Analysis of Dementia Services in the UK: Policy and Practice

This essay provides a critical analysis of contemporary issues in healthcare policy and practice, specifically focusing on dementia services within the United Kingdom, with a particular emphasis on the London Borough of Bromley. The introduction highlights the growing challenge of dementia and its impact on individuals and the healthcare system. The main body delves into the key issues identified within dementia services, including a critical evaluation of the effectiveness of existing policies and the quality of care provided. It examines the application of frameworks such as Kurt Lewin's Change Model to address these issues, along with management and policy frameworks. The essay also discusses the importance of staff training and policy frameworks in delivering effective dementia services. The analysis includes an overview of the challenges faced by the healthcare industry and proposes potential solutions to improve the quality of care. The essay also examines the effectiveness of dementia services in the London Borough of Bromley, considering the application of various frameworks along with the concepts regarding the issue.

Contemporary Issues in
Healthcare Policy and Practice
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Table of Contents
INTRODUCTION...........................................................................................................................3
MAIN BODY...................................................................................................................................3
Critical analysis of the key issues identified within dementia services......................................3
Application of range of frameworks and concepts regarding the issue.....................................6
CONCLUSION................................................................................................................................9
REFERENCES..............................................................................................................................11
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INTRODUCTION
Over the years, healthcare industry of United Kingdom has faced ample number of issues
while raising living standards, hygiene and so on. The major reason that came in front was
accelerating rates of various diseases, which led them to take immediate actions. Here, mental
health is one of the subsection within health sector that majorly affects individuals throughout
life from the age of all the individuals (Bajpai, 2018). It has been analysed that, mental health
disorders like dementia and more within United Kingdom has impacted daily lives of more than
850,000. Including this, based on the assumptions it has been found that these numbers will
reach to one million or may be more than that in the year of 2021.
This essay is going to be enclosed with a particular mental health disease i.e. Dementia.
Basically, this disease particularly characterized by different elements like decline in memory,
language related issues, issues while solving different problems along with other thinking related
skills. This has impacted on an individual's ability to conduct daily activities. Away with this,
primal symptom is memory loss, which can be considered as a good example of a person who is
suffering from Dementia. Also, this disease consists of more than 200 subtypes where five most
common types are: mixed dementia, vascular dementia, Alzheimer’s disease, frontotemporal
dementia and dementia with Lewy bodies. On the other hand, information in relation to this
particular topic will be taken from qualitative investigations done by various researchers in past.
Including this in this essay, the borough which has been taken into consideration is The
London Borough of Bromley, that specifically considered as one of the most affected area of
London by different types of Dementia. In order to reduce numbers of people who got affected
by Dementia, both local and national government has taken various steps. Along side this,
assignment will show effectiveness and quality of Dementia services in relation to both
nationally and local borough of London. Lastly, essay will also consider application of various
frameworks along with the concepts regarding issue.
MAIN BODY
Critical analysis of the key issues identified within dementia services
Dementia in United Kingdom is said to be a growing challenge for healthcare industry.
As the public ages and individuals live for more, it has gotten one of the most significant well-
being and care issues confronting the world (Brownson and et. al., 2017). In England it is
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assessed that around 676,000 individuals have dementia. In the entire of the UK, the quantity of
individuals with dementia is assessed at 850,000. Dementia primarily influences more seasoned
individuals, and after the age of 65, the probability of creating dementia generally duplicates at
regular intervals. In any case, for some dementia can grow prior, introducing various issues for
the individual influenced, their carer and their family. There are around 540,000 carers of
individuals with dementia in England that are continuously serving them, so that they could get
recover real soon (Cherry and Jacob, 2016).
Away with this, if it is talked about the quality of dementia services that has been given
by Department of Health and National Health Services (NHS) are providing support for system
change. This has specifically raised professional awareness of dementia among public within
United Kingdom. The effectiveness can be understood with a good example of Government’s
first National Dementia Strategy i.e. Living well with dementia. Basically, this policy was
formulated and presented in front of public in the year of 2009, where it outlined three key scope
for the individuals who were dealing with dementia. Here, it is said that quality of life was
particularly be considered as something that led carers in England to keep their focus on. All the
three segments were enhancement of diagnosis rate of individuals that are dealing through
dementia. Including this, removal of stigma, which specifically leads a person to go through
different drastic condition. The third attribute was linked with increasing service for individuals
who has dementia. This raised awareness, which can be considered as a primal effectiveness that
was seen of dementia service offered by national government. If it is critically analysed then it
can also be said that considering only the three dimensions, a policy cannot be developed in
relation to a disease. The reason behind this saying is that, every single individual consists of
various health issues. Therefore, it is not that easy for health practitioners to conduct the
investigation on a particular area (Cooper and Quick, 2017).
Also, it has been found that professional and public awareness was specifically spread
through considering different norms and conditions so that quality of the dementia service could
effectively gets improvised. Some of the norms or rules, which were followed was individuals
should be informed of the benefits of timely diagnosis and care, no discrimination and lastly,
social exclusion. Including this, it is said that both of the national health care agencies also took
into consideration of Early diagnosis and intervention where effectiveness of all the good-
quality early diagnosis and intervention for all has also been taken into consideration considering
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a number of deliverables like all people with dementia to have access to a pathway of care that
delivers: a quick and capable expert assessment, exact finding that is delicately imparted to the
individual with dementia and their carers, prompt treatment. The framework needs to have the
ability to see each one of those with dementia. Under this, it is critically analysed that, all the
existing policies developed by Government and London Borough of Bromley has not worked
appropriately and this is the reason behind increasing numbers of patients dealing with dementia
and Alzheimer's (Evans, 2016).
On the other hand, if it is talked about dementia services that has been given in The
London Borough of Bromley by Joint commissioning of local authorities, considering an
effective i.e. continuity of support and advice outcome. This is where, continuous support has
been given by many health practitioners (neurologists, neurosurgeons and neurohypophysis).
Here, it has been analysed that advice that is specifically been given has directly provided quality
services to those individuals who were dealing with dementia including their carers as well.
Effectiveness of this approach where creation of dementia friendly communities brought
improvement within the awareness among citizens of The London Borough of Bromley. Quality
was also raised with the help of establishment of various dementia-friendly policies that led by
Alzheimer’s Society. Also, if it is critically analysed then it can be said that there were various
patients that has reported against mental hospitals and practitioners in relation to the quality
service that was served was not that appropriate in nature, which resulted high depression in
relation to mental health (Feo and Kitson, 2016).
In present context, Kurt Lewin's Change Model is specifically taken into consideration,
which consists of three stages that has helped this approach in building different concepts in
relation to change. Including this, it is said that this model could effectively deliver a number of
opportunities for authorities to bring change considering a particular framework. In this model all
the stages are: unfreezing, changing along with the refreezing steps.
For operating it in new and fresh way unfreezing is used which involves changing of old
ideas for implementation of new ones. This is done because existing faculties in health care
services are not enough to satisfy patients which is impacting negatively on firm services as it
will lead in patient dissatisfaction so their is need to bring new ideas in health care services.
Basically, if it is talked about both the place the whole United Kingdom and The London
Borough of Bromley, then the existing number of staff within different hospitals in relation to
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mental health are not that much. This impacted upon awareness and has resulted increase within
the number of patients who are having dementia. In present context, the change that are required
within the mental healthcare department is particular related to number of staff member, which
are less in numbers at the moment. Therefore, driving force in present context is directly linking
with the appropriate needs of patients. The next step is implementing change it is done through
changing in idea method and techniques which will benefit to industry as building trust of
customers this is to satisfy the needs of customer and fulfilment of unfreezing process. Under
this, change that is required to be implemented is directly linked with staff, where recruitment
policies of hospitals within United Kingdom and London Borough of Bromley could effectively
gets improvised (Goldson, 2019).
The third step in this process is refreezing which states that the change should be
implemented on organisation and that must be adopted permanently on organisation as fixed
function till the need of change does not arise. This model have several benefit to hospitality
industry as there is continuous need to adopt change in there functioning because of building
trust of its customers and forming specialized group of people who can run organisation in any
circumstances without any problem. refreezing also aid in positive response of patients as it
reduce the chances of failure and will introduce new facilities for running hospitality industry. In
present context, restraining force that came in front was change is not acceptable by existing staff
within mental health industry of United Kingdom and within London Borough of Bromley as
well.
Application of range of frameworks and concepts regarding the issue
For London Borough of Bromley, it is mandatory that all staff of hospitality industry
must use theory and framework of leadership and management. Which will help in providing
clinical support in reducing the chances of dementia in old age and will prevent form it. This will
also help in increasing medical facilities (Hubley and Copeman, 2018).
Management and organisational approaches
It include theses are the general rules and regulations which are formed to achieve goals
and objectives with proper utilization of organisational resources which are scare in nature , for
hospitality industry management is important as to facilitating their customers in effective way
by fulfilling there needs there are various theory which can help in maintain mental ability of
patients (Zych, Farrington and Ttofi, 2019).
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Fayol theory : This theory is best for the condition of London Borough of Bromley, as it
will help staff of hospitality firm For London Borough of Bromley, managing and dividing work
accordingly with effective utilization of resources this will also help firm in identifying new
opportunities to make good treatment its patients.
Taylor theory: According to Taylor theory staff can be motivated through effective
management of their pay by compensating them according to abilities and talent of employee
their moral will get boosted. This will aid the London Borough of Bromley in getting more
facility and good treatment (Jupp, 2016).
System theory: There are various issues which London Borough of Bromley area is
facing which is need to fulfil. Challenges that they are facing are worst of its own kind like lack
of beds, shortage of equipment and patients, lack of medical practitioners these all thinks can be
solved with the help of system theory implementation.
Policy frameworks
Policy framework is a set of rules and regulation formed by a firm to facilitate smooth
working in their organisation (Wolfson, 2017). For London Borough of Bromley, there is great
need of effective policy and rues because they have to aware people for prevention from this
problem and for this they have to fit mental health of children and adults. It have to work in
direction of removal of loneliness from there life with the help of forming social groups.
depression is main reason of dementia but good policy framework can help in removal of it as it
will increase chances of social interaction and working and living together.
Best practice approaches
Different hospitals provide services to improve mental disorders faced by patients in
London Borough of Bromley. They support patients who are suffering from different mental
pressure related problems like dementia and Alzheimer's may need help with wide range of
issues at some point in their life (Khamisa and et. al., 2016).
Ethical approaches
Ethics involve analysis of moral obligations. There are different approaches considering
mental healthcare of individuals and society. There are various principles of ethics such as
anatomy which refers to right of the patient to recover his health condition. In relation to this, it
is said that patients within London Borough of Bromley along with the whole country i.e. United
Kingdom, has dealt with various issues like work pressure, which also impacted on their day to
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day lives. Therefore, it is needed by hospitals to consider elements like Beneficence. This is
where, care practitioners needs to provide best service and benefits to patients dealing with
various problems like Alzheimer's and dementia. Non-Maleficence is a ethical principle which
means that decision of health practitioners should not put any negative impact other individuals
and society even when it is beneficial for patient. Justice states that there should be fair medical
decisions (McCormack and McCance, 2016). Theory for ethical approaches include:
Virtue ethical theory:
This theory involve virtues of an individual in decision making process. Different mental
health institutes can implement this theory understand that what virtues are necessary for the
good of public mental health issues in London Borough of Bromley and then decide accordingly.
Value based approaches:
Value based approaches made by the respective industry i.e. mental, NHS and more has
specifically delivered quality care for their patients. Under this methodology, diverse emotional
wellness foundations try to give better mind to individuals dealing with patients i.e. lower cost.
They guarantee that healthcare experts like Neurologists and different mental health practitioners
like surgeons are giving right consideration to their patients at opportune time in London
Borough of Bromley. Thus, a worth based methodology cause specialist co-ops to co-ordinate
with one another and maintain a strategic distance from to settle on choices independently
(Palaiologou, 2016). On the other hand, it is said that value based methodologies has also
accepted all the values in relation to considering all the confirmation when settling on choices
about consideration. In this way, particular value based consideration help in reshaping all the
medicinal services association like NHS and improve results i.e. reduction within the number of
dementia related cases.
Leadership approaches
Leadership is said to be a crucial ability that has been taken into consideration by
healthcare industry where, policies along with the management related guidance is being done.
Since, the number of patients of dementia is continuously increasing, therefore, it can easily be
said that the whole leadership management system should be changed of mental health
department of London Borough of Bromley. This is where, a small change within the system
could lead London Borough of Bromley to take right actions in relation to spreading awareness
of dementia related information and so on. On the other hand, if it is talked about the change that
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is required to be implemented then it can related to various leadership theories, that would lead
to attain a number of goals and objectives like reduction in cases of dementia within the borough
and in all over United Kingdom and some of these are mentioned underneath :
Transformational Theory: This theory may lead all the different agencies within hospital
industry to bring change within the numbers of dementia cases. Through this, better engagement
within the staff with leader can easily be seen, which will lead them to perform better and may
become much more motivated as well, while serving to individuals (Schaltegger and Burritt,
2017).
Transactional theory: This specific theory of leadership association has given number of
disciplinary rules and regulations of their workers for improving their presentation in London
Borough of Bromley. But, if it is critically analysed then this transactional theory cannot be
applied among all the different areas and may impact negatively on performance level as well of
hospitals serving to patients dealing with dementia in London Borough of Bromley.
Wagner’s chronic care model:
This model aides in building assistance related methodologies, for example, activity
arranging, critical thinking, objective setting and subsequent meet-ups. distinctive psychological
wellness organizations should utilize this model to convey errands among medicinal services
professionals and to convey quality consideration to their patients in London Borough of
Bromley (Pilgrim, 2019).
CONCLUSION
Considering the information given above, it is concluded that spreading awareness about
dos and dont's in relation to dementia could help patients dealing with it. Including this, it is said
that change management along with the appropriate measures in relation to dementia that can be
implemented in order to reduce ratio of individuals that are dealing with mental health conditions
like dementia. Including this, it is said that organizational along with the management
approaches among healthcare industry are made to deliver best quality of treatment to the
individuals. Tools and approaches are executed in the association to improve well-being state of
patients and administrations of association. Subsequently, it is compulsory to concentrate on
well-being states of people managing dementia as nowadays their state of mind is affecting each
other day and they are confronting mental scatters, for example, uneasiness, mental pressure,
dementia, Alzheimer's and numerous other.
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On the other hand, it is also summarised that inclusion of expert medicinal services
professionals needs to have specific goal that right and suitable treatment should be possible.
Coordinated consideration ideas are should be executed in such associations to improve benefits
in regard of value, effectiveness and client fulfilment. Change the board approaches are also said
to be some of the crucial ones, which helps in utilising advancement within the healthcare sector
and new innovations for specialist organizations. Including this, it is also concluded that staying
healthy, performing exercise, eat appropriate food, controlling hygiene, managing health related
problems in relation to high blood pressure, diabetes, along with the high cholesterol could help
an individual in becoming self aware and reduce the chances of getting involved among social
aspects. Away with this, considering different approaches like Kurt Lewin's Change Model,
Integrated care concepts, Wagner’s chronic care model and more could help both government of
United Kingdom and local community to effectively take into consideration of change, which
might reduce the chances of facing any risks while applying a particular change.
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REFERENCES
Books and Journals
Bajpai, A., 2018. Child rights in India: Law, policy, and practice. Oxford University Press.
Brownson, R. C. and et. al., 2017. Evidence-based public health. Oxford university press.
Cherry, B. and Jacob, S. R., 2016. Contemporary nursing: Issues, trends, & management.
Elsevier Health Sciences.
Cooper, C. and Quick, J. C. eds., 2017. The handbook of stress and health: A guide to research
and practice. John Wiley & Sons.
Evans, T., 2016. Professional discretion in welfare services: Beyond street-level bureaucracy.
Routledge.
Feo, R. and Kitson, A., 2016. Promoting patient-centred fundamental care in acute healthcare
systems. International journal of nursing studies. 57. pp.1-11.
Goldson, B. ed., 2019. Youth justice: contemporary policy and practice. Routledge.
Hubley, J. and Copeman, J., 2018. Practical health promotion. John Wiley & Sons.
Jupp, P. C., 2016. Contemporary issues in the sociology of death, dying and disposal. Springer.
Khamisa, N. and et. al., 2016. Work related stress, burnout, job satisfaction and general health of
nurses: A follow‐up study. International journal of nursing practice. 22(6). pp.538-545.
McCormack, B. and McCance, T. eds., 2016. Person-centred practice in nursing and health
care: theory and practice. John Wiley & Sons.
Palaiologou, I. ed., 2016. The early years foundation stage: Theory and practice. Sage.
Pilgrim, D., 2019. Key concepts in mental health. SAGE Publications Limited.
Schaltegger, S. and Burritt, R., 2017. Contemporary environmental accounting: issues, concepts
and practice. Routledge.
Spalek, B., 2016. Crime victims: Theory, policy and practice. Macmillan International Higher
Education.
Wolfson, M., 2017. The fight against big tobacco: The movement, the state, and the public's
health. Transaction Publishers.
Zych, I., Farrington, D. P. and Ttofi, M. M., 2019. Protective factors against bullying and
cyberbullying: A systematic review of meta-analyses. Aggression and violent
behavior. 45. pp.4-19.
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