Health and Social Care Bill 2011: a legal basis for charging and providing fewer health services to people in England

BMJ ◽  
2012 ◽  
Vol 344 (mar08 2) ◽  
pp. e1729-e1729 ◽  
Author(s):  
A. M. Pollock ◽  
D. Price ◽  
P. Roderick
Keyword(s):  
Health Services ◽  
Social Care ◽  
Legal Basis ◽  
Health And Social Care

UK-wide health policy under the Coalition

2016 ◽  
Author(s):  
David Hughes
Keyword(s):  
Health Policy ◽  
Northern Ireland ◽  
Health Services ◽  
Policy Making ◽  
Social Care ◽  
The Other ◽  
Executive Orders ◽  
Health Reforms ◽  
Policy Responses ◽  
Health And Social Care

A volume on health reforms under the Coalition must necessarily expand its focus beyond Westminster to consider the larger UK policy context. Legislation enacted in 1998 established devolved assemblies in Scotland, Wales and Northern Ireland with power to make law or issue executive orders in certain specified areas, including health services. This meant that an English NHS overseen by the Westminster Parliament now existed alongside separate NHS systems accountable to devolved governments in the other UK countries. Thus, the major Coalition health reforms heralded by the Health and Social Care Act 2012 applied in the main to England only. However, devolved administrations needed to formulate appropriate policy responses that either maintained differences or moved closer to the English policies. This chapter describes the divergent approaches between the four UK NHS systems, but also sheds light on the nature of coalition policy making.

scholarly journals The Health and Social Care Act 2012: what will it mean for mental health services in England?

2012 ◽  
Vol 36 (11) ◽  
pp. 401-403 ◽  
Author(s):  
Frank Holloway
Keyword(s):  
Mental Health ◽  
National Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
National Health ◽  
Social Care ◽  
Health And Social Care

SummaryThe Health and Social Care Act 2012 brings in profound changes to the organisation of healthcare in England. These changes are briefly described and their implications for mental health services are explored. They occur as the National Health Service (NHS) and social care are experiencing significant financial cuts, the payment by results regime is being introduced for mental health and the NHS is pursuing the personalisation agenda. Psychiatrists have an opportunity to influence the commissioning of mental health services if they understand the organisational changes and work within the new commissioning structures.

scholarly journals Synthesis for health services and policy: case studies in the scoping of reviews

2021 ◽  
Vol 9 (15) ◽  
pp. 1-84
Author(s):  
Rob Anderson ◽  
Andrew Booth ◽  
Alison Eastwood ◽  
Mark Rodgers ◽  
Liz Shaw ◽  
...  
Keyword(s):  
Health Services ◽  
Case Studies ◽  
Systematic Reviews ◽  
Information Exchange ◽  
Social Care ◽  
Evidence Synthesis ◽  
Synthesis Methods ◽  
Health And Social Care ◽  
Review Team ◽  
The University

Background For systematic reviews to be rigorous, deliverable and useful, they need a well-defined review question. Scoping for a review also requires the specification of clear inclusion criteria and planned synthesis methods. Guidance is lacking on how to develop these, especially in the context of undertaking rapid and responsive systematic reviews to inform health services and health policy. Objective This report describes and discusses the experiences of review scoping of three commissioned research centres that conducted evidence syntheses to inform health and social care organisation, delivery and policy in the UK, between 2017 and 2020. Data sources Sources included researcher recollection, project meeting minutes, e-mail correspondence with stakeholders and scoping searches, from allocation of a review topic through to review protocol agreement. Methods We produced eight descriptive case studies of selected reviews from the three teams. From case studies, we identified key issues that shape the processes of scoping and question formulation for evidence synthesis. The issues were then discussed and lessons drawn. Findings Across the eight diverse case studies, we identified 14 recurrent issues that were important in shaping the scoping processes and formulating a review’s questions. There were ‘consultative issues’ that related to securing input from review commissioners, policy customers, experts, patients and other stakeholders. These included managing and deciding priorities, reconciling different priorities/perspectives, achieving buy-in and engagement, educating the end-user about synthesis processes and products, and managing stakeholder expectations. There were ‘interface issues’ that related to the interaction between the review team and potential review users. These included identifying the niche/gap and optimising value, assuring and balancing rigour/reliability/relevance, and assuring the transferability/applicability of study evidence to specific policy/service user contexts. There were also ‘technical issues’ that were associated with the methods and conduct of the review. These were choosing the method(s) of synthesis, balancing fixed and fluid review questions/components/definitions, taking stock of what research already exists, mapping versus scoping versus reviewing, scoping/relevance as a continuous process and not just an initial stage, and calibrating general compared with specific and broad compared with deep coverage of topics. Limitations As a retrospective joint reflection by review teams on their experiences of scoping processes, this report is not based on prospectively collected research data. In addition, our evaluations were not externally validated by, for example, policy and service evidence users or patients and the public. Conclusions We have summarised our reflections on scoping from this programme of reviews as 14 common issues and 28 practical ‘lessons learned’. Effective scoping of rapid, responsive reviews extends beyond information exchange and technical procedures for specifying a ‘gap’ in the evidence. These considerations work alongside social processes, in particular the building of relationships and shared understanding between reviewers, research commissioners and potential review users that may be reflective of consultancy, negotiation and co-production models of research and information use. Funding This report has been based on work commissioned by the National Institute for Health Research (NIHR) Health Services and Delivery Research (HSDR) programme as three university-based evidence synthesis centres to inform the organisation, delivery and commissioning of health and social care; at the University of Exeter (NIHR 16/47/22), the University of Sheffield (NIHR 16/47/17) and the University of York (NIHR 16/47/11). This report was commissioned by the NIHR HSDR programme as a review project (NIHR132708) within the NIHR HSDR programme. This project was funded by the NIHR HSDR programme and will be published in full in Health Services and Delivery Research; Vol. 9, No. 15. See the NIHR Journals Library website for further project information.

Mental health services for people with intellectual disability in the United Kingdom

2018 ◽  
Vol 12 (3/4) ◽  
pp. 91-98 ◽  
Author(s):  
Bhathika Perera ◽  
Ken Courtenay
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Intellectual Disabilities ◽  
Social Care ◽  
Community Support ◽  
Content Type ◽  
Health And Social Care ◽  
People With Intellectual Disabilities ◽  
The Uk

Purpose Services for people with intellectual disabilities in the UK have evolved over the years from hospital-based care to more community provision. There are multiple reasons for these changes, however, often it was due to changes in social policy or following a scandal in provision. The paper aims to discuss these issues. Design/methodology/approach Providing services to meet the health and social care needs of people with intellectual disabilities is well-established in the four countries of the UK with support from legislation. There are often specialist mental health and social care teams. Dedicated professionals work with people with intellectual disabilities who experience mental health problems with a focus on support in the community. A range of services for children and adults and for offenders exist across the UK that often vary in composition and structure. Findings The challenges in providing mental health services for children and adults with intellectual disabilities in the future include recruitment and training of the workforce with the remit of enhancing community support and reduced in-patient care. Practical implications This paper helps the reader to understand how ID mental health services are organised in the UK. Originality/value This paper gives a summary of the ID mental health services in the UK. Even though there are various papers looking at different aspects of mental health services for people with ID in the UK, this paper brings all that information together to help reader get a better understanding of the mental health services for people with ID.

Sex workers access to health and social care services: A social justice response

2020 ◽  
Vol 28 (3) ◽  
pp. 333-348
Author(s):  
Leigh-Ann Sweeney ◽  
Leonard Taylor ◽  
Michal Molcho
Keyword(s):  
Social Justice ◽  
Health Services ◽  
Sex Work ◽  
Sex Workers ◽  
Social Care ◽  
Service Providers ◽  
Sex Industry ◽  
Care Services ◽  
Health And Social Care ◽  
Provision Of Services

This research explores service providers’ views on the barriers that prevent women in the sex work industry in Ireland from accessing co-ordinated health services. A purposive sample of eight service providers in the field of women’s health and social care in the West of Ireland were selected and interviewed for this study. The service providers were asked about their perception of the barriers of sex workers accessing health and social care services. Using thematic analysis, three key themes were identified: (1) lack of knowledge of women’s involvement in sex work; (2) identified barriers to health services; and (3) legislative and policy barriers to providing supportive services. While the service providers acknowledged that they do not knowingly provide services for sex workers, they all recognise that some of their service users are at risk of, and potentially are, involved in sex work. Yet, they were able to identify some of the barriers sex workers face when accessing their services. All these barriers were the result to the services’ limited capacity to support women engaging in sex work. At the time of data collection, the legislative context meant that selling sex under certain conditions was outside the law. This study highlights the consequences that criminalisation can have on the health of sex workers and the need for a paradigm shift in existing health and social care services. In this paper, we propose that a social justice rather than a criminal justice approach has the potential to address sex workers’ right to access appropriate health care. This paper gives due recognition to marginalised women, and advocates for better provision of services for women in the sex industry, while considering the new legislation of 2017.

scholarly journals Challenges Affecting Access to Health and Social Care Resources and Time Management among Parents of Children with Rett Syndrome: A Qualitative Case Study

2020 ◽  
Vol 17 (12) ◽  
pp. 4466 ◽  
Author(s):  
Javier Güeita-Rodriguez ◽  
Pilar Famoso-Pérez ◽  
Jaime Salom-Moreno ◽  
Pilar Carrasco-Garrido ◽  
Jorge Pérez-Corrales ◽  
...  
Keyword(s):  
Qualitative Research ◽  
Health Services ◽  
Rett Syndrome ◽  
Time Management ◽  
Social Care ◽  
Qualitative Case Study ◽  
Social Needs ◽  
Entire Family ◽  
Health And Social Care

Rare diseases face serious sustainability challenges regarding the distribution of resources geared at health and social needs. Our aim was to describe the barriers experienced by parents of children with Rett Syndrome for accessing care resources. A qualitative case study was conducted among 31 parents of children with Rett syndrome. Data were collected through in-depth interviews, focus groups, researchers’ field notes and parents’ personal documents. A thematic analysis was performed and the Standards for Reporting Qualitative Research (SRQR) guidelines were followed. Three main themes emerged from the data: (a) essential health resources; (b) bureaucracy and social care; and (c) time management constraints. Parents have difficulties accessing appropriate health services for their children. Administrative obstacles exist for accessing public health services, forcing parents to bear the financial cost of specialized care. Time is an essential factor, which conditions the organization of activities for the entire family. Qualitative research offers insight into how parents of children with Rett syndrome experience access to resources and may help improve understanding of how Rett syndrome impacts the lives of both the children and their parents.

scholarly journals How the Health and Social Care Act 2012 has affected commissioning of mental health in England

2019 ◽  
Vol 69 (suppl 1) ◽  
pp. bjgp19X703373
Author(s):  
Alisha Patel
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Social Care ◽  
Third Sector ◽  
High Volume ◽  
Performance Data ◽  
For Profit ◽  
Health And Social Care ◽  
And Performance

BackgroundNHS mental health services are under pressure due to chronic underfunding and constrained resources. The Health & Social Care Act implemented an extensive restructure of the NHS and introduced three new legal duties: duty to arrange, promote competition, and integrate services.AimTo establish how the Health and Social Care Act 2012 affected commissioning of mental health services in England and how the duties are being fulfilled.MethodFreedom of Information (FOI) requests were sent to all 211 clinical commissioning groups in England. The number, value, and length of all contracts for mental health services were requested from 2013 to 2016 by type and name of provider; as well as a range of quality and performance data.ResultsThe FOI received a 93% response rate. CCGs commissioned between 1–127 contracts each: 65.3% of all contracts were awarded to the third sector (private for profit, not for profit, and voluntary organisations), amounting to 6% of the total value of contracts commissioned. NHS foundation trusts were awarded 25% of contracts, worth 70% of the total value of contracts. 71% of contracts had no evidence of quality monitoring.ConclusionThe high volume and low value of contracts commissioned to third sector organisations fulfils the new duty to arrange but not to integrate; showing considerable fragmentation of mental health provision. The emerging external market is a result of the Health & Social Care Act promoting diversification of the provider market. Finally, the lack of quality and performance data raises concerns over the transparency and accountability of an NHS that is increasingly being provided by companies.

scholarly journals The impacts of GP federations in England on practices and on health and social care interfaces: four case studies

2020 ◽  
Vol 8 (11) ◽  
pp. 1-118
Author(s):  
Ruth McDonald ◽  
Lisa Riste ◽  
Simon Bailey ◽  
Fay Bradley ◽  
Jonathan Hammond ◽  
...  
Keyword(s):  
Health Services ◽  
Case Studies ◽  
Quantitative Methods ◽  
Social Care ◽  
Research Programme ◽  
Central Authority ◽  
Cross Sectional ◽  
Health And Social Care ◽  
General Practices ◽  
Future Work

Background General practices have begun working collaboratively in general practitioner federations, which vary in scope, geographical reach and organisational form. Objectives The aim was to assess how federating affects practice processes, workforce, innovations in practices and the interface with health and social care stakeholders. Design This was a structured cross-sectional comparison of four case studies, using observation of meetings, interviews and analysis of documents. We combined inductive analysis with literature on ‘meta-organisations’ and networks to provide a theoretically informed analysis. Results All federations were ‘bottom-up’ voluntary membership organisations but with formal central authority structures. Practice processes were affected substantially in only one site. In this site, practices accepted the rules imposed by federation arrangements in a context of voluntary participation. Federating helped ease workforce pressures in two sites. Progress regarding innovations in practice and working with health and social care stakeholders was slower than federations anticipated. The approach of each federation central authority in terms of the extent to which it (1) sought to exercise control over member practices and (2) was engaged in ‘system proactivity’ (i.e. the degree of proactivity in working across a broader spatial and temporal context) was important in explaining variations in progress towards stated aims. We developed a typology to reflect the different approaches and found that an approach consisting of high levels of both top-down control and system proactivity was effective. One site adopted this ‘authoritative’ approach. In another site, rather than creating expectations of practices, the focus was on supporting them by attempting to solve the immediate problems they faced. This ‘indulgent’ approach was more effective than the approach used in the other two sites. These had a more distant ‘neglectful’ relationship with practices, characterised by low levels of both control over members and system proactivity. Other key factors explaining progress (or lack thereof) were competition between federations (if any), relationship with the Clinical Commissioning Group, money, history, leadership and management issues, size and geography; these interacted in a dynamic way. In the context of a tight deadline and fixed targets, federations were able to respond to the requirements to provide additional services as part of NHS Improving Access to General Practice policy in a way that would not have been possible in the absence of federations. However, this added to pressures faced by busy clinicians and managers. Limitations The focus was on only four sites; therefore, any federations that were more active than those federations in these four sites will have been excluded. In addition, although patients were interviewed, because most were unaware of federations, they generally had little to say on the subject. Conclusions General practices working collaboratively can produce benefits, but this takes time and effort. The approach of the federation central authority (authoritative, indulgent or neglectful) was hugely influential in affecting processes and outcomes. However, progress was generally slower than anticipated, and negligible in one case. Future work Future work would benefit from multimethod designs, which provide in-depth, longitudinal, qualitative and quantitative methods, to shed light on processes and impacts. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 11. See the NIHR Journals Library website for further project information.

Enablers and Facilitators for Sustainable Implementation of E-Services in Two-Sided Markets and Ecosystems

2018 ◽  
pp. 188-201
Author(s):  
Vivian Vimarlund
Keyword(s):  
Health Services ◽  
Social Care ◽  
Driving Forces ◽  
Potential Contribution ◽  
Improve Quality ◽  
Health And Wellbeing ◽  
Sustainable Implementation ◽  
Health Innovations ◽  
Health And Social Care ◽  
Two Sided Markets

E-health innovations are globally described as one of the major driving forces to innovate health and social care because its potential contribution to improve quality, access to care, and to engage patients in decisions related to their own health and wellbeing .However, despite the increasing number of reports that indicate the potential savings and benefits that e-health services can bring to the sector, generic implementation of e-health services that contribute to develop and sustain new ways to deliver health and social care are not yet reported. In this chapter, we suggest enablers and facilitators for generic implementation of e-health services in two-sided markets as e-health.

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