1. Unit 2: Working in Health and Social Care
Starter:
Discuss what do we mean by:
Public sector
Private sector
Voluntary sector?
Write a definition for each in your notes.
Holy Cross College Hospital
NHS Foundation Trust
May 2018

2. Learning objectives… By the end of this section, you will be able to:
Identify the different sectors in health and care.
Describe how they are funded.
Explain the range of organisations within each sector and the services they offer.
Discuss the impact of each sector on the people in our case studies.

3. Sectors in Health and Social Care
There are three sectors which provide different experiences of care.
These sectors and the organisations within them work together to provide the services people need.
What are the key differences between the 3 types of sector?
Task:
Discuss with the person sitting next to you and write down your ideas in your workbook.

4. Public Sector (Statutory) services
Task:
Where does the funding come from?
NHS Foundation Trusts:
Hospitals
Mental health services
Community health services
Adult Social care
Children's services
GP practices
Task:
Which are Healthcare and which are Social Care?
Which are Primary care and which are Secondary care?
Direct and indirect taxation
Do not seek to make a profit

5. In your workbook, write down examples for each category.
NHS
Three categories of care:
Primary healthcare
Secondary healthcare
Tertiary healthcare
1o care: GP, Dentist Pharmacist, Optician, (walk in)
2o care: Hospitals, Mental health series, many community health services e.g. health visitor or midwife (needs a GP referral)
3o care: specialist and complex care services, neuro surgery, spinal injury units etc.
Task:
In your workbook, write down examples for each category.

6. First point of contact for patients
NHS Primary Care
First point of contact for patients
Primary Care GP
Dentist
Optician
Pharmacist
How would a service user access these services?

7. NHS Secondary Care How would a service user access these services?
Most hospital services
Mental Health services
Many community health services
How would a service user access these services?
Via the GP who would refer a patient
Direct access to A and E

8. NHS Tertiary Care How would a service user access these services?
Spinal injury unit
Hospice support
Highly specialised units
Neurosurgery
Transplants
Secure forensic mental health services
Specialist and complex care
How would a service user access these services?

9. NHS Foundation Trusts
Independent organisations funded by the government.
Their aim is to move decision making from a centralised NHS to local communities
Task:
What are the advantages of local community decision making?
To respond to local needs and wishes.

10. NHS Mental Health Foundation Trust
Some support offered by GP
Specialist service providers: counsellors, psychologists, psychiatrists, psychiatric nurses
In-patient support for people with very severe problems.
Trusts are managed by the community – including patients families, friends, local organisations, local residents.
Psychiatrists are trained medical doctors, they can prescribe medications, and they spend much of their time with patients on medication management as a course of treatment. Psychologists focus extensively on psychotherapy and treating emotional and mental suffering in patients with behavioural intervention.
Advantages: specialists are well-trained experts, access to the best equipment and treatments, most-up-to-date knowledge and treatments, can do more in-depth investigations.
Disadvantages: conflict with normal social workers, less continuity for the SU, deskilling the normal SW.
Task:
What are the advantages / disadvantages of having specialist mental health services?

11. NHS Community Health Services Work with GPs and social services
Provide care for service users to enable them to live as independently as possible in the community rather than hospital or residential care.
Task:
Think of as many examples of Community Health Services as you can.
What are the advantages of Community Health Services?
Healthcare at home, in clinics, surgeries and pharmacies should be seen as the default and desirable place for most people’s healthcare with only intense need, high risk and specialist intervention requiring the unique abilities of a hospital. Hospitals can be risky places for the older people with complex chronic diseases with increased rates of infection and sometimes over-treatment.
Rapid response, early intervention, prevention rather than cure, self care
Reduce pressure on hospitals
Maintain independence, improve well being reduced cost to NHS
Reduce isolation
Can take control and recover on own terms
Emergency hospital admissions – most expensive, most disruption to individual and to elective, planned admissions, and waiting lists

12. NHS Community Health Services
Adult and community nursing services
Specialist services e.g. sexual health clinic
Walk-in centres
Community Health Services
Health visiting and school nursing
Palliative / End of life care
Palliative care – specialist care for people with serious illnesses, which aims to provide relief from symptoms and to reduce stress for patients and families.
Physiotherapy
Speech therapy
Occupational therapy

13. Adult Social Care
For people over the age of 18 who have disabilities, mental health problems or frail
Unable to support themselves without support and assistance
Task:
Who is responsible for Adult Social Care services?
What services do Adult Social Care offer?
Local Authorities

14. Adult Social Care Adult Social Care Care, stimulation and company
Cooking, cleaning, shopping and personal needs
Sheltered Housing Schemes
Day centres
Care in Service Users own home
Adult Social Care
Residential care
Older people, disabilities, mental illness
In some areas Care Trusts have been set up – both NHS mental health services AND local authority provision for people with mental illnesses.
Training Centres for adults with learning difficulties
Respite or short term residential care

15. Children’s Services The responsibility of Local Authorities.
Their aim is to support and protect vulnerable children and young people, their families and young carers.
Task:
Which providers do Children's services work very closely with?
Education and NHS
What support do Children’s Services offer?

16. Children’s Services Safeguarding children who are at risk of abuse
Nursery care (Under 5s) and After school clubs
Abuse, significant harm, sexual, physical, emotional harm or neglect
Children’s Services
Fostering and Adoption
Parenting skills for parents and carers
Surestart Children’s Centres
Practical help in the home

17. GP Practices First point of access to health and care provision.
Medical conditions and preventative healthcare.
Initial diagnosis and referrals to specialists for further investigation and treatment
Nurses, health visitors, healthcare assistants
Education, social services, the police
Task:
Who do GPs work with in the multi-disciplinary team?
Which other agencies do they also work with?

18. The GP Contract Task: How are GP practices funded?
Are they all funded the same amount?
Which patient groups take up the most GP time?
Women consult more than men
Morbidity – levels of ill health
Mortality – death rate
Greater workload in residential homes / nursing
New patients – more work than established
Big cities
University practice
Areas with greater migrant populations

19. The GP Contract Funding assessment takes into account:
The age of their patients
Their gender
Levels of morbidity and mortality on the local area
Number of people living in residential or nursing homes
Patient turnover
Task:
What type of GP practice would you expect to receive the highest level of funding?

20. Often known as charities.
The Voluntary Sector
Often known as charities.
They vary widely in their size, history and services they provide. They include well known group such as:
• Shelter
• NSPCC
• The Samaritans
They rely on charitable donations and fundraising but may also get support from central or local government.

21. How many people turn to Shelter for help and advice a year?
In England, how many homeless families are living in temporary accommodation?
Shelter

22. Every Childhood: What do the NSPCC do?
12/5/2018
Every Childhood: What do the NSPCC do?
NSPCC

23. Why do people call the Samaritans?
The Samaritans

24. What do Jump do?
Where is Jump based?
How is Jump funded?
Choose a service user and briefly tell their story…

25. The Voluntary Sector
Third Sector services are social care services provided by voluntary organisations.
Government departments sometimes pay charities to provide services on their behalf.
For example, MENCAP provides residential care, day care and educational services for people with learning difficulties and service users can use their personal funding to pay for these services.

26. The Voluntary Sector Key features of a Voluntary organisation:
Not run for profit
Use volunteers for at least some of their services
Managed independently of central government or local authorities

27. The Voluntary Sector How have charities recently been in the news?
Think Higher:
What are the disadvantages / weaknesses with the voluntary sector?
Oxfam, one of the UK's biggest charities, has dominated the headlines in recent weeks following allegations its staff hired prostitutes while working overseas.
Motivation and absenteeism in volunteers
Funding issues – can’t predict
Difficult to monitor and inspect

28. The Private Sector
Managed by commercial companies. These are organisations that need to make a profit to stay in business.
Often provide services for central government and local authorities including adult social care, NHS and children’s services.
Make a profit for the owners

29. The Private Sector Task: Why might people choose to go private?
Nurseries and pre-schools
Hospitals
Domestic help
Domiciliary day care services
Private Sector Services
Childminders
Priory group – private mental health services
Some common reasons for considering seeking help through the private sector might be:
You're not receiving the support you want from your NHS GP.
You want a second (or third) opinion, and your NHS GP isn't able to provide it.
You want to access support more quickly, for example if there is a long waiting list for talking therapies on the NHS in your area.
You're looking for a specialist treatment or more choice of treatments and providers.
You want more intensive support, or support over a longer period of time.
You want access to treatment that isn’t available through the NHS.
You want to attend a private hospital or clinic.
Dentistry
Residential and nursing homes for older people
Task:
Why might people choose to go private?
Mental health services

30. How Private Healthcare works in England
The Private Sector
How Private Healthcare works in England
Make a profit for the owners

31. The Private Sector Funded by: Fees paid by the service users
Payments form a healthcare insurance scheme, e.g. Saga, AXA or BUPA
Grants and other payments from central and local government
Make a profit for the owners
Expensive to S U. Basic package won’t cover much.
Paying every month even if you don’t need it.
Costs change
Creates inequality – most vulnerable
Think Higher:
What are the weaknesses of the Private Sector?

32. Research the local services you have been given and fill in the table.
Local Services Research task
Research the local services you have been given and fill in the table.
How are they funded? Which Sector do they belong to?
Which service user groups do they support?
Highlight them in the details section.
Make a profit for the owners

33. Informal Services Offered unpaid by people who want to help
Families, relatives, church, babysitting groups etc.
Make a profit for the owners