Healthcare and Health Policy Analysis

This assignment requires a comprehensive analysis of various aspects related to healthcare management and policy. It involves reviewing and analyzing research papers on topics such as financial crisis and austerity's impact on European health systems, methods for economic evaluation of healthcare programs, and the inevitable application of big data to healthcare. Additionally, it touches upon organizational issues in implementing health information technology innovations, an assessment of progress towards universal health coverage in BRICS countries, disparities in breast cancer treatment and outcomes, and eliminating waste in US healthcare. The assignment also includes a discussion on governance at a distance through social marketing and the politics of responsibility, grandparents providing care to grandchildren, and management of large qualitative data sets.

Managing Financial
Resources in Health and
Social Care

Table of Contents
INTRODUCTION...........................................................................................................................1
TASK ..............................................................................................................................................1
1.1 Principles of costing and business process system:..............................................................1
1.2 Information which are needed to manage financial information:.........................................2
1.3 Regulatory requirement for managing financial resources:..................................................3
1.4 System for managing financial resources in the cited organisation:.....................................4
M1...............................................................................................................................................5
D1................................................................................................................................................5
2.1 Diverse sources of income available to cited organisation:..................................................5
2.2 Analyse the factors which affects the availability of financial resources:............................6
2.3 Review different kinds of budget expenditure in Silloth nursing and residential care home:
.....................................................................................................................................................7
2.4 How decisions about expenditures are made:.......................................................................7
M2...............................................................................................................................................8
D2................................................................................................................................................8
3.1 How financial shortfalls can be managed:............................................................................8
3.2 Explain the actions that would take to overcome financial fraud.........................................9
3.3 Evaluate budget-monitoring arrangements in a health or social care organisation.............10
M3.............................................................................................................................................10
D3..............................................................................................................................................11
4.1 Information required to make financial decisions relating to a health and social care
services......................................................................................................................................11
4.2 Analyse the relationship between Silloth nursing & residential care service delivered and
'cost and expenditure' :..............................................................................................................12
4.3 Evaluate how financial considerations impact upon a service user....................................12
4.4 Suggesting ways to improve care service provided by cited firm:.....................................13
CONCLUSION..............................................................................................................................13
REFERENCES..............................................................................................................................15

INTRODUCTION
This is the report which is based on the case study of Silloth nursing and residential and
care home which audited financial statement for the year ended 31st March, 2008 which address
the principles of costing and cost control systems, such report would likewise discuss how
systems are implemented with the cited care home in order to manage financial resources in a
health and social care, systems and processes for handling financial resources, controlling budget
and expenses (Giordano and Shah, 2014). The main aim of the this report is to permits health
and social care manager to emerge knowing of how to manage their actual expenses against
fixed costs.
In this report, Silloth Nursing and Residential Care Home management managing its
financial resources in an effective manner so that the business can get the competitive advantages
by lowering its services to the general public. By applying this techniques, firm can avoid the
expenses effectively so that the business can offer services at a lower rate to the clients. There
are various methods that can be used by the Silloth Nursing and Residential Care Home in order
to manage its financial resource in this report.
TASK
1.1 Principles of costing and business process system:
In connection with the provided case study, cost control is the way by which costs
occurred by the cited organisation are determined, quantified, grouped together in a most
effective manner, and these compared with the budgeted figure. Such kind of comparison renders
management an information they are required to assess the effects of their operations, and to
assist them to come for taking business decisions. The amount covered in the provision of
products and services is known as the costs. Silloth nursing and residential care home is required
to understand about how much they have incurred on the products or services, but first the firm is
required to measure the cost of other things that would assist to renders for its product and
services. Such would assist the firm to assess if they would earn profits or losing money by
calculating cash inflow (Cresswell and Sheikh, 2013). Although, this can be said that there are
diverse kinds of costs which are categorised into direct or indirect costs. As far case study is
concerned, under this direct and indirect costs are decided by the silloth nursing and residential
care home manager. This can be said that the direct cost are those which could derived wholly to
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the product, this can be said that this cost is normally determined with the products and services.
Direct costs are staff cost, maintenance of patients, domestic, establishment cost, staff cost etc.
On the other hand, this can be said that the indirect costs are those that are not directly
apportioned to the specific product, like- budgeting, buying, making of payroll etc.
The Business control framework of Silloth Nursing and Residential Care Home is additionally
required to keep up and watch the compliance issues like adhering to laws, rules and regulations
which are identified with health care. In business there are diverse principles that will be
followed and some of them are as follows:
 Charging of abnormal cost in costing: In an organisation there are some abnormal
accidents which occur such as fire, riots or any other and the loss that is to be borne due
to this will be considered as abnormal cost. There will be no linkage of it with other
activities.
 Relation exist among cost and its cause: It can be said that all the cost which are
incurred are related to its cause. Cost is identified on basis of allocation of resources.
 Earlier cost are to be ignored: Consideration will not be provided to any cost which
has been made in past period as by that excessive load will be created on company.
 Identifying all costs of the company: This principles of costing focuses on particular
product or activity of a project. According to this principle Silloth Nursing and
Residential Care Home should create a budget on the basis of estimation of all types of
costs. For instance, costs for a Silloth Nursing and Residential Care Home could be
estimated and a project budget would be established. After this, costs of overall activities
should be controlled at the time of occurrence.
 Eliminating Unnecessary costs: According to this principle, company should eliminate
unnecessary costs through breaking down all expenses into individual items and
arranging this into categories. This principles helps Silloth Nursing and Residential Care
Home in analyzing those costs that doesn't have any importance to a business. This
unnecessary costs could easily be eliminated by the company if identified.
1.2 Information which are needed to manage financial information:
To manage financial resources in a hospital, there is a need to have financial accounting
information by the manager (Giordano and Shah, 2014). So that they could effectively manage
the available resources in an effective manner. Although, this can be said that financial
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accounting information covers an income statement, balance sheet and the cash flow statement.
Although, this can be said that the financial statement are made on yearly basis. Cash flow
statements reflects the movement of cash inflows and outflows in this cited organisation. This
helps the cited organisation to know about the funding requirement and effective utilisation of
such resources effectively. Balance sheet provides a picture of company's assets, liabilities and
shareholder equity for a specific period, emphasizing about how much organisation owns, owes
and shareholders investment. While firm's Income statement is also requires to be known as
profit and loss statement which reflects firm's records of earnings and profitability for a specified
period of time. Silloth nursing and residential care home net income for the year ended 31st
march 2008 was £31,450 which was in negative figure in the 2007.
Performance measures of strategic objectives are crucial information which are required
in context of managing financial resources. These performance measures contains market shares,
cash flow, profitability and market position. Objectives of the cited organisation attained by
enhancing customer satisfaction, firm's flexibility and productivity. Customer demand is requires
to be satisfied. For managing financial resources in a firm, manager of the firm is required to
know about the source of earning and they also requires to know about the employee level, and
assure about the services what employees are providing to the firm's client, know about the
expenditures related to the capital, know about the amount of wages and salaries which is
requires to pay to the firm, and likewise look at the allocation of resources which would
introduce money to the cited organisation.
1.3 Regulatory requirement for managing financial resources:
Regulation is the controlling system which put in place by the government by way of
acts, rules, regulations and policies in order to investigate the firm and individual. Henceforth,
these helps the firm for limiting financial fraud, motivate ethical practices and equality,
consumer protection, accountability, hold integrity and efficient and organised structure. A
company is required to incorporate its business with the company house under a firm name in
order to comply with the regulatory legislations and policies and also to guarantee adequate
management and fairness of the firm. Although, proprietary business does not have incorporation
as per the law. But there is a requirement to inform HM Revenue and Customs. Entire limited
company are regulated by the Law to publish annual financial statements (Busse, Aboneh and
Tefera, 2014). The need of financial statement is to render information about the financial
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position, performance and vary in financial position of a firm. This is needs to HM Revenue &
Customs and Regulators like- company house to needs financial statements for identifying the
proper of taxes and other duties disclosed and paid by a firm. Each firm is required to audit their
financial statements, which consists of the statement of financial activities, balance sheet.
Some of the important regulations which are to be met in the process of management of
resources are provided below:
 In order to manage all the additional expenses and risk, it is required that proper
insurance shall be made so that they can be managed in the most appropriate manner.
 There are various techniques which are used for processing and rules shall be made by
which proper reviewing and monitoring will e made possible.
 The risk which is related to all the operations is to be managed in proper manner and that
is done by the use of regulations.
Franchise are required to be gained and for that permission will have to be regulated. There will
be need to make committee in respect of external and internal audit.
1.4 System for managing financial resources in the cited organisation:
Financial system is the procedure which lead financial activities of a firm. There are
diverse factors which incorporate the financial system of various levels. For managing financial
resources, there are diverse systems: which are budgeting, IT system, financial accounting
system, payment system, auditing system. Although, some of them are as follows:
IT system would access fair information, processing, sharing, storage and easy access by diverse
departments. Examples are electronic payment system, and so on (White, Oelke and Friesen,
2012).
Budgeting assist firm to stop over spending, motivate staff to attain budgeting goals and pre-set
targets.
An audit framework is a computer program which is designed to gather data, performing
unmethodical checks on processes, scrutinising whole internal financial activities and assisting in
making final reports. In addition to this, training is required for staff, guaranteed and dedicated
computer system. Few of the advantages are, this support to disclose fraudulent tasks within the
firm, assessing risk, recognizing crucial areas of modifications, major understanding of financial
records, guarantee financial control, capabilities and quality. This is all about wastage of time,
audit inadequacy in the data entry may not easy to rectify.
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M1
Strategies to find appropriate solutions to manage financial resources:
 Improvement in rate base and identifying the need to renew assets: In this strategy,
rate base which is required rate of return will be improved by adding desired profit into it.
Some assets which needs maintenance will also be renewed through repairing (Berwick
and Hackbarth, 2012). It will help company in saving extra financial resources to
purchase new machines.
 Establishment of critical renewal investment levels will be done: In this strategy,
critical renewal investment levels based on productivity and returns on investments will
be established.
 10 Year Assets Renewal program will be updated; Assets which has crossed and near
to dismissal will be considered for renewing to extend its life span.
D1
Some of the innovative ideas to manage financial resources are given below:
 Strategic planning procedure have been assessed: Here strategic planning like,
implementation of Kaizen methods, ABC analyses has been assessed.
 The justifiability of results of audits are assessed: The results came after application of
above data will be analyses and certain methods to improve the outcomes will be applied.
 The adopted forthcoming strategies is wholly investigated with detailed
justification: All the above strategies has been adopted after testing its feasibility and
certain provisions has been put to control all activities (Enthoven, 2014).
2.1 Diverse sources of income available to cited organisation:
There are diverse sources of income which are accessible to the firm under health and
social care sector as income which is most crucial for attaining the delivery of sound health care
services to the public, likewise for emergence and expansion of business ventures. Therefore,
self pay, non-patients, grants, contribution, tax support from government, third party payer
insurance and other kinds of income.
The main sources of income for Silloth Nursing and Residential Care Home home care are:
Funding from regulatory bodies, various grants, rent grabbed from leased property, gain from
revaluation of company assets. While in general, there are diverse sources of income which
comes from charitable care home and henceforth accumulate from fund raising events. These
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are:offering tea, strawberry, chocolate with consideration, while at the time of Christmas, selling
of cups is the major sourced of finance. By presenting in front of general public, old mama and
old papa dance, and also people visit them and render them money. Another source of income
are donation, lottery, voluntary, payroll, payment and other ways.
2.2 Analyse the factors which affects the availability of financial resources:
Accessibility of financial resources of health care facilities such as Silloth Nursing and
Residential Care Home care home is totally affected by diverse financial related risks and
payment by service providers and the business firms. The revenue could also be gathered from
various sources such as governing agencies, diverse social insurance resources such as tax, from
individual firms and premiums. The diverse health care firms running their operating in
emerging nations face challenges in the form of raising adequate funds due to low income level
and scarce institutional and management capacity. Henceforth, the accessibility of the firm based
on the out of pocket payment in these nations (Wheeler, Reeder-Hayes and Carey, 2013). Second
key factor is link to risk pooling (Hacker and Walker, 2013). By taking the help of risk pooling
Silloth Nursing and Residential Care Home Care home emerge and handle raised capital for
sharing financial risks among the various contributories.
These are the factors that affects the accessibility of the financial resources in the chosen
business.
Some of the important factors that are to be taken into consideration are as follows:
Profit level: If the profitability of the firm will be high then it will have good image in market
and it helps it in raising all the capital from there. Investors will be happy to invest as they
can see that they will be getting good return in exchange of it in the future period.
Costs: The cost shall be incurred in staff management as by that there will be rise in
efficiency of them . This is because they will feel satisfied and work in better manner. By this
there will be increase in the overall productivity of Silloth Nursing and Residential Care
Home.
2.3 Review different kinds of budget expenditure in Silloth nursing and residential care home:
A budget is a planning tool which is quantified in monetary terms, formed and sanctioned
prior to a fixed period of time, normally demonstrating planned income to be manufactured and
or expenses to be happen at the time of period and the capital to be engaged at the time of
specified period and capital to be employed in order to gain the provided set of targets.
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There are so many types of budget expenditures which are majorly related to health and
social care sector organisations. This covers personal budgets, operating budgets, sales budgets,
and others. The operational budget demonstrates the goods and services of firms which could be
introduced under the service sector at the time of budget period (Marten and et. al., 2014).
Personal budget covers the determining of expenses incurred by the firm under a financial year.
The expenses covers labour costs and others which are related to the personal. Under this sector,
consumption of human resource has attained a great impact on the personal budget and this is
done due to the growing competition and increased reliability on the resource driven technology.
2.4 How decisions about expenditures are made:
The procedure of decision making on expenditures in Silloth Nursing and Residential
Care Home are totally based on the in-depth assessment and knowing the needs business houses.
There is a strong needs for managing the financial resources as this is the main aspects by which
entire firm's key decisions are made. In Silloth Nursing and Residential Care Home home care
process, decision making on forecasting expenses and regulating of current expenditures are
emerged by using of environmental screening. Value added to the service followed by the
accountabilities and the firm itself, the expenditures are considers in order to make operational
and strategic planning. Forecasting of diverse financial risks, adequate abilities of project
management and assumptions and calculations of cost benefits and other factors are used in order
to make decisions in an effective manner.
Some of the major tools which are to be considered for making of decisions are:
l NPV: Under this all the cash flow that are arising will have to be discounted by the rate
so that present value of them can be determined. On the basis of them then difference
among the inflows and outflows is calculated which is used to decide whether profit will
be made or not.
l Profitability analysis: Under this it is identified that whether proper balance is made in
expenses or not. This is needed as then only profits can be made which is the major
requirement of business.
M2
Application of appropriate techniques:
 Audit are completed with implementation to a firm implementing adequate tools: In
this step audit of financial statements and end report has been completed. The techniques
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are implemented with the appropriate tools like budget control, cash flows, planning and
estimation.
 Stakeholder analysis is completed for the firm: Stakeholder like banks, investors,
shareholders, suppliers, etc. has been analysed at this stage.
 Adequate strategic tools are implemented for identifying forthcoming strategies for
the firm: Adequate strategic tools like Gantt chart, decision tree, variance analysis, etc.
has been implemented successfully in this step.
 Adequate roles and resources & targets are determined with few implementation to
the firm: Required role which is to played by managers and their policies has been made
successfully in this step.
D2
Clear connection are made between the firm, student's answers and literature,
render an effective academic basis: Here, a team were hired to accomplished a project and
these team members were directed and organised to achieve essential tasks. Methods like past
experiences, trend analysis and variance analyses were used to see projects financial
improvements and projects and also efforts were measured through calculating outcomes gained
in profitability to business finance operations.
3.1 How financial shortfalls can be managed:
Finance shortfalls implies the situation in which company have not enough funds to cover
its obligations due to lack of availability of funds. A shortfall situation may be unexpected as a
result of a current situation or it can be predicted event that will occur in future. It can be
temporary or long-term situation (Cresswell and Sheikh, 2013). So it is important for an
organisation to manage their financial shortfalls through investing money on businesses that will
generate dividend to overcome financial short fall. They should also need to approach to their
creditors or suppliers to make payment to them after providing services to their customers. In
order to manage, reduce and eliminate the financial shortfall, it is necessarily required to
implement some strategic measures such as priorities, Virement, managing cash flow process,
controlling and monitor financial resources, credit facility management etc. It is required for an
organisation such as Silloth nursing & residential care home to evaluate and appraise every
project in order to determine viability and profitability of such projects through conducting
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investment appraiser. This will help to give priority to those projects which helps in achieving
desired goals and targets in order to avoid shortfall situation (Luo and et. al., 2012). There is also
another way to manage shortfall situation is to motivate their customers to make payment
through bank credit cards rather than using account facility they have with the organisation.
Virement which is also one of the important measure to manage financial shortfall which implies
that the manager should need to transfer the funds from one department who has surplus funds to
another department who faces shortage of funds.
3.2 Explain the actions that would take to overcome financial fraud
When organisation follows pre-mediated act in order to get unfair gain is called as fraud.
For example when an organisation refuse to show its annual financial report to HMRC. Silloth
nursing & residential care home should need to implement fraud management control system in
order to detect, prevent and response. The organisation should need to carry out investigation,
brainstorming, gather the relevant information, review business control system and internal and
external auditing system and also need to review the whistle-blower report in order to interpret
and understand the financial fraud such as misappropriation of assets, financial reporting or
corruption. The management of Silloth nursing & residential care home should need to conduct a
risk assessment to understand and identify areas of risk, types of risk and measures that can be
implemented in order to monitor and prevent such risk when they occur. Investigation should
also be done within the organisation in order to find out the staff members who commits fraud
either through misrepresentation of material facts or through using his position in an organisation
(Crawshaw, 2012). It is required to encourage the staff member in order to provide information
about such suspicions act to their line managers so that they put certain corrective measures to
prevent these fraudulent acts. It is also required to conduct brainstorming session in order to
prevent fraudulent act within an organisation. It can be done through organising team and
conducting meeting with the purpose of identifying and assessing the risk that may occur in
future. An organisation should also need to communicate policy statements and the
consequences of non-compliance. In order to analyse all issues regarding fraud, staff and
management malpractices and monitory audit and financial records, a fraud monitory officer will
need to be appointed so that no fraudulent act could be conducted in near future.
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3.3 Evaluate budget-monitoring arrangements in a health or social care organisation
Budgetary control is the process of preparing plans and budgets in order to monitor actual
activity and expenditure or income and if there is any difference occurs then certain corrective
measures should need to be taken (Murdoch and Detsky, 2013). Therefore in order to monitor all
financial activities of the organisation, Budget monitor procedures are need to be implemented .It
helps in analysing the financial records to identify problems and irregularities in the balance
sheet and through the spread sheet manager are able to check all inventories, expenses, stock for
error and discrepancies. The organisation should have cost control centre to control and analysis
of expenditure and income at the cost centre level. The cost incurred by an organisation should
need to be identified, quantified, grouped together in an appropriate manner and thereafter
compared with planned limits. Some basic principles of budgetary control system and monitory
includes clear division of responsibility which need to be identified in order to avoid confusion
and speed up action, consistency which should be maintained related to the comparison purpose,
commitment accounting, and expenditure profiling. Manager can also use spreadsheet data and
cash flow figures, evaluate progress, identify problems and plans. Expenditure profiling which is
one of the basic principle of monitoring budget helps the manager to obtain decision and after
end of the period the manager is able to compare actual data with the pre-determined targets and
thus should make a report containing the budgeted and actual figures with the reasons of the
variances by the financial department and a meeting should be held with the main departmental
heads (Buchbinder and Shanks, 2016). Effective management monitoring entails regular
scrutiny, making comparison of what was forecasted and what is actually happening in an
organisation.
M3
 Adequate structure and approaches are used .
 Justified and comprehensive analysis are covered.
 Technical language is appropriately implemented via entire answers.
D3
 Audit is completed by applying various management strategies.
 Assignment is fully completed on time.
 Diverse roles are identified with detailed analysis.
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4.1 Information required to make financial decisions relating to a health and social care services
To set up a business, financial decision making process plays an important and crucial
role. Decision making process is a practice that happens in an organisation on day to day basis.
For Silloth nursing & residential care home, their decision are made at management level based
on information compilation and analysis from profit and loss accounts, spreadsheet, cash flow,
budget and inventory. Management needs some time to make decisions at various level, such
decisions include: capital investment, company performance and risk management. In most
organisation the top level management usually take strategic and crucial decision through
consulting with all departmental heads. The factors like payback to for the investment should
also need to be considered (Mladovsky and et. al., 2012). The decision related to the capital
investment related to the how much to pay investors, the profitability of the company or the
expected return on investment should need to be considered. Likewise making decision related to
managing risk should also be considered through which company able to know about their
capability to take risk and how they control and monitor the risk. This all related decision need to
be implemented in order to determine the suitability of the business in the best interest of the
customers. Therefore in order to make strategic, tactical or daily operational financial decision,
various information is required to support and direct the decision making process. This
information includes awareness of the following:
 Source of income
 what to produce or the types of service to offer
 cost and expenditure, purchases, pricing
 knowing the suitability of systems in pace
 how much to produce
 where to locate
 who to use and whether to develop new strategies or stick to existing ones
4.2 Analyse the relationship between Silloth nursing & residential care service delivered and
'cost and expenditure' :
Factors such as safe and conductive environment, service user happiness and comfort,
person centred approach and outdoor activities for patient should need to be considered in order
to ascertain the quality of Silloth nursing & residential care to service user (Drummond and et.
al., 2015). It is necessarily required to identify the key issues which affecting the service user
11

through consulting with service users and family to identify those issues. If some of the keys
issue are not identified it will be very difficult to justify cost and expenditure of the
organisational against the outcomes and quality of service. However, in order to make positive
effect of cost and expenditure towards the quality of service, the Silloth nursing & residential
care home ought to be comprehensible, proficient, suitable, continuous, well organised, effective,
safe, sustainable and responsive. The manager should understand the needs of the service users,
staff development and training, necessary needed equipment and supervising and monitoring of
the service. Focusing on these priorities will help in improving quality and service user
satisfaction. It is also required to monitor and evaluate the staff performance and appraisers in
order to determine areas of improvement. As money is a scare means, cost and expenditure exists
as a method to manage money and money is managed in order to ensure the delivering of quality
care service.
4.3 Evaluate how financial considerations impact upon a service user
Financial consideration impact a service user in many ways. One such aspect is the
financial consideration on staff in form of cost of staff, method of training and mode of training
i.e. e-learning or workshop. Consideration in whether to spend or not to spend on suitable
training staff training will affect the service user (Karanikolos and et. al., 2013). A decision
should need to made whether to investing on development , monitoring and supervision of staff
or not. Therefore through this consideration the Silloth nursing & residential care home will be
able to reduce the staff turnover and help in retaining highly motivated and competent staff to
provide quality. If the management does not invest in good training then the individuals would
not get quality service as the staff is incompetent and not capable enough in the basic functions
as well. Consideration on amount of staff wage expenditure and the need for staffing levels
according to the individual needs. If the enough staff is provided then personal centred
approaches can be implemented otherwise lack of enough staff could lead to lack of accessibility
of required services.
4.4 Suggesting ways to improve care service provided by cited firm:
Financial system is composition of inter-relationship between all financial institution and
their process, for example shareholders, creditors, banks, accounting bodies, companies house,
cash flow, finance management, financial statement, budgets etc (Chartier, 2014). Understanding
the financial system and process will help the organisation to make transformations to the system
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and at this same time enhance the quality and effectiveness of the service. There are different
ways of improving the quality of health and social care which are as follows: Payment by results: It transfers the risk and responsibility from the government to the
healthcare providers under the government policy. It also motivates healthcare to enhance
their services to attain excellent value for money. As per PRB system Silloth nursing &
residential care home will make sure that all services should be provided with required
standard and desired outcomes which help the user to get value for money and
satisfaction with the service. Benefit cap: SNRC could lobby the government on getting a higher benefit cap from the
patients before the local authority steps in. NHS charging overseas visitors: SNRC could charge a higher price from foreigners who
seek care in their homes.
 Equity and excellence: Pay drug companies according to the value of new medicines. To
promote innovation, money will follow the patient through transparent, comprehensive
and stable payment systems and providers will be paid according to their performance
(Swayne, Duncan and Ginter, 2012).
CONCLUSION
From the above report it can be concluded that it is very necessary that finance shall be
managed for health and social care sector as by that requirements of patients are met. Certain
costing principle are there that can be used. All all the information that is required for resources
management id identified and also the regulations that are to be followed for it is discussed. The
income can be earned from various sources and they have been identified together with the
manner in which various systems in respect of them can be evaluated. Budgets are very essential
in this process and types of them are determined. There are various issues which are faced in
respect of it and the manner in which they can be resolved has also been identified in this project.
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