As stated in block three Formal carers are contracted paid carers this could be in the form of contracted community nurses or hospital nursing staff or care home staff as well as other paid contracted carers/staff.
Informal carers could be unpaid family members or friend's possibly community based carers or generally someone on a voluntary basis caring for a friend relative or in a working environment.
We are also answering what does health mean? How would carers ensure health? Is it simply cooking a healthy meal or providing emotional support for a family member or more complex issues like looking after an ill patient nursing them back to full health?
Implications for health I feel would have a positive outcome when the two partnerships work together it would ensure better communication and understanding and also have better involvement for the two parties. Evidence for this is could be foster care; working with social services and foster carers getting a child into a loving long term foster home thus ensuring the child's 'mental and physical' health is good and their needs be it emotional or physical are met. We can also say this could be when hospital staff and family's work together to get a family member out of hospital and well. Allowing families in hospital to help with the physical needs of the patient ie: washing and dressing empowering the family as they would feel much more feel involved with the recovery and maybe this would help in speeding up the recovery of the patient, this would also take off some pressure of already overworked nursing staff.
Services such as city health care partnership (NHS Hull) help minimise the need for acute care in hospital through early interventions, community based treatment and promotion of healthy lifestyles this is an organisation that works with different health services and partnerships to provide support and care thus helping patients, families, service users and care providers with better health facilities and support which in turn will makes a stronger network of care this is where informal and formal care is interlinked.
Social workers play a part in ensuring partnerships work together, be it family's or health professionals this also ensures better health of the service user and empowerment to families and carers alike. Care services have improved over the years and also knowledge and responsibilities, thus providing better access to care and support to clients and their families A two-year study, commissioned by the Department of Health, looked at 16 sites across England which formed an Integrated Care Pilot program. The sites trialed different ways of integrating care, such as between gp's, community nurses, hospitals and social services. Research carried out by Ernst & Young, RAND Europe and the University of Cambridge (2012) considered the impact of better integrated care on elderly people at risk of emergency hospital admissions and the treatment of conditions including dementia and mental health problems. It looked at staff and patient views on the work of the pilot's scheme and also the impact on hospital admissions and lengths of stay in hospital. This report found that improvements on care increased and cost to the NHS decreased when integrated partnership schemes were put in place. In a recent review, Ovretveit (2011) concluded that the answer to the question 'Does clinical coordination improve quality and save money?' was 'Yes, it can'; depending on the approach used and how well it was carried out. Despite uncertainty and conflict revealed in the report the need for integrated care maintains a very good approach to ensuring adequate healthcare and services, and much effort has been put into learning from other countries that already adopt this approach (Rosen et al., 2011) iv and providing guidance to the NHS on strategies that could be used (Ham et al., 2008v; Lewis et al., 2010vi; Ham and Curry, 2011vii).
Informal care still remains the predominant type of care provided as shown in the 2005() department of health care report into the role of informal carers, it showed that of which the roles and responsibilities provided by social services and councils 1.47 million clients (85% of all clients) received community-based services following assessment, and 250,000 clients received residential-based services following assessment.
I think overall the implications for poor health would be relatively small when formal and informal carers work together. If a good level of shared responsibility is not met this could cause problems for the service user and or the families or care/nursing staff. Things like families and care staff not agreeing on the level of care needed or ideas of care thus causing the client/patient to be torn between formal and informal care practices this could possibly endanger the health of the client. Also poor communication would have an impact on the health of the client which could result in possible neglect and or a decline in their mental state.
Ham C, Curry N. Integrated Care. What is it? Does it Work? What does it Mean for the NHS? London: Kings Fund, 2011.
Ham C, Glasby J, Parker H, Smith J. Altogether Now? Policy Options for Integrating Care. Birmingham: Health Services Management Centre, University of Birmingham, 2008.
Lewis R, Rosen R, Goodwin N, Dixon J. Where Next for Integrated Care Organisations in the English NHS? London: Kings Fund and Nuffield Trust, 2010.
Ovretveit J. Does Clinical Coordination Improve Quality and Save Money? London: Health Foundation, 2011.
Rosen R, Lewis G, Mountford J. Integration in Action: Four International Case Studies. London: Nuffield Trust, 2011.
TMA04 Part 2
Assess the contribution that screening programs can make to the populations health.
I think we first need to establish what is screening and what types of screening programs are available.
Screening is a process of identifying apparently healthy people who may be at increased risk of a disease or condition. They can then be offered information, further tests and appropriate treatment to reduce their risk and or any complications arising from the disease or condition. Treatment can then be started promptly ensuring quality of life and enabling advice on issues such as lifestyle choices. This preventative measure can improve survival as we see from early detection of breast cancer (Tabar et al., 1989)
There are many screening programs available far too many to mention a far cry from 10-15 years ago. There is no accurate evidence that states just how many screening programs are running at present but according to the uk screening portal there are over 20 basic screening tests available testing aortic aneurysm where an estimated 5000 people die each year to sickle cell disease where 17,354 identified as carriers and many many more in between.
Many aim to diagnose possible illness far earlier and even before any patient has symptoms; some screening programs are aimed at new born babies and even babies still in the womb down syndrome screening program is but one of these in utero programs this is a combined blood test and special type of ultrasound test known as a nuchal translucency scan and although it is not possible to prevent this genetic abnormality that causes Down's syndrome, it has become possible to identify more accurately during pregnancy the likely risk that the baby is affected and advice and decisions on what to do next can then be sought. As stated in unit 14 "disease cannot be totally irradiated but it can be reduced by preventative action" and early detection through screening is a good way of doing this.
Screening programs seem to deliver a positive outcome, saving many lives through early detection although as with most problems in the health service money plays a part and it has been debated on whether it is simply too costly to use all these screening programs than to just treat illnesses as they arrive (Butler., 1993) There has been much debate on screening being a waste of money as reported by the bbc in 2009. The chlamydia screening program as it was reported by The National Audit Office that £17m could have been saved, nearly half the sum spent, if the programme had been better run as failings in this program led to many under 25's not being tested , the prime target group.
There is lots of evidence through the NHS website to suggest that screening does save and improve lives but there has also been suggestion that a person could be unnecessarily worried or even harmed if they are tested for something the NHS simply cannot treat this would undoubtedly cause great stress and anguish. As stated in unit 14 research has focused on many potential risks to screening programs a report by Marshal (2006) Stated many physical and psychological harm can occur due to screening programs as a person taking the test could be wrongly labelled as sick or at high risk this could lead to the person using this as a reason to 'give up' or let themselves go. Although screening programs are voluntary so any concern would be discussed with a doctor prior to having the screening test done and screening would be done with the interests of the patient in mind and as a priority. I think this risk factor can only be assessed on an individual basis on whether it is best to know or just adopt a wait and see approach. Many people with illness which is hereditary would I think want to know if they would too be struck with the same illness although I have met people in my line of health work which simply do not want to know.
Knowledge is definitely power and I feel that screening programs can only be a good thing preventing and helping to prevent and eradicate many illness's and diseases this in turn will help the nation's overall health. The NHS has spent millions on screening programs as it costs around 400 million a year between 500 different organisations (NSC annual report 20011/12) unfortunately there is no clear evidence to see on how much money is spent each year treating preventable illness but I feel 400 million this nowhere near the amount needed each year, overall the positives on screening programs I feel out way any negatives discussed in the vast array of reports and studies done on this issue and surly screening can only be a good thing to empower the nation and get them into better health.