A Comprehensive Report on Public Health and Social Care in the UK

This report provides an overview of public health and social care in the United Kingdom, focusing on strategies to measure, monitor, and control HIV. It details various approaches and strategies employed by the NHS and other agencies, including Public Health England, to address public health challenges. The report also explores the historical context, tracing the evolution of public health from the Sanitary Revolution to the establishment of the NHS and the implementation of modern health initiatives. Statistical data from Public Health England is presented, highlighting key issues such as late HIV diagnoses. Furthermore, the report covers the roles of different agencies in public health, educational programs, and public awareness campaigns. The report concludes with a discussion of the challenges and future directions in the field of public health and social care.

Understanding
public health and
social care

Contents
ITRODUCTION.........................................................................................................................................3
1.1 Strategies to measure, monitor and control the HIV..................................................................3
1.2 Approaches and strategies to control and measure the HIV....................................................3
1.3 Role of different agencies.............................................................................................................5
1.4 Statistical data from the (Public Health England (PHE)............................................................5
2.1 The Sanitary Revolution (the poor law of 1834).........................................................................7
2.2 First National Public Health Act (1848).......................................................................................7
2.3 John Snow and John Simon Sanitary Act 1866.........................................................................8
2.4 Establishment of NHS (1948).......................................................................................................8
2.5 The Black Report 1980..................................................................................................................9
2.6 The Acheson Report (1998)..........................................................................................................9
2.7 Choosing Health (2004) to the present day..............................................................................10
CONCLUSION........................................................................................................................................10
REFERENCES........................................................................................................................................12
..................................................................................................................................................................13

ITRODUCTION
The science that protects the common people from the diseases and helps in the
improving of the health of local civilians my making many health improving policies is
known as the public health. This definition of public health differs from person to person.
The safety strategies are developed by the research of diseases and the prevention
methodologies of the various kind of injuries (Marmot and Bell, 2012). It concentrates on
the entire condition of the health of the human beings not only deals with some
diseases. It also involves the facilities of the personal services like providing
vaccinations, medicines, first aid, etc. to each individual. The present report is based on
the understanding of the public health and social care. The report is explaining the
different approaches taken by the NHS to control the best cancer in the United
Kingdom.
1.1 Strategies to measure, monitor and control the HIV
In general, HIV incidence is expressed as the estimated number of persons newly
infected with HIV during a specified time period (e.g., a year), or as a rate calculated by
dividing the estimated number of persons newly infected with HIV during a specified
time period by the number of persons at risk for HIV infection (Derose and et.al., 2011).
It is important to understand the difference between HIV incidence and new diagnoses
of HIV infection. HIV incidence refers to persons newly infected with HIV, whereas
individuals newly diagnosed with HIV may have been infected years before being
diagnosed.
1.2 Approaches and strategies to control and measure the HIV
Surveillance: - The 2015 HIV Surveillance Report marked the transition to
presenting diagnosis, death, and prevalence data without statistical adjustments for
delays in reporting of cases to CDC. CDC periodically assesses the portfolio of the
National HIV Surveillance System (NHSS) to determine whether methods and
efficiencies in data collection and analysis meet the information needs of the nation
(Boulwar and et,al., 2016). In determining that adjustments for reporting delays were no
longer necessary, CDC considered improvements in data quality as a result of the
following: availability of additional case information; shorter time for processing
duplicates from multiple states; a better system for national data processing. CDC

continues to statistically adjust transmission category data by using multiple imputation
techniques to account for missing transmission category information in cases reported
to CDC.
Table. HIV infection stage, based on age-specific CD4+ T-lymphocyte count or CD4+ T-
lymphocyte percentage of total lymphocytes*
Stage*
Age on date of CD4 T-lymphocyte test
<1 year 1—5 years 6 years through adult
Cells/μL % Cells/μL % Cells/μL %
1 ≥1,500 ≥34 ≥1,000 ≥30 ≥500 ≥26
2 750—1,499 26—33 500—999 22—29 200—499 14—25
3 <750 <26 <500 <22 <200 <14
HIV monitoring and stage 3 (AIDS) classifications
HIV infection is classified as stage 3 (AIDS) when the immune system of a person
infected with HIV becomes severely compromised (measured by CD4 cell count) or the
person becomes ill with an opportunistic infection. In the absence of treatment, AIDS
usually develops 8 to 10 years after initial HIV infection; with early HIV diagnosis and
treatment, this may be delayed by many years. With the release of the Revised
Surveillance Case Definition for HIV Infection — United States, 2014 CDC now uses a
stage system to describe HIV infection (Øvretveit, 2011).
Diagnoses of HIV infection and deaths of persons with diagnosed HIV
infection are the number of persons diagnosed with HIV infection and the number of
persons with a diagnosed HIV infection who have died in a given time period,
respectively (Paina and Peters, 2012). Note that diagnoses of HIV infection are
regardless of stage of disease at diagnosis that is, persons diagnosed with HIV infection

who have not progressed to stage 3 (AIDS); persons who were diagnosed with HIV
infection and classified as stage 3 (AIDS) at the same time; and persons who were
diagnosed with HIV infection that later received a stage (3) classification. Also note that
deaths of persons with a diagnosis of HIV infection may be due to any cause. Other
systems, such as the National Vital Statistics Reports, provide data on HIV infection as
a cause of death in the US population (Paina and Peters, 2012).
To provide the reader with a more accurate understanding of the number of persons
diagnosed with HIV infection who have died, CDC includes in its surveillance report
data on persons diagnosed with HIV infection regardless of the stage of disease at
death, which includes persons with infection that may have been classified as stage 3 at
the time of death.
Stage 3 (AIDS) and deaths of persons with infection ever classified as stage 3
(AIDS) are the number of persons with infection classified as stage 3 (AIDS) and the
number of persons with infection ever classified as stage 3 (AIDS) who have died in a
given time period, respectively. Note that deaths of persons with infection ever classified
as stage 3 can be due to any cause, and the category is therefore different from the
designation deaths due to AIDS (Mockford and et.al., 2012).
1.3 Role of different agencies
The health protection agency after becoming the part of Public Health England in
the year of 2003 plays a role of providing approaches in order to protect the UK public
health by taking the help of NHS, local authorities and other sectors serving to the
health of common people. Additionally, the PHE (public health England) founded in 1
April 2013 is an executive agency in the United Kingdom has the mission of protecting
and improving the national health to minimize the inequality among the social classes.

1.4 Statistical data from the (Public Health England (PHE)
(Figure: Image by Public Health England, 2017)
39% of people newly diagnosed with HIV in 2015 were diagnosed at late stage of
infection. You can see from the chart below that men who have sex with men were the
least likely group to be diagnosed late (30%), and heterosexual men were most likely to
be diagnosed late (55%) (Karanikolos and et.al. 2013).
The rate of late diagnosis varied quite a bit regionally, and it was highest in the Midlands
and East of England, where late diagnosis rate was 50%.
Andrew Horton, HIV Prevention Lead at Staffordshire and Stoke-on-Trent Partnership
NHS Trust, said:
"We really want people to know how important it is to get an early diagnosis, as it
ensures better health. It has never been easier to get tested for HIV, and we offer
a quick finger prick testing drop in on the last Wednesday and Thursday of every month,
which give results in 20 minutes."

The education of HIV and its awareness are following:
School education: In the UK, state schools have to provide Sex and Relationship
Education (SRE) but independent schools do not. Parents also have the right to
withdraw their children from SRE, though few do so. In a review of the National
Curriculum in 2013, the UK government said that all state schools "should make
provision for personal, social, health and economic education (PSHE), drawing on good
practice" and that SRE is an "important and necessary part of all pupils’ PSHE
education."
Public awareness: In the early years of the epidemic, there were a number of high
profile public awareness campaigns in the UK warning people about how you get HIV
and calling for people to adopt safer sex behaviors.
In 1987, the government ran a major public information campaign called 'AIDS: Don't
Die of Ignorance' which used television adverts and sent an information leaflet to every
household.
Since then, there have been very few public HIV awareness campaigns. Even sexual
health campaigns such as 'Condom Essential Wear' in 2009 made no reference to HIV.
More recently, a government-funded initiative called 'National HIV Testing Week' that
has been running since 2011, aims to increase HIV awareness and testing among key
affected populations in England, particularly men who have sex with men and African
people

2.1 The Sanitary Revolution (the poor law of 1834)
In 1834, a Poor Law Amendment Act was introduced by the parliament of the
United Kingdom by the Whig Government of Early Grey. This law fully replaced the
previous legislation which was based on the poor law of 1601 (Boulwar and et.al.2016).
It attempted to alter the poverty relief system in the nation like England Wales. This
came into practice for reducing the cost of taking care of the poor people because it
stopped the transfer of money to the poor one except the exceptional situations. Now a
condition is kept where anyone who wanted to help the poor they had to go into the
workhouse to provide them money i.e. the poor one are provided food, clothes in the
work houses after providing them several hours of work. The work may be physical or
mental labour . The cruelty starts here by giving them poor diet like bread and poor
watery soup. Even the poor one works only when they are wearing the scheduled
uniform. They also have to follow strict rules and regulations. This condition becomes
more terrible when they are appointed only when they needed desperately. Some
person like Richard Oaster was against this law. They spoke out by calling the work
houses as the prisons for the poor.
2.2 First National Public Health Act (1848)
The 1848 Public Health Act was the first step taken by the UK parliament on the
road to develop the public health. Edwin Chadwick was a social reformer who played a
vital role in creating this law (Millar and Hall, 2013). The Whilst who were working as the
secretary of the poor law commissioners investigated the problems against the
sanitation of the poor people. He published the’ sanitary condition of laboring population
of the Great Britain’. He paid himself the costing of the publications as the poor law
commission but he did not want to recognize with this report publication. The most
important steps to improve the public health considered by the Whilst are listed below:
 Improvement in the drainage and sewers
 Removing of refuse from streets, houses and roads
 The provision of portable water
 Appointment of medical officer in each town
This act establishes a central board of health but having the limited power and no or
very less money. The Sunderland was assumed to giving the responsibilities for the
clean water supply, drainage improvement and provision of sewer, removing the
nuisances as well as paving. The loans were approved and provided by the banking
sector but that have to be paid back as per the interest rates at the allotted deadline.

2.3 John Snow and John Simon Sanitary Act 1866
The john Snow and John Simon Sanitary Act 1866 was the next step that was
taken in 1866 against the cholera epidemics. This Sanitary act of this year made
compulsion against the arrangement of sanitary inspection and the removal of
nuisances in the area of poor people by the local authorities. It ordered to provide the
machinery so that the central government can keep them up by aiding in this
happening. The principles of the local authority had been attacked by the coming of this
sanitary ac (Aveyard, 2014). The act made offences against quarantine as the poor
sanitary and drainage system gives rises to the spreading of infectious diseases. This
law successfully defeated the fifth disease, the cholera by stopping it to spread by
taking healthy strategies of improving the sewer and sanitary system. But this creates
a great deal of waste and duplications as the different authorities or the government
overlapped in doing this work. The Semon was the first medical officer wanted to
establish a central coordinating government department that would show more
comprehensive nature than the current ministry of health but this did not happen and
the local government set up act of 1871 having new legislations.
2.4 Establishment of NHS (1948)
The National Health service came into force by the establishment of National
Health Service Act 1946 in the England. The founder of the NHS was the Aneurin
Bevan. The NHS came into the practice on 5th July 1948. The NHS provided the
following services:
 Hospital services: In order to manage the hospital services, fourteen regional
hospitals board were created to look after the services of the hospitals in England
and the Wales. Apart from these the government developed four hundred
hospital management committees to administer these 14 hospitals. Other
teaching hospitals are established and their arrangement was seen by the Board
of governors.
 Primary care: They were developed by the GPs. Gps were the contractor that
was not dependent on the government. The services of dentists, eye specialist
and the pharmacists are provided to the people but on the independent basis as
they are employed by independent contractors or they even play the role of
contractors (Derose and et.al., 2011).
 Community services: The local authorities provided many services to the local
peoples like vaccination, child welfare clinics, services of ambulance, etc. These
services like health education, immunizations were sanctioned under the poor
law act.

2.5 The Black Report 1980
The Black report was published by the Department of the Health as
documentation in 1980 in the United Kingdom. This was introduced to identify the
discrimination of the economic peoples as the death rates is shown twice more of the
social class V than the class I (Baldock and et.al., 2011). Edwin Chadwick has
published the general report of the Sanitary conditions of the poor people who are
forced to do the work on daily wages. This report shows that the average death rate of
gentry was at the age of 35. On the contrary it was recorded 15 for the labours and
servants. The black report shows that there was an improvement in the health
conditions across all the classes during the early years i.e. thirty-five of the National
Health Service. But the differences were still recorded between the economic social
classes. There were continuous differences shown in the infant death rates and the
discrimination in providing medical services. The Black report concluded that the
inequality between the different groups of people causes several problems like failing in
the National Health Service and also giving bad impacts on the economy, education,
dieting, jobs, income and more sectors of the society.
2.6 The Acheson Report (1998)
The Acheson report was a document that was published in the year of 1998 by
the Donald Acheson. It totally titled the Independent Inquiry into inequalities in Health
Reports. There were different members that contributed in the inquiry of the report.
Some of them are listed below:
 Donald Acheson (the chair person)
 Margaret Whitehead
 David Barker
 Michael Marmot
 Jacky chambers
 Hilary Graham
This report has shown the same health disparities existence and the inequalities among
the social class members. This reflected the decrement of the death rates of the people
of upper social class while the lower one is dying continuously by the increment in the
mortality rate in the year of 1970 to 1990 (Swayne and.et.al, 2012). This report also
contained approx. thirty-nine policies suggestions in the sector of taxation and
agriculture. The report recommended that the factors such as the employment, income,
education, etc. should be improved this automatically developed the health and hygiene
of the people. However, the reduction of the health inequalities is not achieved. As per
the survey of Fisal studies (IFS 2008) the percentage of the national income are
collected by the richest sections of the society has been increased by 1.7%. On the
other hand, the poorest section of the society faces a decline of 0.2% income.

2.7 Choosing Health (2004) to the present day
This is a white report published in the year of 2004 in the England. The history of
the England reflects that there was continuous improvement of the health of the
common peoples. At the starting of the twenty first century the England have to develop
new health policies in order to improve the services of the health. The three principles of
the new public health approach are following:
1. Informed choice: The public gives their views of making their own choices. But
the children coming in the youngster age group have to make inform by the elder
one to their choices or rights regarding the health (Willis and Keleher, 2016).
2. Personalization: In this principle, all the people are not satisfied by the present
health services as they realize that their needs are not fulfilled. So, each
individual has the right to make their personal decision of health and ask the UK
government for the health services (Reeves Espin and Zwarenstein, 2011).
3. Working together: It has been concluded that the government body and the
civilians of the nation cannot lonely contribute in improving the health services
but to achieve the better or improved health conditions both of them to work
together including the communities, the medical and business advisors, the NHS
as well as the media.
CONCLUSION
From the above based report, it has been concluded that the public health and
social care can be achieved by the contribution of both the communities as well as
National Health Service agencies. The various approaches and the strategies to
measure monitor and control the diseases like Diabetes type 2. The various health
agencies like Health Protection Agency, Public Health England and Cancer research
UK, etc. helps effectively to the society in developing the health services by controlling
the diseases. They provide immunization, health related education as well as maintain
the environmental and legislation control of the nation.

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