1. Week 5- The Organisation of Health Services Part 2

2. Re-cap from Last Week’s Session Working with the person next to you write down the meanings of the following Words and Phrases:  Statutory sector  Voluntary sector  Informal sector  Private Sector  Private practitioner  Informal carers

3. Learning Outcomes Understand the role of Primary Health Care Understand the role of Secondary Health Care Understand the role of Tertiary Health Care

4. Health Services Provided in the Statutory Sector The NHS is the main provider of statutory health care in the UK. The three main types of care offered to patients in the statutory system are:  Primary Health Care  Secondary Health Care  Tertiary Health Care

5. Primary Health Care Primary health care organisations are usually the first point of contact for people who need health care Primary health care is carried out in community settings, such as health centres and clinics and is provided by a number of practitioners working together as a primary health care team (PHCT). The GP is a key member of the team. Other primary health care workers include district nurses, community psychiatric nurses and health visitors. Primary health care workers provide direct services for the local population. They make home visits to patients who are unable to go to a surgery or health centre. The GP is often the practitioner who has the responsibility of being the team leader to coordinator. The PCHT is involved in providing care in cases of minor illness or injury and in monitoring people’s health to prevent them from becoming ill or to prevent their condition worsening. PCHT often provide a range of checkups, clinics and classes aimed at health improvement and illness prevention. In many health centres the GP or practice nurse will see people who come in feeling unwell, wanting a diagnosis of their illness and some treatment. Many of these visits are for common complaints like colds, flu and bruises and psychological problems such as depression or anxiety. If a patient has more serious illness PHCT will refer them to local secondary level services, such as a general hospital.

6. Hospitals generally provide secondary level of care. They become involved if someone has already been diagnosed with an illness, disease or other condition (such as pregnancy) that requires medical, nursing or therapeutic help. Patients who go into hospital have usually been referred to the secondary services of the medical team or a specialist by their GP or another member of the PHCT. Most secondary hospital care is provided by NHS trusts. These health care services are provided through a number of different kinds of hospital. These are:  District General Hospitals  Local Community Hospitals  National Teaching Hospitals and Specialist Units Secondary Health Care

7. District general hospitals provide a range of health care services for the whole population of an area. They provide services for acutely ill people who need an operation or treatment that involves contact with specially trained doctors or nurses. Local community hospitals usually provide a more limited range of treatments for smaller populations of people in an area. They often have facilities for people to be seen on an outpatient basis and usually have much smaller inpatient facilities than the district general hospital. National teaching hospitals and specialist units provide highly specialist medical, surgical and psychiatric treatments to patients who may be referred from anywhere in the country. Their expertise is available both to inpatients and outpatients. Two examples of this kind of hospital are Great Ormond Hospital for sick children in London and the Royal National Orthopaedic Hospital at Stanmore,Middlesex.

8. Tertiary Health Care Tertiary health care refers to long-term and rehabilitative care. Tertiary care is concerned with helping people to adapt and come to terms with an illness or disability that they may have for the rest of their lives. Some tertiary health care, such as long-term physiotherapy, may result in improved functioning and well-being for the patient, depending on the problems that he or she has. Other forms of tertiary care, such as the care offered by hospices, are focused on maintaining the patient’s comfort and dignity when his or her condition will result in death. Tertiary care is usually specialist and requires a referral from secondary care providers. The number of people receiving tertiary care is relatively small compared to those receiving primary and secondary care.

9. Next Week Looking at the Voluntary, Informal and Private Sectors