National Health Service - Research Paper Example

NATIONAL HEALTH SERVICE Introduction Established in 1948, the objective of National Health Service (the NHS) was to avail comprehensive health services for improving mental and the physical health of the people via the prevention or diagnosis and the treatment of illness.  The NHS funding is via a taxation system or regime. The Free medicinal service at the point of utilization originates from the principle standards at the establishment of the NHS by the UK Labor government of the 1948 (White, 2010 pg. 12-17). Practically speaking, the "free at the point of utilization or use" this implies that anybody legitimately enrolled with the framework, inclusive of the UK natives and legitimate immigrants get the full-expansiveness of non-critical and critical health care with no out-of-pocket installment. Some NHS services do oblige a monetary commitment from the patient, for instance, dental consideration, eye tests, the long-term care and prescriptions. Providers of Care The current framework in UK set out in the NHS Act of 1977 was changed substantially through the Health and Social Care Act of 2012. The 1977 NHS’s Act catered for the family health services that is the services availed by the general dental practitioners, family doctors, chemists and ophthalmic opticians. The presence of the health care in hospitals or also in the community health services, for instance, services availed by the midwives, clinics, and health visitors. The Family Health Services can be used interchangeably with Primary care services (Dougherty, Lister and West-Oram, 2013 pg. 13-50) . In the Secondary care, the NHS trusts and hospitals have inherited a non-comparable collection of hospitals that have been adapted into the system.  The Hospital’s Plan of the 1962 was defined about this and also subsequent planned on taking into account of the alternating distribution of the population, and also the developments in the medical science (Peate, 2010 pg. 107-150). Most of the people reached the hospital via referral, but emergency and accident departments were under the NHS Direct call.  All the services were provided by the NHS trusts, and increasingly the foundation trusts increased its responsibilities, and freedom of actions.  The NHS would work within the legal framework that would lay down particular quality, financial, or partnership requirements; and there was more than one hospital NHS’ trust. The trusts would also avail services to the community via health centres, in peoples’ homes or clinics. The trusts would merge, with each others of the similar nature or expounded services, for instance, an acute hospital trust would take on the community health services. Over 300 or the Trusts are running the community and hospitals services; the numbers are changing with restructuring or mergers (White, 2010 pg. 45-69).  Health Service Policies: The Core Principles The NHS was set on the basis of core principles. Any essence satisfactory or adequate health service is for the poor and the rich being treated alike or in a similar manner; poverty should not be considered as a disability, and while wealth as an advantaged. Most of the things have been changed or modified over the years, for instance in 1948 the NHS started owning nearly all the capital stock that hospital services being given.  The Department later expressed its core values as a universal service provider for all based on hospital and clinical needs but not with the ability of paying; provider of comprehensive services; synchronizing its services on the preferences and needs of each individual patients, or their families, or their carers’ decision; responding to various or different needs and requirement of different populations; valuing and supporting its staff; ensuring that the public funds meant for healthcare are devoted solely towards the NHS patients; and assistance towards keeping people healthy or working on reducing health inequalities (Shaw, 2011 pg. 1-13). How the NHS is Structured The English NHS is regulated by the UK government via the Department of Health (the DH); responsible for its services. The NHS commissions most of the primary care services, inclusive of the General Practitioners, and other specialist, and also allocates funds. There are numerous types of organisations that are commissioned for providing the NHS services, and these includes the NHS trusts and other private sector companies. Most of the NHS trusts have converted into NHS the foundation trusts hence allowing them to have increased financial freedoms and independent legal status. The NHS trusts is divided into NHS acute trusts that administer hospitals, specialist care, and treatment centres, and it administers at least two hospitals in every site; the NHS ambulance service trusts; NHS mental health trusts that specialize in treating or managing mental illness; and NHS care trusts that avail both social and health care services. Any organizational structure has to be requisite or reflect its core functions; hence the core purpose of the NHS is availing and the delivery of comparable good care throughout the country, the UK (Roberts and Priest, 2010 pg. 127-159).  Therefore a hierarchical system should be expressed, instead of the autonomous local bodies; NHS’s structure has repeatedly been changing for the last 60 years, and at times appearing to form a full circle (Anon, 2015 pg. 15-40).  In 2013, the NHS’s organisational structure was altered as consequences from the Health and Social Care Act of 2012, that entailed who was to make decisions, while who was responsible when it came to spending the money.  Within the health service having the purchaser-provider split, this readily allowed private stakeholders or providers enter the competitive market in providing NHS services (Weaver et al., 2010 pg. 54-82).  The NHS’ chart of is shown in figure one below.    Figure 1. NHS Hierarchal chart (Crisp, 2011 pg. 61) The chart indicates clearly the separations among those who function as purchasers or do commission of the health care, and those who functioned as providers, they have continued since 1990, being questioned of its costs, may be some 14% of total budget (Luker, Orr and McHugh, 2011 pg. 35-61).  The 2012 Act has associated with the notion of the increased private provider of the NHS services. But in reality, the private providers of the NHS services long precedes the legislation; the concerns are the introduced new role of Monitor or the healthcare regulator that could lead increase in use of the private sector competition, and the balancing of care options between charities, private companies, and NHS organizations. The major fund holders of the NHS system are the Primary Care Trusts (the PCTs), which notable for commissioning healthcare from the NHS trusts, private providers and GPs. The PCTs disburse funds towards the fund via a contract form or agreed tariff, using the guidelines stipulated by the Department of Health. PCTs get a budget on approved formula basis in relation to the population or on the specific local requirements or needs from the Department of Health; the PCTs are supposed to "break even", not showing a deficit existing in their budgets at the given end financial year. In the case of failing to meet the financial objectives, it results in dismissal or replacement of the Trusts Board of Managers or Directors; all NHS’ divisions are obligated to break even all their finances at the end of each financial year. Organization The NHS is not unified in Britain; this reflects NHS in Northern Ireland, England, Wales and Scotland (Emslie and Hancock, 2008 pg. 5-7). The NHS England concurred with NHS’s constitution, in 2009, that sets out the and obligations of the NHS, its staff, and clients of the service and carries extra non-binding pledges in regards to numerous critical parts of its operations (Davies, 2008 pg. 204-210). The Health and Social Care Act of 2012 gave most of General Practitioner (the GP) led groups duties or responsibility of commissioning the local NHS services (Priest, 2012 pg. 23-85). As from April 2013, most of the Primary Care Trusts (the PCTs) were replaced by the GP -led organizations known as the Clinical Commissioning Groups (the CCGs). In the new organizational system, the NHS’ new commissioning board or the NHS England is responsible for the overseeing the NHS via the Department of Health (Brooker and Waugh, 2013 pg. 30-51). Future Challenges The Kings Fund conference of 2014 was held towards the future challenges expected for the NHS, with speakers and delegates looking at the implications of the changing policies and the political environment of individuals working within the NHS or other leading caregiving organisations (The Kings Fund, 2010 par. 2). There is need for addressing some major weaknesses of the NHS current system; there is urgent need for engaging and empowering professionals and patients, as one of the greatest focus on the outcomes methodology (Welfare and Carter, 2008 pg. 110-160). There is a need for bridging the gap between social and health care, and the addressing of the health inequalities. These problems should be directed towards the GPs; for their continued innovative ways towards or with the local community in empowering the traditionally deprived and under-served population, thus aimed at showing what this would result or mean in reality (Peckham and Hann, 2010 pg. 21-50). The NHS should embark on the National Programme for IT, availing the infrastructure for booking appointments, elective surgery, electronic prescribing, the national care records, and electronic prescribing. The underdeveloped programme of IT funded and delays should be dealt away with. The records are crucial, since the absence of computer residence or identity background checks on patients at hospitals and clinics allows people overseas residents travelling to the UK in search of free treatment; thus the expense transferred to the UK taxpayer (The Kings Fund, 2010 par. 6). There are problems with funding, structures, or processes; the present system involving the primary care trusts and strategic health authorities is for an uncertain future; there are large numbers of top managers facing personal insecurity when clear direction or tight grip is required. The £20 billion collective financial challenge for the unmet cost pressures for three years is regarded by the majority as trump. Failing patients know the present care pathway regularly, thus turning the acute hospitals toward a warehouses for the frail and older people (Thomas, 2013 pg. 24-50). People need great outcomes from the NHS, and this pushes for the relentless focus towards the provision of improved quality care – the care service that is safe, clinically effective and avails as good patient experience as possible. In addition, people want services to be availed when they need them, provided or offered in a way or manner that is convenient for them and also meets their needs. The NHS England is embarking on the delivery of high-quality care for the achievement of improved or excellent outcomes; patients to remain the epicentre of our work. The NHS has formulated Outcomes Framework that illustrates the five main groups or categories of better outcomes: It wants to prevent and fight for people from dying prematurely, thus increase life expectancy. They want to ensure that people with or living long-term conditions, inclusive of those with mental illnesses, receive quality of life. The NHS wants to ensure various patients recover successfully and quickly from ill-health or injuries. There is guaranteed patient’s great experience towards their care. The will be translating their outcome through specified measurable ambitions that are believed to be critical indicators towards success and, furthermore against which they can track our progress. They will be working with clinicians or staff in the English NHS in Securing of additional years of life of the people with physical or treatable mental health conditions; and reducing the amount of time that people spend on avoiding hospital via better and integrated healthcare care at the community level, or outside of hospital. Conclusion Empowering staff and patients are critical, but the empowerment is not enough. There is need for workforce equipped with various skills, carrying duties or working differently in order to deliver an integrated care that can stop hospitals from turning into warehouses, and enabling patients to be in control of individual health (Stephenson, 2011 pg. 104-118). There is need for workforce that utilizes over 12 years of their medical training to their best effect, and uses the clinical staff, such as nurses, pharmacists, and the physicians assistants, in delivering the significant quantities of routine care efficiently and effectively. References Anon, 2015. [online] Available at: http://www.health.org.uk/ fundingoverview [Accessed 6 Mar. 2015]. Brooker, C. and Waugh, A. 2013. Foundations of Nursing Practice. London: Elsevier Health Sciences UK. Crisp, N. 2011. 24 hours to save the NHS. Oxford: Oxford University Press. Davies, P. 2008. The NHS Handbook. London: NHS Confederation. Dougherty, L., Lister, S. and West-Oram, A. (n.d.). The Royal Marsden manual of clinical nursing procedures. Emslie, S. and Hancock, C. 2008. Issues in healthcare risk management. Oxford: Healthcare Governance Ltd. Lewis, G., Sheringham, J., Lopez Bernal, J. and Crayford, T. (n.d.). Mastering public health. Luker, K., Orr, J. and McHugh, G. 2011. Health Visiting. New York, NY: John Wiley & Sons. Peate, I. 2010. Nursing care and the activities of living. Chichester, West Sussex: Blackwell Pub. Peckham, S. and Hann, A. 2010. Public health ethics and practice. Bristol, UK: Policy. Priest, H. 2012. Introduction to the psychological care. London: Routledge. Roberts, P. and Priest, H. 2010. Healthcare research. Chichester, West Sussex: J. Wiley. Shaw, R. 2011. Management Essentials for doctors. Cambridge, UK: Cambridge University Press. Stephenson, M. 2011. The Hands-on Guide to Surgical Training. New York, NY: John Wiley & Sons. The Kings Fund, 2010. Challenges for the NHS in the next five years. [online] Available at: http://www.kingsfund.org.uk/blog/2010/06/future-challenges-nhs-looking-ahead-next-five-years [Accessed 6 Mar. 2015]. Thomas, J. 2013. A nurses guide to management and leadership on the ward. Edinburgh: Churchill Livingstone/Elsevier. Weaver, C., Delaney, C., Weber, P. and Carr, R. 2010. Nursing and informatics for the 21st century. Chicago, IL: The Healthcare Management Society. Welfare, M. and Carter, J. 2008. The Foundation Programme. Edinburgh: Churchill Livingstone/Elsevier. White, T. 2010. A guide to the NHS. Abingdon, Oxon: Radcliffe. White, T. 2010. Hospital Management. Oxford: Radcliffe Publishing White, T. 2010. The doctors handbook. Oxford: Radcliffe Publishing. Read More