Healthcare Environment Assignment in PDF

Running head: HEALTHCARE ENVIRONMENT
Healthcare Environment
Name of the Student
Name of the University
Author note

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EXECUTIVE SUMMARY
This paper intends to analyse one London boroughs, Hammersmith and Fulham to help it make
decision about the funding. The level of investment should the borough make in Health and
Social Care Social Enterprise can be decided with the help of PEST analysis. Under PEST
analysis, the role of the political, social and cultural, economic and technological factors are
discussed. This paper also suggests recommendation in to improve the healthcare environment of
the borough.

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Table of Contents
Introduction......................................................................................................................................3
Discussion........................................................................................................................................3
Background to Hammersmith and Fulham......................................................................................3
Meaning of PEST analysis...............................................................................................................4
PEST analysis..................................................................................................................................5
PEST analysis findings....................................................................................................................9
Political factors............................................................................................................................9
Economic factors.........................................................................................................................9
Social and Cultural factors.........................................................................................................10
Technological factors.................................................................................................................11
Conclusion.....................................................................................................................................12
Recommendation...........................................................................................................................12
References......................................................................................................................................15

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Introduction
The administrative division of many English-speaking country is known as the borough.
However, the role of the borough varies depending on their functions in different countries. One
of the major borough of the London is London borough of Hammersmith and Fulham (Remes et
al. 2016). The health and social care plays an important role in the wellbeing and development of
the borough. Therefore, it is essential to invest in the health and social care social enterprise for
the development. It helps to overcome the serious challenges faced related to the health concerns.
In addition, funding is required to improve the healthcare environment of the borough. This
paper taken into consideration PEST analysis of the borough to help with the decision of the
funding in the health and social care social enterprise. Here, the funding decisions of the borough
that had already taken in this regard is also examined.
Discussion
Background to Hammersmith and Fulham
The London borough of Hammersmith and Fulham is partly situated in the southwest
London and partly situated in the west London. It is one of the vital London borough, which was
created in 1st April 1955. In this borough, many international corporations have established their
offices due to its good connectivity (Iacobucci 2019). The name of the local council of this
borough is Hammersmith and Fulham London Borough Council. In terms of residential property,
the London borough of Hammersmith and Fulham is considered as one of the most expensive
boroughs of the United Kingdom (UK). Other expensive boroughs of the UK include Camden,
Kensington and Chelsea and the city of Westminster. The main unique feature of the borough is
presence of the three professional football clubs such as Fuham, Chelsea and Queens Park

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Rangers. The total area of the Hammersmith and Fulham is 6.33 sq. mi and it ranks 313th out of
317. According to the 2011 Census the population of the borough was 182,493, which has scaled
up by 1.4% to 185,004 in 2018. The population growth has continued at a faster rate between
2011 and 2018. The number of residents belongs from the ethnic group remained 100,500 as per
2011 census, which was 55.1 % of total population. There are several ethnic minorities in the
borough such as Mixed (5.5%), Black Caribbean (3.9%), other Asian (4%) and Black African
(5.8%). As of 2018, the level of employment of borough remained high at 76.4%. There was a
wide gap between the rich and poor of the borough, where the income of rich was almost double
than the poor. Health and social care is dedicated to maintain any health concerns of the borough.
An organization that implements strategies to maximize improvements in social, financial and
environmental wellbeing is known as the social enterprise (Farmer et al. 2016). The borough of
Hammersmith and Fulham need to invest in social and health care social enterprise to bring
transformation in the healthcare environment of the borough.
Meaning of PEST analysis
A framework that analyse the political, socio-cultural, economic and technological
factors related to macro environment is called PEST analysis. The application of the PEST
analysis is helpful in examining the external environmental factors (Hamilton et al. 2015).
Therefore, the application of the PEST analysis is wide in the strategic management for the
environmental scanning. Here, in order to conduct the research related to the funding in borough
of Hammersmith and Fulham for the health and social care social enterprise, the PEST analysis
is undertaken in this regard. The strategic tool of the PEST analysis, helps to understand the
potential, operation and growth of the healthcare environment for the Hammersmith and Fulham.

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The external factors such as political factors examine the how the government should intervene
in the function of the borough in order to improve healthcare environment.
Moreover, economic factors include economic growth and investments made in the
health and social care, which influence the funding decision of the borough in the healthcare
sector. Likewise, there are various social and cultural factors that impacts the external
environment of the borough. Therefore, to take decisions related to the funding for setting up
health and social care social enterprise, these factors should be assessed properly (Buckland
2017). The social and cultural factors include population growth, health safety and consciousness
and other cultural aspects of the borough. The role of the technological factors are also crucial in
determining the health and social care social enterprise finding of the Hammersmith and Fulham.
Under the PEST analysis, the technological factors investigates those factors that government
implemented for the development of the healthcare sector (Fuller 2016). Other than the level of
the technological changes, it also emphasis on the research and development activities conducted
in this aspect. Thus, with the help of PEST analysis, the decision making process in the
Hammersmith and Fulham borough related to funding in health and social care social enterprise
can be initiated.
PEST analysis
Political
 To fulfill the requirements related to
the public heath, the Health and Social
Care Act 2012 is established (Bacon
et al. 2017). Moreover, addition of
social enterprise will prove beneficial
Economic
 The borough planned to invest in
services that support early intervention
and prevention of the health allied
issues. However, the borough
curtailed the health spending by 44

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for the health and social care.
 The delivery and development of the
social and health care services are
aimed to achieve with the help of the
Joint Strategic Needs Assessment
(JSNA) (Mungham 2016). The social
enterprise will help in relationship and
capacity building in health care.
 The clinical commissioning groups
(CCG) of the borough required a
public health advice service. Thus,
CCGs may work with the social
enterprise on social value priorities in
healthcare (Lbhf.gov.uk. 2020).
 Brexit may influence the position of
the borough in terms of healthcare
services due to political turmoil
(Mungham 2016). The crisis of
healthcare services can be solved
through the social enterprise.
 As the implication of the Brexit is
unknown, the public spending will be
impacted due to the Brexit. However,
million pound in 2019 (Lbhf.gov.uk.
2020). Therefore, the borough may
avail financial aid from the social
enterprise.
 The healthcare provision of the
borough is influenced by the austerity
plan of the national government. Thus,
social enterprise may improve the
sector (Farmer et al. 2016).
 The increasing demand for services
and austerity forced the increase in
council tax. In 2019, the inflation rate
was 1.8%, which also pushed up the
council tax by 55 million pound per
year (Ons.gov.uk. 2020). Hence, the
intervention of the social enterprise is
required to control it.
 Hammersmith and Fulham council
adopted new strategy to help people
with homelessness, which created
pressure on healthcare funding
(Ashby, Griffin and Agrawal 2015).
The inclusion of social enterprise may

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the public service can be encouraged
with the help of social enterprise (Wry
and York 2017).
help the borough.
 Hammersmith and Fulham is the first
borough that adopted the universal
credit, although, it created some
technical glitches, which can be
corrected through social enterprise
(Peters et al. 2015). The additional
amount allotted for social care of
elderly, children and disabled people
include 10.8 million pound.
Social and Cultural
 The council of the borough is
committed to bring equalities in terms
of health services by eliminating
inequalities, which can be maintained
through the strategies suggested by the
social enterprise (Lbhf.gov.uk 2015).
 In 2018, the population of the borough
has expanded 1.4% to 185,004. Social
enterprise will offer pioneering and
innovative health and social care in
borough (Puffett, N., 2017).
 The childhood obesity in the
Technological
 It will emphasis on any kind of lack in
building evidence through innovation,
which include piloting evaluation and
initiatives (Ashby, Griffin and
Agrawal 2015). The required skills of
the healthcare sector can be achieved
from the social enterprise.
 As the safety of the data is vital, it
required the application of the
technology. Here, the role of social
enterprise is vital due to patient-
centered, integrated services (Ashby,

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Hammersmith and Fulham borough is
increasing. The health disorders of the
disadvantaged children is a major
problem of the borough. The
suggestions to control this health
disorder is provided by the social
enterprise (Procter et al. 2015).
 Another major health issue that is
prevalent in the borough include
respiratory illness, which leads to
early mortality (Iacobucci 2019). The
preventive measures can be suggested
by the social enterprise in this regard.
 The total percentage of ethnic group
remains 55.1% of the total population.
The main ethnic minorities exists in
the borough include Mixed (5.5%),
Black Caribbean (3.9%), Black
African (58%) and Other Asian (4%)
(Ons.gov.uk 2020). Thus, in order to
provide health services to the vast
ethnic group social enterprise is
required.
Griffin and Agrawal 2015).
 To treat the health hazards advanced
micro technology is implemented. The
social enterprise along with charity
sector offer advanced and integrated
health services (Wry and York 2017).
 Gadgets and equipment is provided for
the elderly people to help them at
home, which can be supplied through
social enterprise (Fuller, J.S., 2016).
 The increased use of technology also
bring some problems due to lack of
training and skills (Jolapara 2020).
Social enterprise helps to train people
to scale up the use of technology in
health and social care.

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PEST analysis findings
Political factors
One of the major political factor that may influence the London borough of
Hammersmith and Fulham is Brexit. The top concern of the borough remain higher inflation and
lower numbers of nurses and builders because of Bexit. Brexit will impact thousands of EU
citizens as they will be uncertain about their status (Puffett 2017). Thus, it will affect the funding
allotted for the healthcare environment of the borough. In addition, the required nurses and staffs
for the hospital and care homes will be difficult to arrange, which will aggravate the problems
related to health and hygiene. As a result, the shortages of nurses and inflation will increase the
health service cost of the Hammersmith and Fulham by 1.4 million pound.
Therefore, the impact of the Brexit will be significant on the investment of the health and
social care social enterprise. Under section 12 of the Health and Social Care Act 2012, it is
essential to make improvements in the health of the public through the help of local authorities
(Myers 2017). Some serious health risks caused by the overweight, smoking and obesity is
checked under the management system of Health and Social care. The important contribution to
the Joint strategic needs assessments are also conducted under the Health and social care Act
2012. Therefore, it increased the budget for the health and social care. The people aged between
40 and 74 are eligible for the heath checkups under the section 6c of the NHS act 2006. All these
services increased the cost in this segment of the borough.

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Economic factors
The council of the Hammersmith and Fulham proposed more funding to control violent
crime under the social care and services. The council also abolished the changes for the disabled
and elderly people home care (Procter et al. 2015). Thus, the budget pushed up the spending by
additional amount of 10.8 million pound to offer social care services for disabled and elderly
people and children. In addition, the pressure of the council tax also increased by 2.7 % to the
level of inflation-level due to the incrsing demand for services and austerity plan of the
government. However, the council tax bill of the Hammersmith and Fulham remained 3rd lowest
in the UK in 2019. Therefore, the additional cost burden will aggravate the pressure on the health
and social care budget of the borough. It may need to limit the funding in the health and social
care social enterprise of the borough.
Furthermore, to meet the increasing cost of looking after of disabled and older people in
Hammersmith and Fulham, the social care levy of the government would be applied. In 2019, the
government imposed austerity stripped away an amount of 3.5 million pound from the borough.
Therefore, the borough received less amount from the UK government, which plunges the
financial efficiency of the borough to invest in health and social care social enterprise further
(Burki 2019). The budget of the borough also added an amount of 10.8 million pound to meet
rising demand for services, increasing prices and statutory obligation. Thus, it will impact the
funding of the Hammersmith and Fulham in health and social care.
Social and Cultural factors
The socio economic contrast is prevailed in the London borough of Hammersmith and
Fulham. There exists wide variations of deprived and affluent people. Thus, this feature of the
borough results in health inequalities and health outcomes. Therefore, the cultural diversity of

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the borough forces to emphasis on health and social care. Children from some areas of the
borough are recognized as disadvantaged. As they live in poverty, it results in poorer social and
health outcomes (Buckland, D., 2017). The number of the child obesity also increased
drastically, which created health hazards across the borough of Hammersmith and Fulham. The
borough decided to invest 850,000 pound per year for the treatment of the child with obesity.
It planned to reduce the number of child obesity significantly by 2025 (Mungham 2016).
It will improve the quality of life among the children of the borough. Another health hazard that
the borough decided to eliminate is smoking. In order to stop smoking and allied health issues,
the borough initiated stop smoking interventions. There exists youth prevention team to conduct
workshops in college and schools to prevent the children and young people from taking tobacco.
Moreover, it remains a key priority of the Hammersmith and Fulham council to prevent these
health issues through the health and social care initiates. Therefore, the funding in this regard is
also remained higher to control the early mortality and respiratory illness from taking up
smoking. In addition, NHS also conducted health check-up programmes for the respiratory
illness.
Technological factors
The borough is offered services for the elderly and disabled people under the health and
social care. Moreover, it tried to help them assist with advanced gadgets and equipment at home
to solve any kind health related problems. Thus, it helped them to overcome any kind of learning
or physical disability with the help of technology. The gadgets and equipment used in this
regard include fall detector, alarm pendants and bed sensors. However, these service are
associated with the telecare that provide support to the elderly and disabled people in day to day
life. Furthermore, the installation service is also offered under the administration of the borough

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of Hammersmith and Fulham (Smith et al. 2019). Likewise, any service related problems
associated with the gadgets and equipment can be resolved by the borough council. Hence, a
large amount of funding is allotted for the technological improvements of the health and social
care segment. The implementation of the digital strategy in health and social care enables the
treatments to be conducted on the basis of micro technology. Thus, it reduces the risks of
negative outcomes as the advanced technology is implemented in this regard. However, the cost
of this kind of service remains very high, which in turn increases the burden of the cost under
health and social care social enterprise.
Conclusion
The analysis of the external environment based on the political, economic, socio-cultural
and technological factors for the London borough of Hammersmith and Fulham helps to take
decision related to the funding in health and social care social enterprise. The major political
factor that may affect the funding of the borough in health and social care is Brexit (Peters et al.
2015). The economic factors that influence the investments in healthcare include austerity
imposed by the government and increased council tax by the Hammersmith and Fulham. The
health inequalities led to the social contrast and health issues such as obesity and respiratory
illness. Therefore, the borough invested a huge amount for the early detection and prevention of
the disease. This analysis helps to determine the further investments in the health and social care
social enterprise.
Recommendation
After the PEST analysis of the London borough of Hammersmith and Fulham in terms of
funding in health and social care social enterprise, it is clear that the borough should curtail cost
in some areas to improve the health and social care segment (Leung and Law 2017). Therefore,

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this external environmental analysis will help the borough council to allocate the funding
efficiently to achieve the aim of the borough in health and social care.
Recommendation for Economic factors
Other than increasing the council tax to meet the growing cost of the austerity imposed
by the government. The borough council should look for additional source of funding to mitigate
the higher level of spending in this regard, which can be achieved through the social enterprise.
The DoE provided grant for 75% of the expenditure and local authority provided 25% of the total
expenditure (Procter et al. 2015).
Recommendation for Political factors
Moreover, borough of Hammersmith and Fulham should also adopt some early measures
to negate the adverse impact of the Brexit on the funding of the health and social care social
enterprise. The required public service for the increased population can be obtained through the
inclusion of the social enterprise (Mungham 2016).
The position of the GP-led organization responsible for the buying and planning of the
health services for the residents of the Hammersmith and Fulham borough named clinical
commissioning group should be strengthen with the help of social enterprise. As it would offer
strategies to maximize the wellbeing of the organization to serve in a better way.
Recommendation for Socio-Economic factors
The higher cases of child obesity led to the higher spending in health and social care.
Moreover, the population growth also forced 30%-40% people to rely on food bank for the daily

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food (Jenner, P., 2016). The inclusion of the social enterprise will be helpful in effective
management of the public spending for the public services and funding for the food supply.
Recommendation for technological factors
The lack of training and skills for the use of advanced gadget and equipment in
healthcare is a crucial problem (Lbhf.gov.uk. 2020). In 2016, the standardized mortality ratio
was 87, which can be minimized through proper skills and training. Thus, the suggestion to
improve the application of the advanced technology through investing in proper training and
skills. This will minimize the cases of casualties in health and social care.

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References
Ashby, G.A., Griffin, C. and Agrawal, N., 2015. Brain injury and deprivation of liberty on
neurosciences wards:‘a gilded cage is still a cage’. Practical neurology, 15(5), pp.361-368.
Bacon, L., Gnani, S., Wingfield, D., Durack, C. and Khan, S., 2017. Are we stripping the care
out of care plans?. The British Journal of General Practice, 67(657), p.181.
Buckland, D., 2017. Communication in the age of digital healthcare. Prescriber, 28(11), pp.40-
42.
Burki, T., 2019. GP at hand: a digital revolution for health care provision?. The
Lancet, 394(10197), pp.457-460.
Farmer, J., De Cotta, T., McKinnon, K., Barraket, J., Munoz, S.A., Douglas, H. and Roy, M.J.,
2016. Social enterprise and wellbeing in community life. Social Enterprise Journal.
Fuller, J.S., 2016. The impact of the Health and Social Care Act, 2012 on the health and
wellbeing of rough sleepers. Journal of Integrated Care.
Hamilton, F.L., Laverty, A.A., Huckvale, K., Car, J., Majeed, A. and Millett, C., 2015. Financial
incentives and inequalities in smoking cessation interventions in primary care: before-and-after
study. Nicotine & Tobacco Research, 18(3), pp.341-350.
Iacobucci, G., 2019. GP at Hand in talks to form its own primary care network.
Iacobucci, G., 2019. GP at Hand is given go ahead to expand to Birmingham.
Jenner, P., 2016. Social enterprise sustainability revisited: an international perspective. Social
Enterprise Journal.

16HEALTHCARE ENVIRONMENT
Jolapara, H., 2020. London Borough of Hammersmith & Fulham.
Lbhf.gov.uk 2015. LBHF. Health and care. [online] Available at:
https://www.lbhf.gov.uk/health-and-care.
Lbhf.gov.uk. 2020. [online] Available at:
https://www.lbhf.gov.uk/sites/default/files/section_attachments/borough-profile-2018.pdf.
Leung, M.G. and Law, V., 2017. Postnatal Practices and Health Beliefs by the Chinese
Community in the UK & Ireland.
Mungham, G., 2016. Geoffrey Pearson. Mischief, Morality and Mobs: Essays in Honour of
Geoffrey Pearson, 39(4), p.189pp.
Myers, J., 2017. To austerity and beyond! Third sector innovation or creeping privatization of
public sector services?. Public Money & Management, 37(2), pp.97-104.
Ons.gov.uk. 2020. Home - Office for National Statistics. [online] Available at:
https://www.ons.gov.uk/.
Peters, M., Hunter, C., Kelly, L., Potter, C., Gibbons, E., Jenkinson, C., Towers, A.M., Forder, J.,
Coulter, A. and Fitzpatrick, R., 2015. The development of the long-term conditions questionnaire
(LTCQ).
Procter, S., Loveday, H., Nakisa, M., Nasir, L., Berry, Z., Chaggar, G. and Wilson, J.A., 2015.
Practice Nurse Education Needs Analysis survey results.
Puffett, N., 2017. Tri-borough collapse: the fallout.

17HEALTHCARE ENVIRONMENT
Remes, O., Brayne, C., Van Der Linde, R. and Lafortune, L., 2016. A systematic review of
reviews on the prevalence of anxiety disorders in adult populations. Brain and behavior, 6(7),
p.e00497.
Smith, J., Wistow, G., Holder, H. and Gaskins, M., 2019. Evaluating the design and
implementation of the whole systems integrated care programme in North West London: why
commissioning proved (again) to be the weakest link. BMC health services research, 19(1),
p.228.
Wry, T. and York, J.G., 2017. An identity-based approach to social enterprise. Academy of
Management Review, 42(3), pp.437-460.