the first responder who observes patients vital signs and take necessary information at the scene.

Ambulance Care Assistant or ACA – Assist in transporting patients to and from the hospital and also admits, transfers and discharges patients. Helps patients to get to their appointments and make sure that they are settled after transporting them back home. Maintaining constant contact with control room when out and about and updating the team with any changes. Responsible for routine check-up and maintenance of allotted hospital vehicle.

Care Home Jobs – Duties involve coordinating care and resources, house cleaning, maintaining personal hygiene, making meals and health improvement activities and exercises.

Community Care Jobs – Provide aid and access to patients based on their personal care plan. Assist in personal hygiene, toilet functions, prescriptions, diet monitoring, attending medical appointments, walking, and exercising, shopping, pension collection, reading, writing and providing companionship.

Nursing Jobs – This role involves a range of duties and a broad scope of responsibility. The job involves working closely with the health care team and administering the prescribed treatment, medication and care given by physicians. Since the role involves close contact and interaction with patients, nurses are expected to have a calming personality and the ability to aid in the recovery process.

Your article writer Zoe Bean is regarded as an expert in the social care sector where she works as a nurse. She has been helping potential nurses for a number of years to find Care Assistant Jobs. For anyone looking around for employment in the Health and Social Care industry, or a career in nursing, then reading through the useful guides written by Zoe will definitely help you find the best solutions for your needs.