UK Healthcare Policy: Reforms, Impact on Service Users Analysis

This report examines the healthcare policies and reforms implemented in the UK, focusing on the impact on service users. It discusses the main healthcare policy reforms, including the increased involvement of the private sector and the shift towards a market-based healthcare system. The report analyzes the Conservative/Liberal coalition health agenda, emphasizing the commitment to increasing public expenditure on health and freeing the NHS from political management. It also explores the influence of ideologies and stakeholders on policy development, as well as the impact of policies developed during the coalition government on service users, particularly those with long-term conditions. The report concludes by highlighting the importance of high-quality healthcare services in supporting individuals and addressing health problems. Desklib offers a wide range of resources including solved assignments and past papers for students.

Health And Social Care

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................3
MAIN BODY..................................................................................................................................3
1.1 Main healthcare policy reforms.............................................................................................3
1.2 Conservative\ liberal coalition health agenda........................................................................5
1.3 Recent proposals in healthcare policy and its impact on service users.................................8
2.1 Ideologies and backgrounds which affects the healthcare policy developments.................10
2.2 Stakeholders can influence policy development..................................................................12
3.1 Impact of policy that developed during coalition government on service users in healthcare
...................................................................................................................................................14
3.2 The government policy on supporting service users with long term condition and
implication for service user.......................................................................................................17
CONCLUSION..............................................................................................................................20
REFERENCES................................................................................................................................1

INTRODUCTION
Health and social care are related to the services which are provided in UK. It includes all
the infrastructure of healthcare and the private sector. It is related to the treatment of bad health
and medical conditions in the healthcare centres as well as in the community. Social care is about
the care and support required for vulnerable people, normally in a community. It is not possible
to consider a world without any health or social care. Nurturing in this system has helped many
individuals and their families (Hawkins and McCambridge, 2019). There is some difference and
also an interconnection between health and social care. Health provides function to attain welfare
and is dependent on many reasons such as biological, environmental and some other living
standards. The aim of healthcare is offer medical care to individuals while also dealing with the
diagnosis and treatment of physical and mental disabilities. It is one of the biggest necessities
and helps in reducing social inequality at the time of health care. On the other hand, social care
deals with the day to day activities of living and following the basic hygiene and maintaining the
same. Having social care can help reducing the unnecessary visits to the healthcare systems and
also helps in quick discharge of patients lastly, making it less dependent on healthcare bodies.
Both health and social care will produce collaborative work which will make the society a better
place. This report deals with the different policies of healthcare and the factors influencing them.
MAIN BODY
1.1 Main healthcare policy reforms
During the time of election, healthcare was seen to have as the main issue from the public
side. The labour party responded to take this concern and reform different policies to introduce
more private sector involvement in the delivery of the healthcare. The basic standard of taking
care of the patients in the private hospitals of Britain is below the level which is found in the
public hospitals (Ferlie, 2017). There were new contracting arrangements made which resulted in
the increase of administration costs from inside of the systems. There was more faith in the
private sector management and its techniques which misplaced during the time when the real
problem on the national health services of the capacity. The labour party is committed to redefine
the different aspects of the healthcare and making it as a personal responsibility rather than
making it as a right. This lead Britain move towards the market based healthcare system.
National health services have contributed in providing free access to the healthcare for the people

of UK at very low costs. The labour government has planned to reform the system in a radical
way. The labour government kept the belief of direct state and ownership for the public facility
being inefficient (Cummins, 2018). Labour party had a great involvement in the profits sector
where ownership and the operations of the publicly funded healthcare facilities, They said that
NHS must use the for profit sector during the time of commissioning healthcare services. Private
companies are supposed to bring in the management which is by the publicly owned hospitals.
This policy was clearly informed by the belief where public ownership and management are
hindrance and making an efficiently working healthcare system. NHS is supposed to move
towards a more market based model. The proposals of these policies were non ideological and
were made to discourage the public debate regarding the changes. Depending on the public
healthcare companies were there to offer a state funded health care system by introducing new
stakeholders in the healthcare system of Britain having the financial claims on the revenues of
NHS. This lead to increase in the costs of administration for NHS and moving the healthcare
provision.
The new labour government was appointed in 1997, which marked by making different
pledges used to dismantle the internal market. Regardless of the ideology, unacceptability in the
internal market is seen to lead sharp inequalities in the service provisions. New labour promised
to spend the saving generated from the scrapping the internal market and reducing on the waiting
for no exception (Buchan, Seccombe and Smith, 2018). The reports of the patient were left for
hours and days on waiting for the beds in hospital to be available. They established national
standards for the treatment and the program to modernise the national health services. They
formed commission for health improvement and national institute of clinical excellence which
was the key moment for the labour health policy. Because of this, the central body of the central
body was investigated and medical benefits were assessed with the methods of cost effectiveness
for different treatments and issuing the guidelines for services. It assessed the clinical
performance of the health service providers while also carrying out investigations on the serious
failures in healthcare. Performance indicators were set and the government published the list
having the rating regarding the performance.
New labour attained the level of command and control and also attempted in modernising
the hearts and minds for the national health services. Different agencies formed were converted
in the NHS institute which aimed for improvements and innovation. This was done to promote

the innovative thinking and changing the ways of working (Smith, 2018). The priorities of the
policy by new labour was about improving the access and reducing the waiting and then later on
increasing the choices given to the patient with the wide range of healthcare providers. This lead
the private sector to provide service in more timely as well as efficient manner where the NHS
can purchase the services in order to generate benefits for the patients.
The labour government of UK brought many changes in the national health services from
the year 1997 to 2010. This was aimed to increase the choices given to the patients regarding the
place of the elective hospital care and boosting more competition between the public and private
service providers for the funded patients. In the year 2006, they initiated a health reform
evaluation program to determine the impact of changes. The high quality care represented the
aim of the government to focus on the next level for healthcare system reform in the UK by
putting in the quality of care while improving the responsiveness and efficiency (Allsop, 2018).
The cultural and behavioural changes lead the NHS to focus more on the generating high quality
for care. Public health budgets were introduced which were less problematic, depending on the
assumptions. The issues were focused on remedying and remaining the central part of the
reformed agenda. In the approach of the labour government resulted in forming the cuts in the
service which is done by the number of managers and having an increased efficiency. It made
NHS more financially attention. A project was introduced to reform the nurse trainings which
was a major change in the style of nursing training where the students nurse is a hospital
employee in a system supernumerary. It spends the parts of their time in getting higher education
and being a part of the clinical placement. There were new mechanism launched for the conjoint
funding for health and social services (Papageorgiou, and et.al., 2020). The new health policies
focused on handling the inequalities. New labour has taken some steps which will produce long
lasting benefits to the service users. High quality of healthcare services play an important part in
the lives of people and supports them from going through health problems.
1.2 Conservative\ liberal coalition health agenda
The health and social care act is about the implementation of different reformed programs
within the timetable which is feasible and there is an anticipated costs saving to be achieved. The
time scale in order to implement new time scales are dependent on different arrangements which
were supposed to be tight. The health and well being board was in transition period to trust the

status and allocate the budgets for public health (Ma, Lemos and Vieira, 2020). Main markings
in the process of implementation of new arrangements includes having specific details in the
mandates of new operating organisations including the national health services. In the coalition
of healthcare reform program, the overall framework of the political responsibility as well as
accountability related to the health services in UK had a secretary of state which retains its
ministerial responsibility for the parliament with the provision of health services. The services
offered by the healthcare systems should be free from any charge and making and recovering the
charges which are provided under any enactment. The responsibilities of secretory of state is to
promote comprehensive to the national health services, they are supposed to hold up the
constitution of national health services while improving the quality of services. They are required
to have a continuous improvement in the outcomes generated for the aim on improving the
public health of public and also reducing the health inequalities.
The agreement having specific pledge focusing on increasing the public expenditure on
the health. It stated to an agreement of funding for the national health services must be increased
in real. This pledge was repeated in broad terms and in commitment with the national values
based on need and not ability to pay (Chin, 2018). The plan was to set national health services
free from the political management and releasing the fund for the front line. The other ideas
behind this was to introduce an independent of national health service board and to develop
monitor to economic regulations while keeping the quality regulated. It had planned to
strengthen the local democratic participation and attaining the accountability which included
elected representatives from the boards of primary care trust. The coalition program committed
to the national health as an expression for the national values and to be free at the point required
to use and based not being able to pay. There is a real increase in the health spending for each
year within the parliament.
It also committed to free the national health services from the political management and
increasing the democratic participation. This makes the national health services to be more
responsible for delivering a value for money and developing a much healthier nation. It stated to
stop the top down re organisations working under NHS and are coming in between the way of
attaining proper care for the patient. It ordered to cut the cost of the administration by a third and
pivoting the cash to the front lines. It asked to give every patient the freedom to select any of the
healthcare provider and meet the standards of NHS and within the prices set by the national

health services which includes being independent and also the community sector providers.
There must be high involvement of independent and voluntary providers. According to the
coalition program, the strength of power of having GP as a patient is an expert guide built on
health system and helping in attaining the commission care on the behalf (Vainieri, and et.al.,
2019). It also involves strengthening of the role of care quality commission in order to make it
become an effective quality to inspectorate.
Coalition health agenda is to develop and monitor an economic regulator which will
oversee the different aspects to access, competition and set the price in the NHS. It developed an
independent board for national health in order to allocate the resources while offering
commissioning guidelines (Atherton, and et.al., 2019). It is supposed to directly include the
elected individuals present on the board of primary care trust. It is done with a reminder of the
board of primary care trust which is appointed by the relevant authority as well as the chief
executive and principle officers appointed by the secretory of states. The local primary care trust
is supposed to act as the champions for the patients and commission to the residual services.
This is best taken care of under a wider level and not directly by the GPs. In addition to this, it
also has a responsibility for improving the public health related to that particular area while
working on a close context with the local authority and some other local organisations. The
success of this is measured on the foundation of results obtained.
There is also a published data of for the performance of healthcare providers on online
platforms and make the patients score the hospitals and its doctors depending on the quality of
the care which the patients are receiving. It is important for the hospitals to open up about the
mistakes done and stop on the centrally dictated closure for the maternity wards. There is no
geographical restriction to the patients with a right of choice. The healthcare systems are
required to develop urgent care services along with GP out of hours services and renegotiating
the contract. There are a values based price set for the drugs and treatment. The discharge
coming of the healthcare systems must be improved and proper with the maximization of number
of day care operations and reducing the delays happening before the operations with access to
care and treatments. It is said to increase the patient control and decision making process
including relations with the health records. It is necessary to create cancer drug fund which will
help the patients to have easy access to cancer drugs. There is also a new dentistry contract added
and a support for children hospices.

1.3 Recent proposals in healthcare policy and its impact on service users
The National health council is there to support the policies which are focusing on the aim
to reduce the costs in the health care for the individuals having some of the chronic diseases and
disabilities. The council respects the quality provided in the healthcare and the goals and
aspirations (Gardner, Webster and Barry, 2018). This has helped in gaining health outcomes
which are important for patients. The council of National health is committed to develop more
sustainable ways which are affordable and produce high value for care with the help of
personalized health. NHS has evaluated many proposals which are intended to address the
healthcare costs in a broad range which includes the prices for drugs. NHS is against the policies
with regard to savings when they have a negative impact on the safety and quality for care. These
efforts are made to reduce the healthcare costs based on this value. This value is determined from
the perspective of patient. The recent proposals are made by considering the existing policies and
proposals and the created a patient centred framework with some main principles. It is done to
promote the high value care, stimulate research and competition and having curb costs
responsibly (Robert, Donetto and Williams, 2021). There are area in the policies which have the
potential to reduce the costs for patients and the health care systems. The policy
recommendations were based to reduce the barriers coming in the way of developing the generic
and biosimilar products along with the assist in the approval of some definite generic
applications where the curb patent settlements are the strategies based on the patents is made to
delay the access to the patient with the lower cost medications and beyond the date of patent
expiry. It is important to encourage competition with the help of supporting the policies made by
FDA and being implemented in a clearly based regulatory path for the biosimilars. It allows the
FDA to determine the interchangeability related to the case by case. The proposal is to support
the policy which will help in avoiding company voluntary restricted systems from being a barrier
to the generic and biosimilar samples of the products which are accessed by the company. It tells
to stop the use of single shared REMS programs negotiations in a way which will lead to delay in
generic entry along with causing no harm to the safety provisions.
Proposal contributes in promoting some meaningful way of transparency present around
the price and cost sharing. Standards must be established for the insurers in the way of providing
some estimations of the total costs which is to be paid by the insurer. The cost shared by patients

for all the covered items and services are important topic for making the decisions which
includes time of the plan sections, information which is under easy access and is easy to
understand. This will allow the patients to anticipate the total costs from before attain the
services and gauge the value of their care. Products and services must have a coinsurance which
will estimate what will be provided and the range of increments which will allow meaningful
estimations done by the patients prior from having the service. In order to create value from the
perspectives of patient, will lead in creating patient centred value framework which will result in
drastic improvement of the existing framework by using the view point of the patient. Creating
the National standards for the service providers and displaying the billing information with the
accessible and consumer friendly way. Here, the patients are able to have a value of their care
with the means of understanding the cost information for the offered products and services. This
includes having the charges set by the service provider and negotiated rates where ever it is
applicable in the cost sharing information. It is to protect the patients from the surprise medical
bills which is done by ensuring the facilities which is supposed to be disclosed to the patients in
an advance way and at the point of service where the status for network for all the providers is
related to the care and includes the provider settings which will help in facilitating the in network
with the specific providers which are out of the network. It is not allowed to have a balance
billing out of the network for the providers required in both emergency and non emergency care.
This will help in preventing in billing from the patients through direct means for the remaining
charges without the agreement of health plans for the payment. It is required to have an
improved disclosures by the insurance companies with an up to date information about the in and
out network of the provider with the patients and providers. It includes the hospital setting and
facilitating the services which are out of the network. It is important to establish a process for
defining the out of network claim and should be paid in full amount.
The proposal was made to facilitate the implementation of the value based insurance
design and to promote the same in the medicare advantage. This includes having the increased
flexibility for some of services such as transportation and other social services which are
integrated with the behavioural care services. It is required to support the development and use of
the outcome which is measured in order to determine the amount to be paid along with the new
benefit models. This will provide new access in having a greater use of measures which are
based on the outcomes which are necessary for the patients in the evaluating their effectiveness

of new models. This will help in promoting and developing the quality measures which are the
patient generated data having their experience and reports of the generated outcomes. It said to
allow the health plans with the flexibility to provide the coverage and some additional services
which will help in managing the chronic diseases before the deductible. Healthcare systems are
supposed to address the barriers of the value based arrangements.
2.1 Ideologies and backgrounds which affects the healthcare policy developments
A wide range of information makes up for the evidence in the process of policy making
which is ranged from the evidence generated from the research conducted as well as information
generated in the process. Evidence can also be generated with new ideas and interests taken from
the knowledge of individuals or even a group of people (Lewis, Waite and Hodkinson, 2017). It
is done to restrict the focus in narrowing down the discussions present in subsequent text to
generate the evidence from the research. Ideas and ideologies are the major parameter in
determining the consideration of bringing the evidence related to the policy. Ideas help in
shaping the belief systems which is important for the policy models. This model highlights each
of the policy which is formed by the coalitions based on the certain type of ideologies and ideas.
For the power and the relations of power for the health professionals and healthcare users, power
is about the means of the capability which is required to achieve the desired outcome and do
something about it. In the process of making the policy, the concept of power is taken in more
relational sense and having power over each other. The power of decision making is given to the
individuals who are rich in political resources such as social standing and wealth, can directly
influence the policy decisions. Individuals in non decision making power are able to use their
influence in imposing limits on the policy agenda (Parnell, and et.al., 2020). Power to control
helps in having the impact in shaping the preferences. All the members involves in the policy
process are having their own interests and the voluntary collection of the individuals attempt to
influence the policy in order to attain the specific goals.
The sectional groups will contribute in protecting and enhancing the interests of their
members. This influence depends on the government. These groups have more influence over the
government generated policies as the cooperation of sectional groups is more important due to
economic reasons and the implementation of these policies. A medical professional is considered
to be a very dominant section of the groups. The cause groups are there to promote and raise

awareness about a particular issue and are formed on spontaneous basis with some actions which
are unconnected with the individuals based on beliefs. These interest groups perform some
function such as participation in order to get involved in the politics and put forward the
opinions. They represent the range of opinions which are under policy making considerations.
these groups are motivated which help them to draw new issues in the attention of government
and develop new policies. They build pressure for taking actions while monitoring the
performance and behaviour of government. Interest groups use their knowledge to address a
particular issue and deliver the services without taking help of any government funding.
Ideologies are the belief systems which are allocated to use the power within the society.
In the case of health, ideologies revolve around the individual freedom and the authority of the
state. It forms the balance between individuals and the collective responsibilities. The ideology
of collectivism puts a great emphasis on the role of state and other collective arrangements which
are highly critical of individualism. The principle means of social intervention is used to support
the public health interventions which are entrenched about the personal liberties. Libertarianism
is used to emphasis on the freedom of individuals to pursue the activities without having any
interference of the state. It stands against the unfairness to force the individuals to sacrifice
personal freedom to have a common good. It is helpful in increasing the individual responsibility
regarding health and believing that the individuals are free to make their own choices regarding
their health. The green ideology is opposed creating the destructiveness of the industrial society
and pursuit of having economic growth at all costs. It adopts the way of health which highlights
the illness rising from around the environment in which people live in. For example in the case
of cigarette smoking, have an inverse association with the tax levels and mainly in the poor
people and teenagers. Individuals having an ideology against stopping cigarette will reject the
idea of banning one and will argue on the topic of influencing the behaviours of people and to
choose the individual freedom (Graham-Clarke, and et.al., 2019). They will believe that cigarette
smoking is a behaviour and in under the control of the individual itself. The individuals in policy
planning who has the ideology that cigarette smoking is not an individual decision but is
influenced by the social cultural vibe can lead to accepting the ban and not infringing in the
freedom of choice for the citizens.
The changes in political imperatives will reflect on the political ideologies. Factors which
influence the process of making the policies includes having a lack of quality in the evidence,

difficulty in applying and being resource constraints during the time of applications. Ideologies
will not affect the way in which the evidence is received for the policy circles but the extent to
which it is used in making the policy (Courtenay and et.al., 2018). The ideas which come from
the funding organisations are the ones which generate a lot of funding and this can be seen in the
example of HIV which created a lot of buzz and draw some resources when compared to the
other issues which were more severe on the health of public people. The reason behind this is
that HIV fits well in the frame of ideas in the minds of people deciding for the funding. The base
of developing the policies is determined by the ideas and is designed in such a way which makes
the ideas fit in the frame and generating results from centres with favourable results. The policy
which fits the ideologies of people gets more preference in publication and comes in the public
attention. Individual interest and ideas are very likely to shape the process of policy making.
Ideologies which are govern by different shapes are leading to the generation of evidence (Carter
and Martin, 2018). This knowledge is considered when filling the gaps making an evidence
based policy.
2.2 Stakeholders can influence policy development
Stakeholders are very important part of the population. Stakeholders are interested in the
results because they are associated with gain or loss of planning process. They are also known as
interest groups. Stakeholders consists of an individual, groups or companies. Policy makers who
design policies must be listen to stakeholders. Policy making should be done by considering
stakeholders (Mirza and Wagner, 2018). In the policy development process stakeholders are
involved which focus on policy problems and improving resources for policy development. It
can be said that popular public problems can be finds out everywhere on multiple domain or on
other organisation domain. It can be related to air quality improvement or regarding food safety.
In order to address these problems government or authorities make public policies. Now
stakeholders is also having interference in policy making and in government work. Stakeholder
engagement in the policy is dependent on how much they are connected with the policy
procedure. Policy making process is not easy and is complex. As policies are developed for
stakeholders so they have great impact on policy development. If stakeholder does not gets
impressed with the policy or feels that the policy is not for the betterment of the society and
protest against such policies.