Healthcare Policy Analysis: Diabetes, NHS, and Nursing Roles in the UK

This essay provides a comprehensive analysis of UK healthcare policies concerning diabetes and the evolving role of nurses within the National Health Service (NHS). It examines the impact of diabetes as a chronic disease, the increasing number of patients, and the associated complications, including cardiovascular diseases, renal failure, and blindness. The essay delves into the National Service Framework (NSF) program, outlining its standards and objectives for improving diabetes care, including risk reduction, early identification, patient empowerment, and effective clinical management. It also discusses the ethical and legal perspectives of diabetes care, highlighting the challenges faced by healthcare professionals, relevant laws such as the Equality Act 2010 and Data Protection Act 1998, and ethical considerations such as patient privacy and decision-making capacity. The essay concludes by assessing the impact of the NSF on diabetes care, emphasizing improved patient outcomes and enhanced care organization practices, supported by regular audits and adherence to ethical guidelines. The content is supported by evidence and references to academic sources.

Policy and Community
based Nursing

Public health is a matter of vital importance for the government of a nation. It is all about
helping people to stay healthy and protecting them from the threat of harmful diseases. Thus
government and health bodies formulate health policies so that individuals can make healthier
choices irrespective of their circumstances (NHS information. 2013). The present essay explores
a deep and systematic understanding of the health care policies that is employed by the UK
Government in order to provide better care services to care takers. In addition to this, it also
critically analyses health policy for diabetes and its influence on health care services of National
Health Services (NHS) of UK. Besides this, it also features the changing role of nurses in
effective implementation of health policy.
Few decades ago Diabetes was considered as a death warrant in UK. The number of
diabetic patients are increasing in the world including England. The are more than a million of
individuals who are diagnosed with this chronic condition and the number is growing
continuously (Alexiadou and van de Bunt-Kokhuis, 2013). Diabetes is a chronic and progressive
disease which can potentially affect individuals of all ages. The disease significantly affect the
physical and psychological well-being of patients as well as their families. It is comprises of
group of disorders with varied causes depicting a single trait of raised blood sugar level. This is
primarily caused due to lack of a hormone called insulin which regulates blood sugar level in
human body. Complications in diabetes may lead to various health problems such as
cardiovascular diseases, renal failure, stroke and blindness. In addition to this, it can result into
premature death and disability if not cured properly. It has been observed that prolonged
exposure to raised sugar levels in blood causes damage to body tissues. The early diagnosis is
very crucial as the increased blood glucose levels can lead to irreversible changes in tissues and
damaging eyes which makes the affected person blind. In addition to this it also causes damage
to kidneys which leads to progressive renal failure in diabetic patients. Apart from this, there are
several other conditions that occur very frequently in the patients suffering from diabetes. It has
been observed that urinary tract infection is very common among diabetic people. Besides this,
cataract also hit diabetic patients in the long run (Baggott, 2007). Apart from this, mental health
issues such as depression and eating disorders also affect the physical as well as mental well-
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being of individuals. However, the condition does not affect every individual equally in the
society. There are significant inequalities that prevails in the risk involved in the development of
Diabetes. In addition to this, inequality also exist in the access of health care services and quality
of these services with regard to Diabetes.
Diabetes, being a life long disease have a significant impact on various aspects of
affected person's life such as lifestyle, relationship, health, work and life expectancy. It has been
observed that mortality rates increases among affected people due to greater risk of coronary
heart diseases and stroke. In addition to this, leads to additional risks among pregnant women. It
is found that diabetic women have increased chances of miscarriages or still births. Besides this,
the condition may trigger congenital malformation in infants or deaths of new born babies during
infancy (Demers, 2004).
There is a significant impact of Diabetes in health and social care services in UK. Nearly
5 percent of total NHS resources are used for providing care to diabetic patients. In addition to
this, around 10 percent of hospital in patients resources are used in the treatment of diabetic care
takers in UK (Powell, 2002). Further diabetic people are twice as likely to be admitted to care
organizations as compared to their healthier counterparts. It has been observed that NHS costs
increases five folds with the presence of complications in diabetes. Besides this, it has been
estimated that more than three quarters of social services costs are related to residential and
nursing care. Home help services accounts for another one fifth. Therefore it can be said that
presence of diabetic complications increase the social services cost up to four times in UK's
health and social care sector.
Therefore it became very important for UK government to formulate an effective health-
care policy to reduce the negative impact of Diabetes on patients. For this, The National Service
Framework (NSF) program came into big picture in UK. The NSF program was established with
an aim to ameliorate health care services (Primdahl, Kristensen and Swaffield, 2013). This is
done by setting the national standards to improve the quality of services and handling variations
in the care of diabetic patients. The NSF framework for diabetes include range of standards,
important interventions and implications of planning care services. There are number of
standards which are set by NSF in order to identify people with diabetes and providing them
effective care to help them combating this fatal disease (The National service framework, 2011).
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Standard 1 of the framework features NHS practices to craft, implement and monitor
strategies to reduce the risk of developing diabetes among care takers and minimizing
inequalities in the risk of developing the chronic condition. Standard 2 enables NHS to formulate
strategies to identify people who are more likely to develop diabetes. In addition to this, it is also
crucial for NHS to regularly monitor the implemented strategies (Reisman, 2007). Standard 3
assist NHS to formulate health policies that can empower care takers to manage their health
condition effectively and help them in adopting habits to lead a healthy and blissful life. Under
this practice, children, adults and older people affected by diabetes will receive care services that
promotes partnership in decision making activities regarding their health needs. The practice
may be reflected in a shared care plan which will have a definite format and language. The
process may also engage relevant family members and carers of the diabetic patient.
Standard 4 deals with an effective clinical care of adults suffering from diabetes. The
framework features that NHS will provide lifelong quality care services to children and adults
with diabetes (Rummery and Glendinning, 2009). The families of service users are also included
in their day to day care. Standard 5 explains that NHS will remain focused to support patients in
controlling their blood glucose levels and encouraging patients to lead a healthy life in-spite of
the chronic condition. It also aims to develop individuals physically, emotionally and socially.
Standard 6 states that diabetic patients will experience a transition of care from pediatric
services to mature diabetic services irrespective of types of services such hospitals, care homes,
residential homes or community based services (Thielscher, 2010). The transition will be
facilitated in partnership with service users based on their age and health needs. Standard 7
forces NHS to develop, execute and monitor protocols for effective management of emergencies
related to diabetes with the help of trained care professionals. The protocols will also entail the
management of acute diabetic complications and practices to reduce risk of recurrence in future.
Standard 8 deals with care plan of diabetic people during hospital admissions. All care
takers including children, adults and older people will receive effective care for diabetes once
they are admitted to hospitals (Swayne, Duncan and Ginter, 2012). The health care providers will
include clients in decision making processes regarding their disease management. Standard 9
enables NHS and other care organizations to formulate and implement policies to provide care
and support to women with already existing diabetic conditions or those who develop diabetes
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during pregnancy. Standard 10, 11 and 12 deals with detection and management of long term
complications among diabetic patients (Visscher, 2012). NHS will develop policies and
implement them to reduce the risk of long term complications of diabetes such as disability and
premature deaths.
There are certain ethical and legal perspectives associated with complications and long
term care situations in health and social care. Health professionals who are provide care and
support to patients in care organizations are challenged by legal and ethical issues. This happens
because care homes need to abide by complex regulations and also the diabetic patients have
complex medical concerns (Ethical choices in long-term care, 2002). The situation become more
complicated while handing diabetic emergencies. In addition to this, sometimes there are certain
issues that are new and obscure to long term care setting. The frequently occurring issues are
decision making capacity of service users, psychotropic medications, patients abuse, restraints,
effective management health conditions of care takers and aligning health care practices with
organizational policies (Health policy, 2014). In addition to this, sometimes health care workers
lack sound knowledge of legal and ethical framework. As a result they fail to equip themselves
with key skills and knowledge to tackle a complicated situation during diabetic emergencies.
Thus it becomes very important for care professionals to update their skills and knowledge to
effectively handle issues that may arise in the complicated situations.
There are several laws and acts that are set by the regulatory and legislative bodies to
monitor the practices of health-care professions who are involved in providing care and support
to diabetic patients. Some of these important laws are Equality act 2010, that encourages care
organizations to treat all service users equally irrespective of their caste, race, gender, age,
religion, sexual orientation and income levels. Similarly Data Protection Act 1998, which are
formulated by UK legislative bodies to safeguard the data of clients who are undertaking care
services for diabetes (NHS information, 2013). It is a prime responsibility of care organizations
to protect personal information of care takers so that it cannot go in wrong hands and is not
misused.
Other than legal there exist several ethical concerns that lies in the bottom of health and
social care services. Quality of care in health-care organizations raises several issues related to
ethics. Sometimes the needs of care takers are misinterpreted which leads to several conflicts
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among clients and care workers. This is usually occur among individuals who lack decision
making capacity related to their care plan such as children and older people. Similarly issues of
neglect and abuse also critical to mention under the ethical issues in health and social care. There
are several incidences that are reported by regulatory bodies related to abuse of patient by the
care professionals. Therefore it is very important to monitor the behavior and practices of care
professionals while providing care to diabetic patients. Another important area of ethical concern
is associated with patients privacy (Health & Safety Policy HS6, 2008). During hospital
admissions the patients often experience that they lose control over their everyday matters. Such
feelings of lost control contribute to development of hopelessness among diabetic patients.
Therefore it becomes very important for care organizations to empower hospitalized service
users to perform their daily tasks on their own to inculcate the feeling of confidence among
diabetic patients. Ethics plays very critical role in providing long term care services to elderly
patients with diabetes. Ethical issues affect the long term decisions of designing effective care
plan for elderly people.
There is a noticeable impact on the health of diabetic patients after the implementation of
NSF for Diabetes. Effective health policies and allocation of health resources has been observed
to significantly improve the physical health of individuals suffering from diabetes. The quality of
care is also improved due to proper monitoring of the health service framework. The care
organizations face less issues related to operational ineffectiveness due to proper management
practices (Li, 2009).Regular audits of health and social care regulatory authorities enable the
health providers to follow good practices and code of conduct on legal and ethical grounds. All
patients are treated equally irrespective of their age, gender, culture, religion, social status and
economic background. The most important impact of implementation of NSF's policies is that
care organizations have reported to keep a track of unlawful care practices that are harmful for
patients. In addition to this, care organizations also work in partnership with clients in order to
access their health-care needs. The partnership is very beneficial as it allows diabetic patients
and their families to engage in decision making processes regarding formulation of effective care
plan (Lapaige, 2009). Effective communication not only plays important role in helping patients
to make informed decisions but also useful for care professionals to develop cordial relationship
with service users and their families. Besides this, the NSF for diabetes also encouraged health
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providers to improve the quality of care services for patients in order to improve their overall
health and well-being. The framework also impacted the organizational practices regarding
privacy of clients. The care organizations are asked to employ an effective database management
system that can keep the patient's data safe and secured and easily accessible to care
professionals at the time of need. It has been observed that after installing a sound database
management system the operational efficiency is improved by many folds. Physicians and care
assistants can retrieve the relevant information of service users in a timely manner reducing the
chances of confusion and misinterpretation of desires of diabetic patients.
National Service Framework (NSF) program has been designed for the people who are
suffering from the long term critical conditions such as Diabetes. The core of development of
NSF program in UK is to critically analyze the positive impact in the life of people who are
working in health care setting organizations such as NHS (Mockford and et.al., 2012). The health
care organization focuses on effective training and communication as the integral tools in
ensuring equality of policies and procedures implementation at workplace. However, the
diseases are uncertain events which may adversely affect the life of many people. This health
care organization in UK takes this aspect into consideration. As per legislation and laws, they are
inclined to ensure safety and security working policies, systems and procedures are followed as
per National Service Framework. The action plans which are taken by NHS in the similar regards
are devising communication methods and channels for sharing of proper working that takes into
consideration the proper and palliative care of people who are having diabetes diseases.
Every member is responsible at their part to identify the significance working for the care
and quality treatment of diabetic patients. It is essential for all irrespective of management staff,
health care professional and registered nurse (Ohnishi, Nakamura and Takano, 2005).This is vital
so that they can raise their voice in line with the protection and prevention from impact of any
worsen situation such as diabetes.
In this section, various roles of registered nurses who work at NHS to provide care,
treatment are also inclined to be responsible for meeting health and safety needs. Since, National
Service Framework program has been dominant in respect of care of diabetic patients, different
aspects are associated. This commences with the classification of various roles that are played by
the registered nurses. For this, roles played by them at NHS have been critically analyzed.
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According to National Service Framework, registered nurse is responsible to take
reasonable care of patients. By doing the same, they are cooperating with the organization and
following the health and safety legislation (Li, 2009). On similar note, they are inclined to take
active participation by becoming part of resolution training. This is for developing a sense of
prevention and protection against any kind of severe disease while imparting treatment or care
action. This may be inclusive of giving them timely medications, injections, diet etc. In contrary
to same, there are instances where it becomes difficult and challenging for NHS to force
registered nurse to participate training. This may be noticed with response to demographic
factors such as race, education, age, level of education etc. may act as a barrier for them to
undertake the actual delivery from the training. There are also chances when those registered
nurses may not be able to access them due to various reasons.
In a streamline of the job role of registered nurses working at NHS, the need of making
them aware with the proper guidelines which are inclusive in the National Service Framework
program for patients care and treatment. UK is a developing nation where use of technology in
health care services and treatment plays special significance. Line managers at NHS also make
use of technologies for informing, instructing and advising regarding policies and their effective
implementation to the registered nurses. This is essential at their part in order to develop them in
case of change in job role (Powell, 2002). However, in contrary to same, organizational change
has been most critical aspect. The fact that technology has been considered as highly obsolete
method leads to affect their job and care which they are providing to patients as well. Lack of
awareness in that case to registered nurses may have adverse impact on their job role processes.
Workforce development has been another aspect which has been critically analyzed with respect
to role of registered nurses. Effective and positive analysis of National Service Framework
policies and methods will create positive impact.
It can be concluded from the present essay that Nation Service Framework for Diabetes
play very critical role in improving the care services of NHS in response to health needs of
diabetic patients including children, adults and older people. It has been studied that NSF
policies greatly impact the health and well being of patients with diabetes. In this policy care
needs of pregnant women suffering from Diabetes or who are likely to develop the condition
during pregnancy are also considered and strategies are formulated for the same. In addition to
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this there may raise several legal and ethical issues while providing care and support to diabetic
patients. Therefore it becomes very crucial for health care professionals to handle legal and
ethical issues effectively in order to reduce the conflicts with patients. Besides this, nurses also
play important role in implementation of NSF policies in improving the quality of care services
for diabetic patients.
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