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.

The factors influencing access to health and social care in the farming communities of County Down, Northern Ireland

2006 ◽  
Vol 26 (3) ◽  
pp. 373-391 ◽  
Author(s):  
DEIRDRE HEENAN
Keyword(s):  
Health Care ◽  
Northern Ireland ◽  
Older People ◽  
Social Care ◽  
Service Providers ◽  
Farming Communities ◽  
Access To Health ◽  
Health And Social Care ◽  
County Down ◽  
Farming Families

Against a background of limited previous research, this paper examines the access to health and social care among older people in the farming communities of County Down, Northern Ireland. In-depth interviews were conducted with 45 people aged 60 or more years living on family farms to collect information about health care needs and service use and adequacy. In addition, interviews with service providers provided information on their perceptions of the farming communities' needs. The findings indicate that there are specific rural dimensions of access to services and that among the respondents there was substantial unmet need. For many farming families, using services is determined by much more than being able to reach them physically. The lack of reliable information, the culture of stoicism and the absence of appropriate services impeded obtaining effective support. Recent health care policies and strategies have stressed the importance of developing local services that are responsive to need in consultation with service users, but there is worryingly little evidence that this has occurred. It is concluded that if effective outcomes are to be achieved, policies must recognise the specific characteristics of rural populations and be sensitive to the needs, attitudes and expectations of farming families. The current lack of understanding about the distinct needs of these communities at present exacerbates the isolation and marginalisation of already vulnerable older people.

scholarly journals Primary care use of laboratory tests in Northern Ireland’s Western Health and Social Care Trust: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e026647
Author(s):  
Magda Bucholc ◽  
Maurice O’Kane ◽  
Ciaran Mullan ◽  
Siobhan Ashe ◽  
Liam Maguire
Keyword(s):  
Northern Ireland ◽  
Laboratory Test ◽  
Laboratory Tests ◽  
Social Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Socioeconomic Characteristics ◽  
Health And Social Care ◽  
Test Ordering

ObjectivesTo describe the laboratory test ordering patterns by general practitioners (GPs) in Northern Ireland Western Health and Social Care Trust (WHSCT) and explore demographic and socioeconomic associations with test requesting.DesignCross-sectional study.SettingWHSCT, Northern Ireland.Participants55 WHSCT primary care medical practices that remained open throughout the study period 1 April 2011–31 March 2016.OutcomesTo identify the temporal patterns of laboratory test ordering behaviour for eight commonly requested clinical biochemistry tests/test groups in WHSCT. To analyse the extent of variations in laboratory test requests by GPs and to explore whether these variations can be accounted for by clinical outcomes or geographical, demographic and socioeconomic characteristics.ResultsThe median number of adjusted test request rates over 5 consecutive years of the study period decreased by 45.7% for urine albumin/creatinine ratio (p<0.000001) and 19.4% for lipid profiles (p<0.000001) while a 60.6%, 36.6% and 29.5% increase was observed for HbA1c(p<0.000001), immunoglobulins (p=0.000007) and prostate-specific antigen (PSA) (p=0.0003), respectively. The between-practice variation in test ordering rates increased by 272% for immunoglobulins (p=0.008) and 500% for HbA1c(p=0.0001). No statistically significant relationship between ordering activity and either demographic (age and gender) and socioeconomic factors (deprivation) or Quality and Outcome Framework scores was observed. We found the rural–urban differences in between-practice variability in ordering rates for lipid profiles, thyroid profiles, PSA and immunoglobulins to be statistically significant at the Bonferroni-adjusted significance level p<0.01.ConclusionsWe explored potential factors of the interpractice variability in the use of laboratory tests and found that differences in requesting activity appear unrelated to either demographic and socioeconomic characteristics of GP practices or clinical outcome indicators.

Resource Allocation Modelling for Home-Based Health and Social Care Services in Areas Having Differential Population Density Levels: A Case Study in Northern Ireland

2000 ◽  
Vol 13 (3) ◽  
pp. 164-169 ◽  
Author(s):  
Tony Hindle ◽  
Adam Hindle ◽  
Martin Spollen
Keyword(s):  
Resource Allocation ◽  
Northern Ireland ◽  
Social Services ◽  
Social Care ◽  
Geographical Information ◽  
Population Densities ◽  
Relative Population ◽  
Care Services ◽  
Home Based ◽  
Health And Social Care

This project arose from deliberations within the Department of Health and Social Services (DHSS) in Northern Ireland concerning the acceptability of the revenue resource allocation methodology they were using. One problem with the method being used had been the absence of a component that adequately reflected the relative costs associated with the differential population densities of the four health boards into which the Province is divided. This study investigates a particular element of this issue, viz differences in the travelling distances and times of those health and social service professionals who provide visiting services to patients in their own homes. A modelling approach has been developed and used in conjunction with a comprehensive spatial and geographical information system for Northern Ireland. An important outcome of the study has been estimates of the targets that should be set for the annual health and social care travelling distances and times per head of population in the boards, for a range of home-based services. Also, the project has contributed to decisions made by the DHSS in Northern Ireland concerning the annual financial compensations required by boards for costs associated with their relative population densities.

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

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.

Sign in / Sign up

Export Citation Format

Share Document