Healthcare and Social Care in the UK: A Comprehensive Analysis of CVD and HIV

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This essay delves into the crucial role of healthcare and social care agencies in the UK, focusing on the epidemiology of cardiovascular disease (CVD) and HIV. It examines the strategies and approaches employed to control these diseases, analyzes the provision of services for affected individuals, and explores the impact of current lifestyle choices on future healthcare needs. The essay also discusses the importance of promoting wellbeing and the need for continuous improvement in healthcare and social care systems.

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INTRODUCTION
Society should build and conserve the atmosphere in which the community's members

could be healthy. Public health improvement and their maintenance are the responsibility of

all the sectors of the society. Efforts of society could be carried out with a combination of

personal as well as public healthcare/ medical care systems. This essay focuses on the role

of different agencies in healthcare and social care communities. The discussion is made on

the infectious and non-infectious disease of the country. An evaluation is made on the

various strategies and approaches for controlling the incidence of diseases in the

communities. This report uses an appropriate research for determining the current

primacies and methods for provisioning the services for diseased or ill people. The report

also comprises the relationship between the occurrence of disease and the necessities of

services for supporting individuals in the healthcare industry. Analyses would be made on

the impact of the present lifestyle selections on the future requirements of the health care

services.

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LO1
1.1

The following are the healthcare agencies functioning with a motive to protect people’s

health and their roles in the UK community. The different agencies working towards

identifying the level of illness and disease are:

The Secretary of State for Health
is responsible for the overall function of the DH i.e.
Department of Health. The DH facilitates the public health, social care and NHS in England

with its strategic leadership (Pollock and Price, 2011).

The Department of Health
is primarily accountable for the tactical leadership as well as
funding for health and social care sectors of England. The Department of Health is a

governmental department assisted through 23 agencies as well as public bodies.

NHS England
is one of the independent agencies than the government. NHS England’s chief
role is to set on main concern and track of the NHS and to enhance the results of the health

care for the people of England (Boyle, 2011).

Clinical Commissioning Groups (CCGs)
have replaced the PCTs i.e. primary care trusts on 1st
April 2013. CCGs are clinical statutory body led by the NHS, which is responsible for

scheduling and ordering their local area healthcare services. The members of the CCG

include GPs (General practitioners) and other clinicians like consultants and nurses. They

took around 60% budget of the NHS and commissioned for the best secondary care services

and also plays part in the assisting the GP services (Checkland, et al. 2012).

Health and Wellbeing Boards
were formed by means of the local authorities for acting as a
forum on behalf of local commissioners through the NHS, public health, social care and

other health-related services. These boards are formed for increasing the democratic

contributions in the strategic decisions for health and wellbeing services, building stronger

work relationship among the healthcare and social care, boost integration of commissioning

of healthcare and social care services (Coleman, et al. 2014).

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Public Health England (PHE) is accountable for providing expert services as well as national
level leadership for assisting public health and also work along with the NHS as well as the

local government for responding emergencies (Department of Health, 2010).

Vanguards
were established in the year 2015, is a division formed under the Five Year
Forward View of the NHS. There are 50 selected vanguards which are assigned the work for

developing new care models as well as tasked with redesigning the healthcare system.

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1.2
Epidemiology is the study of the spreading as well as causes for health-related events and

situations of particular population groups and use of this study for controlling the health-

related problems. It studies the spreading of disease, a cause of disease, the demotion of

disease & health promotion.

EPIDEMIOLOGY OF CARDIOVASCULAR DISEASE (Non-infectious disease)

Cardiovascular disease (CVD) is a broader term comprising all the heart-related and

circulation diseases. It comprises every condition which is detected at birth/inherited, to

mature level condition like atrial fibrillation, coronary heart, stroke and heart failure.

Figure
1: Deaths from CVD and Numbers Living With CVD
Source: British Heart Foundation, 2018

Cardiovascular or heart and circulatory disease result in more than 25 % of total deaths in

the UK which is more than 150,000 deaths every year with an average of 420 individuals

every day or one death in every 3 minutes. There are approximately 42,000 people below

the age of 75 years die with CVD every year in the UK. There are approximately 7 million

people living with CVD in the UK, out of which 3.5 million are men and 3.5 million are

women. Early deaths from CVD (before the age of 75 years) are very common in north

England, South of Wales, Central Scotland, and in the lowest south of England (British Heart

Foundation, 2018).

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Figure 2: Non-modifiable risk factors include age, gender and ethnicity
Source: Public Health England, 2017

Risk factor for CVD

A risk factor is that cause which enhances an individual’s probability of reaching a disease.

There are various risk factors for getting CVD such as diabetes, smoking, genetic heart

disease family history, high blood cholesterol & pressure, obesity or overweight, physically

inactivity, sex e.g. men have more chances to suffer from CVD in early age than women, age

e.g. the older an individual is, there are more chances to suffer from CVD.

Figure
3: CVD Data
Source: British Heart Foundation, 2018

EPIDEMIOLOGY OF HIV
(Infectious disease)
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HIV refers to Human Immunodeficiency Virus. It is a virus which attack's human immune
system. A person infected from HIV is called to be as “HIV positive”. Once an individual

infected with HIV he will always remain HIV positive.

In the year 2016, 5,164 people were newly encountered with HIV in the UK out of which

3,938 were men and 1,226 were women, with around 278 AIDS cases and 442 people

deaths. Around 54% diagnoses were reported in gay & bisexual and 19% were of other men

who have sex with men (MSM), around 22% diagnoses were among heterosexual women

and men. There were around 130 diagnoses reported among who inject drugs (PWID), 41

acquired infection from mother-to-child transmission (MTCT) with remaining acquired HIV

from other exposures (Public Health England, 2017).

In 2015, there were around 87% (101,200) people diagnosed living with HIV in the UK, out of

96% diagnosed were receiving HIV treatment, and out of those receiving treatment around

94% had suppressed viral load (Public Health England, 2017).

Figure
4: Continuum of HIV care: the United Kingdom, 2015
Source: Public Health England, 2017

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Figure 5: HIV Specialist Care in 2015
Source: National AIDS Trust, 2018

In 2015 the total 88,769 people, comprising 315 children aged below 15, are served with HIV

specialist care (National AIDS Trust, 2018).

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1.3
STRATEGIES AND APPROACHES TO CONTROL CVD IN THE UK

There were various strategies and approaches which is being an implementation to control

the incidence of CVD in the UK. Public Health England in its extensive work had made a

contribution for sugar reduction and wider reformulation programme. The program named

Childhood obesity: a plan for action is being published by the government with the detail of

PHE key commitment’s for reducing sugar, calories, salt and other saturated fats in everyday

food items. An application named Food Smart App is introduced in the year 2017 which

gives information on salt and saturated fat. PHE also restructured the Heart Age Tool that

assists people to determine the age of their heart and any risk of stroke or chances of heart

attack. PHE also published a novel “NHS Health Check Programme: Health equity audit

guidance” during January, 2017 and “The Public Health Burden of Alcohol and the

effectiveness and Cost-effectiveness of Alcohol Control Policies: an evidence review” in

month of December in the year 2016 for examining the impact of alcohol on the people

health, comprising CVD, with effectiveness of control policies for alcohol (Public Health

England, 2017). PHE also extended the campaign of Smoke-Free NHS which is assisting NHS

in maintaining sustainability by providing advice to patients with quitting smoke in very brief

time.

STRATEGIES AND APPROACHES TO CONTROL HIV IN THE UK

One way out to control the HIV is possible by dropping the risk of getting infection of the

virus. Condoms are a highly useful way for dropping HIV transmission as well as other STIs

i.e. Sexually Transmitted Diseases also. Estimates suggest that HIV diagnosis rates had

increased without condom use in MSM category alone up to 400% with new infections. But

the use of a condom is not a sole solution for the epidemic. It needs a combined

comprehensive approach such as the use of antiretroviral therapy (ART) among People with

HIV positive. The ART is used for preventing and treating the HIV infection. It is also been

accepted and approved by the NHS England as well. Treatment as prevention or Tasp should

be a coordinated part of the care plan which should be agreed among the patient and his

clinician. Crucially, all this required to be assisted by the additional preventive strategies

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such as accessibility to condoms as well as interferences aiming towards reducing risk
behaviour (Fenton, 2015).

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LO2
2.1

For provisioning the services for people diagnosed with cardiovascular diseases a new

improvement body is introduced in the NHS Commissioning Board i.e. CB and NHS

improving quality i.e. NHS IQ. They will work for evaluating service model with their relevant

interest to develop it for managing CVD as a family disease in the hospitals and community.

NHS IQ design and check a standardized template, which could be used in the community

and hospitals and also be integrated into the service specification for assessing patients

diagnosed with cardiovascular issues. NHS IQ will work along with PHE, NHS, and Las for

supporting the proper implementation of the NHS Health Check programme. The NHS CB

also works with other interested parties for developing new tools for supporting case

findings during primary care. The strategic clinical networks and NHS IQ will give their

assistance to general practitioners who have low diagnoses rates for cardiovascular disease

(Department of Health, 2013).

The current leading developments for effective leadership in the provisioning of services to

HIV positive people is through telemedicine consultations, radical improvement to have

access to HIV tests, approachability to main population groups. NHS England is praised for

playing its role in the system leadership for providing clinical services as well as optimising

its new HIV clinical reference group, which is recently expanded. The diversity of population

groups and different areas brings the need to have HIV services at the local level instead of

top to bottom. During this research it is being observed that there is lack of direction at the

national level, however, there was a clear appearance of what exactly was required but with

no certain consensus (Baylis, et al. 2017).

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2.2
The prevalence of CVD has increased with the risk factors like drinking and smoking which

could be reduced by the services of the healthcare and social care service providers. They

are working nationally as well as locally for reducing the risky behaviour of smoking and

drinking. In the year2017, the UK government has launched Tobacco Control Plan in the UK

that is aiming towards reducing smoking prevalence in the England adults and reducing the

unequal gap between people in manual and routine jobs and the general public. PHE is the

centre for this services as well as providing support to NHS, system leaders and other

clinicians by data provisioning, implementation of support tools and commissioning. These

resources and tools comprise CLeaR i.e. Challenging services, Leadership & Results, self-

assessment of local tobacco control, training resources availability to healthcare & general

practitioners, frameworks of self-assessment for acute as well as mental health trusts

(Public Health England, 2017). Being a part of service provision the UK government is

working hard to help healthcare services.

The prevalence of HIV in the UK is very high which require a great provision of services. This

relationship could be observed from the data of 2016, where the HIV prevalence in the

PWID (people who injected drugs) have participated in an unlinked anonymous monitoring

i.e. UAM a survey in England was around 0.85%. In the year 2016, only 77% PWID also

participated in England in the UAM survey also reported they have HIV test.

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2.3
There are several factors responsible for today’s unhealthy lifestyle and impacts the current

lifestyle as well such as technological advancements, trade globalization, urbanization with

negative effects of unhealthy diet, population, tobacco consumption, sedentary lifestyle,

consumption of illegal drugs and alcohol etc (Bowling, 2014). All this factors are supposed to

be trend of the present lifestyle practices and routine but it is as harmful as a disease and in

future invitation to so many death threatening diseases like CVD, HIV, Cancer etc. this

pattern of lifestyle is certain to bring future need for the developed healthcare and social

care services in the developed community like the UK. Therefore, poor health cannot be

conferred as an external source of bringing poor health in the public but it is the result of

the present unhealthy practices and lifestyle. It will become a bigger challenge for the future

healthcare sector to deal with all the causes of the current wrong lifestyle habits. The

impact could be seen in various forms such as increased morbidity – most of the future

diseases will be chronic in nature and needs health and medical care for long-term,

excessive growth in the young disable youth, and mental health as well as

neurodegenerative ailments (Marmot, et al. 2010).

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LO3
3.1

Wellbeing is that state under which a person is feeling comfortable within its surroundings.

This wellbeing condition could be obtained by an individual when he is happy, satisfied and

healthy in the atmosphere under which he is surviving. Wellbeing could be categorized as

economic, social, physical, or environmental etc. This wellbeing has a strong connection

with the health of an individual. The kind of disease and its effect also impacts the well-

being of an individual. An individual should be careful about deciding his wellbeing as well as

health priorities considering the impact of the disease he is suffering from.

An individual with acute or mental stress disorder should be treated within the wellbeing of

social and environmental scope (Department of Health, 2010). The social, as well as

environmental wellbeing, helps him to handle the stress, mental trauma, and other critical

mental situations, which could be the result of his early stage bad experiences in life. For

curing his disease, it is needed to provide him with good social surroundings along with

medicinal treatment (Department of Health, 2010). Social wellbeing could be accomplished

with the assistance of the society and social communities. A patient with a mental disorder

should be given emotional support of his family and friends along with the outside society

support.

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3.2
Commonwealth Fund has praised the UK for investing a lot in the improvement of the

healthcare and social care for the public health. Various healthcare settings are there to

develop the new policies and systems for curing the epidemic of the disease in the present

community of the country. There are several examples of HIV for which various programs

have been introduced yet including NAHIP and CHAPS for encouraging and increasing

awareness among people for safer sex using protections etc. All these programs are proved

to be of great importance in reducing STDs infections.

Social Care System

Social care setting provides various social care services which are given by the social care

systems. These care systems or settings have supported both patients and caretaker (service

provider) in dealing with any health-related issues or problems. These systems are well

equipped, give services at home as well as provide financial assistance to the patient (Care

Quality Commission, 2012).

Policies of UK Care Home

In the UK, the care home is one of the efficient healthcare and social care systems of the

service provider. They worked on the guidelines prescribed by the UK government in

relation to healthcare and social care. In to their policies, they have introduced a complaint

policy which gives rights to patients or service user. In this policy, the unsatisfied service

recipient could make a formal complaint in the care home department and the

management will take an action within the three days time period (Care Quality

Commission, 2012). The department will investigate reason and bring out a possible solution

for to the problem. If management fails in resolving the matter the service user go further to

the directors and outside facilities.

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3.3
The health care services and settings are performing with all their efforts but every field

requires a chance to make improvements. The changes made should be as per the demands

of the service users and other patients. The strategies and approaches designed and

adapted for the adult category group may not be suitable for children's. Therefore, it is

essential to have a strategy in line with the targeted group. In caring for children, parent’s

involvement is required as they are the initial caretaker of the child. So the strategies for

the healthcare of children should consider educating parents on the diseases of their

children. Parents should be given information about the cause and effect of that particular

disease which is diagnosed in their children. They should also be given information on the

preventative measures as well as cures which make easy to treat the child during an

emergency.

Changes that could be made at Care Home of the UK

Changes and modifications are the sign of a growing industry or business. Whereas the care

home in the UK is one of the popular most social care providers. Always receives feedbacks

and complaints from its service users which will make it bring changes in their services and

cope up with the hidden unknown improvement areas. Therefore, care home should make

changes as per the group and category of the service user and satisfy them with the best

healthcare service in the industry (Koren, 2010).

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3.4
Behavioural changes that encourage healthy habits and health in individuals are because of

the good and regular practice of the right lifestyle. These behavioural changes could include

the physical activity, exercises and meditation for incorporating good habits into the routine

lifestyle to achieve good health (Wakefield, et al. 2010). This habits if inculcated since

childhood are more advantageous as children are more active in developing habits than an

adult. As we have discussed that one of the reasons for CVD is obesity which and it is

widespread in the UK. The physical exercise is that activity which will encourage the

behavioural change in the UK people and maximize their health. The physical movement is

the beast measure to deal with the bad effects of the overweight and obesity in the

individuals (Frieden, 2010).

In the UK the health care and social care systems should introduce healthcare clubs which

will allow the people of the same group to work out collectively motivating each other for a

healthy lifestyle free from diseases. Organization of sports events could be conducted every

month or once in the 3 months would prove to be beneficial from the health perspective.

The social care setting should make daily plans for individuals and prepare the daily

schedule for the people regularly attending physical activities and should make

implementation of plans accordingly.

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CONCLUSION
It is essential to do make a study on the epidemiology and its causes of various diseases as it

caters data prevalent for the development of the healthcare measures of the country. The

measures taken by the different healthcare agencies are appreciable at every level of their

support and effort. These agencies have played a significant role in the improvement of

plans for various infectious as well as non-infectious disease of the UK. There systems,

policies and other improvement activities as led to reducing the epidemic of various death-

threatening diseases in the UK. The public health is the backbone of any country and the

agencies of healthcare as well as social care have made their full support in protecting the

public health of the UK.

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