Case Study: Understanding Public Health & Social Care in the UK

This case study report, prepared by a care worker at Care UK, examines health inequalities in the United Kingdom. It identifies and discusses five key social determinants of health: employment, age, gender, education, and air pollution, explaining their impact on health disparities. The report also explores corresponding policies such as the Care Standards Act 2000, Health and Social Care Act 2012, and Care Act 2014, analyzing their implementation within Care UK and their effects on service delivery and patient care. Furthermore, it compares internal Public Health data with national statistics, highlighting specific provisions relevant to the organization and the broader UK context.

UNDERSTANDING PUBLIC HEALTH AND SOCIAL CARE
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Table of Contents
Introduction...................................................................................................................3
Section 1: Social determinants of health......................................................................4
Section 2: Corresponding policies for the above Social Determinants of Health.........7
Section 3: Current Public Health Provision................................................................10
Conclusion..................................................................................................................12
References.................................................................................................................13
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Introduction
The term “health inequality” refers to the discrepancy in the distribution of health
determinants and their health status among various population groups. For a better
understanding, the difference in the mobility rate and the potential between young
individuals and elderly group is an example. The presented report has been
prepared by a care worker operating in Care UK. Care UK is a health and social
care organisation based in UK that works in association with Clinical Commissioning
Groups, councils, doctors for offering care services to the elderly group of people,
individuals suffering learning disabilities and facing various health issues. Currently,
the organisation executes its activities through 85 care homes, 7 NHS treatment
centres and 4 clinical assessments.
In the given report, the learner has identified the social determinants of health and
discussed their relation with health inequality prevailing in United Kingdom. Among
various socio-economic determinants like unemployment, education, safe housing,
gender, use of tobacco and alcohol, air pollution, density of fast food outlets, low
income and others, five socio-economic determinants have been explained.
Furthermore, the policies relating to the discussed social determinants and their
implementation in the organisation have also been discussed. A comparison of the
Public Health data available within the organisation has been made with the data
available in UK focusing on a specific provision related with the organisation.
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Section 1: Social determinants of health
As per the World Health Organization (WHO), the Social determinants of health are
the conditions of the people in the societies in respect to education, employment,
age, gender and many other factors (Who.int, 2018). According to Ferrer (2018), the
condition of physical and mental health of the people is directly related to their social
conditions. On the other hand, Fouad et al., (2018) mentioned that the social
determinants of health are determined by the national decision regarding the
distribution of resources and money within the societies. There are some key social
determinants of health that have been discussed below:
Employment – It is one of the key social determinants of health as per WHO. In the
words of Hsieh and Coates (2018), employment is the factor that determines the
social positions of the individuals. At the same time, Ferrer (2018) noted that the
employment and workplace of the individuals determine the health condition of them
and their families. For example, a person works at a construction company in UK as
a lower level worker. As the person works at a lower organizational position, the
income level of the person is low. At the same time, the person works at construction
sites where the level of air pollution is also high. For this person, the chances or
scope for maintaining perfect health condition is not easy and as his income level is
low, it is difficult to avail higher quality medical treatment for him and his family
members. However, the situation will be different if the person is the owner of the
construction company. Therefore, the example is clearly indicating how employment
of the people determines their health condition. In this context, it must be noted that
in Richmond, UK, the people are in better health condition than the people in Tower
Hamlets. As per the statistical data, the employment rate in Richmond is 3%,
whereas the unemployment rate in Tower Hamlet is 8% (Goldberg, 2017). At the
same time, it is also true that there is a huge difference between the average income
level of the people in Richmond and Tower Hamlet and the difference is near about
£10000. It is indicating that the employment opportunity and income level determined
the health condition and longevity of the people in UK.
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Age – This is another major social determinant of health for the people. As per the
statistical report 2016 regarding the health inequalities in the United Kingdom, it has
been identified that the life expectancy of the people in UK has increased from
79.5% to 83.1% in 2016 (Meddings et al. 2017). However, if the statistical reports of
past few years are considered, it can be identified that until the age of 65 years, most
of the people in the UK are in good health condition. The health inequality can be
noticed in the deprived decile groups in UK. It has been identified that the deprived
decile groups in UK that are in the least position have low infant mortality. However,
the scenario is changing because the people in UK are becoming more careful about
the health conditions of their children (Lax et al., 2017). The analysts under WHO
believe that the mental support and little bit care of the family members can enhance
the life condition and expectancy level of the people.
Gender – Gender of the people is also a key social determinant of health. Marmot
(2018) stated that gender wise health inequality is a common issue in most of the
countries including United Kingdom. As per WHO, the gender wise health inequality
has increased because of the weak Equity Knowledge Network in the countries
(Who.int, 2018). As per the statistical reports, in the United Kingdom, life expectancy
level of the male individuals is 15 years more than the life expectancy level of the
female individuals. In this context, Tranter and Secretariat (2017) mentioned that the
social positions of the women influenced the health inequalities in the UK. In the
deprived communities in UK, many women suffer from poor family condition and
negligence of the male family members. Due to negligence, the women mortality
level has declined. However, the situation is a bit better in the highly developed
areas or in the metropolitan cities like, London. In London, the female life expectancy
level is a bit higher than the male life expectancy. The highest life expectancy of the
female is 86.4 years; whereas, in the case of male, it is 83.1 years (Goldberg, 2017).
The main reason behind this changed scenario is the higher social position and
value of the women in London and other developed cities.
Education – Education is another social determinant of health. Hsieh and Coates
(2018) commented that generally the quality of life of the highly educated people is
more than the less educated or illiterate people. It is because strong educational
background helps the people in building better social position and improving their
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financial or economic conditions. A person with sound financial condition can easily
avail higher quality medical support in different health care organizations. On the
other hand, people with less education or illiteracy face difficulties in improving their
financial and social conditions and due to that, their health condition or life
expectancy level reduces (Meddings et al., 2017). In the context of UK, it can be
identified that the people in the urban areas, where education facilities are more, live
long life than the people in the rural areas, where education facilities are limited.
Air pollution – The health conditions of the people also depends on the level of air
pollution in the areas where they live. Marmot (2018) believed that air pollution is one
of the major factors that directly affect the health condition of the people. In the case
of United Kingdom, it has been identified that the life expectancy level of the people
in the industrial belt is lesser than the people in the other areas. Lax et al., (2017)
stated that due to air pollution, people get affected by sever diseases, which reduces
their health condition.
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Section 2: Corresponding policies for the above Social
Determinants of Health
With reference to the above social determinants, the current policies acting in the
Health and Social Care corresponding to them are followed in the health care social
organisations including Care UK as well. Few of the policies related to the health and
social care are “Health Act 1999, Health and Social Care Act 2012, Care Standards
Act 2000, Care Act 2014, Diet and Nutrition Policy, Policies of Health Education and
Health Promotion, Food Safety policies, Pollution policies and Tobacco Advertising
and Promotion Act 2002”. Since Care UK mainly offers services to the elderly group
of individuals, it has focused on the social determinants- age, gender, and
unemployment, as they are highly significant for them. In addition, the impact of
education and air pollution is equally important. As a health care organisation, Care
UK has implemented the following five policies based on the service offered by
them:
 Care Standards Act 2000- As Care UK offers services through nursing
homes and residential care homes, it has to comply with the rules and
regulations of this policy. The core purpose of this policy is to modify the
regulatory system of the care services offered in the regions of England and
Wales (Careukgroup.com, 2018). The policy was formulated for establishing
an autonomous regulating body for the voluntary, social and healthcare
services in Wales and England, popularly to be known as the National Care
Standards Commission. By complying with the policy standards, Care UK has
to register their social workers and conduct professional training of the
workers to educate them on how to provide quality services. The
implementation of this policy has brought changes in the recruitment activities
of the organisation, retention of care staff workers and changes in the
inspection and registration activities. The policy has been effectively
implemented in the organisation; however, it has not offered any specific
benefit to the residents at the care home. Additionally, various problems have
been recognized with the legislation. It does not resolve issues relating to
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shortage of funds needed for offering enduring care services and the need for
setting minimum number of nursing and residential homes. Health and Social Care Act 2012- The purpose is to secure the future
requirements of NHS by bringing change in the challenges faced by it so that
the organisation can deal with the problems to avert crisis in the future. Being
directly related with the NHS treatment system, Care UK has taken initiatives
to follow the set standards of this policy. In order to meet the standards of the
Health and Social Care Act 2012, Care UK has been able to bring innovation
in its services, empower its patients and look at public health from a new
perspective (Davies, 2013). The execution of this act brought major changes
in NHS and its associated organisations, like Care UK. The benefit of
formulation of this Act was that it helped in trimming down the administration
and operational expenses of NHS (JRF, 2018) as well as Care UK and
ensured that health care organisations give more priority of the patients and
their preferences. Another major change brought by the Act was that it
strengthened the role of Care Quality Commission. Care Act 2014- The main goal behind the formulation of the policy was to
offer rational approaches in dealing with social care services offered to the
adult community of London (Skillsforcare.org.uk, 2018). The policy of Care
Act 2014 brought changes in the aims of the organisation. The aims and
objectives of the organisation were modified and made more clear and
specific. In compliance with the policy terms, improvement were brought in the
services rendered by the care organisation, there was less delay in the
execution of services. The Care Act is responsible for combining good and
valuable practices in the organisation and developing new reforms in the
health and social care sector. Following the standards of the Act, health care
organisation has to concentrate on the well-being of its patients by offering
them personalised social services. Along with this, the Care UK has to allow
the local authorities to and partnering association NHS, to concentrate on
larger population, instead of focusing on a specific group or individuals who
fulfil the eligibility for receiving the service or are state-funded. Pollution policies- Despite the fact that Care UK offers care services and is
not involved in the commercial sector, it has to comply with the pollution acts
and policies prevailing in UK. Moreover, this helps the organisation in
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eradicating the diseases caused due to social determinant, namely air
pollution as well as educating its care workers and patients in dealing with the
same (Gov.uk, 2018). Care UK has complied with the policy of Air Quality
Strategy that was developed for the regions of Scotland, England, Northern
Ireland and Wales for setting air quality standards in UK as well as to
decrease the amount of heart-threatening pollutants (Osborn, 2017). In order
to meet the standards of the policy, the organisation has run campaigns on
spreading awareness on the hazardous impacts of air pollution on the health
of the individual. The campaigns focused on the areas, like differences in the
impact of pollutant with differences in age, gender inequality and elderly
group. The positive impact of these campaigns was that patients and the
general public were able to identify elements of air pollution as well as learn
few tactics to avoid themselves from getting affected from polluted air in their
immediate environment. However, being a health care service provider, Care
UK has not been able spread awareness at a mass level, neither focus on the
issue. Policies of Health Education and Health Promotion- With the aim to
promote and educate workers, individuals and patients on health care
services, Care UK follows the UK government’s mandatory policy of offering
professional education and training in the area of healthcare. The Health
Education England (HEE) aims to offer superior quality healthcare services
and improving the health conditions of citizens of England. By imparting
knowledge and education in the area of Health care, the department aims to
create appropriate number of care workers for ensuring that the right number
of individuals acquiring right number of skills and qualities, having correct
values and behavioural approach are available at the appropriate place in the
future (Health Education England, 2018). Care UK has taken assistance from
HEE to offer its workers with fellowship programs to help them gain
professional training and deliver high quality services. Adaption of the policies
in relation to health education and health promotion helped Care UK in
bringing improvement in the quality of services provided by it in its care
homes, NHS treatment centres and the clinical assessments offered by it. As
Care UK’s main focus is on serving the elderly group and individuals suffering
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from dementia and Alzheimer’s diseases, the education programmes aim to
acquire professional training in these areas.
Section 3: Current Public Health Provision
One key public health provision by the given UK placement organization Care UK is
related to dementia. Dementia has become one of the most prevalent psychological
disorders throughout the world, which mainly affects people aged above 60 years. It
has been revealed that as a result of disease progress and symptoms, patients’
quality of life decreases significantly, which also results in non-adherence to the
medical and other therapeutic practices. Care UK is providing considerable solutions
for promoting the quality of life of the patients experiencing this chronic psychological
condition (Careuk.com, 2018). For instance, they are providing care home and
residential care services as their key approach towards improved quality of life of the
dementia patients. In the following ways Care UK is offering excellent care services
to the dementia patients throughout UK.
Getting to know the individual- Understanding the difficulties related moving
home, workers at Care UK engage with each new residents and their family with a
purpose of learning about their likes, dislikes, preferences, personal and medical
history etc, in order build a strong relationship. It develops a trust towards the care
environment and empowers the resident to enjoy the care facilities.
Dementia news- Aligning with the ever changing research area of dementia care,
Care UK team constantly updates the latest ideas, approaches and news, in order to
offer the best facilities and services to the residents as well as outdoor dementia
patients (Careuk.com, 2018).
Dementia friendly environment- For dementia patient, the environment plays a
significant role in promoting their wellbeing. Thus, the Care UK team is continuously
putting their best effort to maintain a dementia friendly environment through the care
homes. Through strong relationship building, they attempt to assess each patient’s
specific needs, in order to make the environment familiar to their desires. Thus, they
have designed the care homes with gardens.
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Support for families and carers- Besides the patients, Care UK is also offering
support to the patient’s families, by understanding the challenges they face, while
dealing with dementia patients. Moreover, involving family members in the care plan
also support ‘person-centred approach’ of care, which is followed by Care UK for
dementia care (Careuk.com, 2018).
Comparison between public health data of a borough and data through UK
Recent estimation in 2015 revealed that people with dementia through UK has been
reached to approximately 850,000 people. According to the report by
Telegraph.co.uk (2013), approximately 1 million people through the UK are expected
to experience dementia by 2020, which would further increase over 2 million by
2051. There are approximately 2 in 100 people above 65 years experiencing
dementia, which increases to one in 5 people among above 85 years old people in
the UK. According to the recent borough dementia statistics, it has been revealed
that dementia diagnosis rates for more than 65 years old people in Bradford district
is 97.55%, which has shown a very high prevalence rate of dementia among the old
age population across the UK borough (Yhscn.nhs.uk, 2018). The data has been
reported by NHS Bradford district at the end period of year 2017.
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Conclusion
Health inequality and problems related to the dispensing of such services would
affect the structure of healthcare services in the country. This report has looked at
the various ways in which social determinants of a country have effects upon patient
care, while analysing the policies and regulations that can be used to fix any
discrepant situations. Some of the these policies are specifically the Health and
Social Care Act of 2012, which have effects upon operations of public health care
provision in the country. Public health care provision also relates to the ways in
which the community would respond to given problems, which have also been
analysed.
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