The Role of Public Health in Health and Social Care
The main focus of health and social care services in the UK is upon ensuring the health and safety of people and protecting them from various diseases. They aim to provide patient-centered services and improving their quality of services to patients infected by various diseases. Such diseases may be infectious or non-infectious. HIV and Breast Cancer are the two diseases studied in this assignment. It further analyses the policies and strategies followed by the healthcare service providers in reference to the services.
There are various authorities in the UK working for healthcare and wellbeing of people and to improve their living conditions. They encourage the good health of individuals by conducting research and organizing activities. These organizations are operating at local, national and international level.
Local Authorities: These are the authorities that are managed and controlled by NHS and other public authorities. Their main role is to ensure that all the individuals in their area and community are provided with health care’s services.
National Health Services (NHS): It isa publicly funded health care service in the UK. It is an independent body whose main role is to ensure sound and improved health outcomes for people in the UK. The main roles and responsibilities of NHS include providing leadership in improving healthcare outcomes and quality of care at the national level.Furthermore, commissioning specialist services and primary care (Bojke, et.al, 2017).
European Union: The role of the European Union (EU) in providing services relating to health care is to complement the services the policies of national healthcare. These service are helping the members of EU in achieving shared objective, pooling of resources for economies of scale generation, and tackling shared challenges among EU countries such as chronic diseases and their impacts, pandemics, or increased life expectancy the impacts of systems of healthcare.
World Health Organization (WHO): This is a global organisation that is concerned with the health of human kind worldwide. Its main roles and responsibilities include providing directions, leadership, and collaborate with the local agencies to handle the matters of public health and safety. In addition to this, it provide assistance in establishing the institutions in different countries that provide technical support and funds for improving the public health. According to the WHO report 2018, it has been acting as a great instrument in intervening drought and malnutrition in Eritrea. Furthermore, it set standards and regulations to promote healthy living condition across the world. It analyses the impact of health issues on human health and well-being. It collaborate and provide assistance with local, national, and international agencies to safeguard the health of general public (Gov.UK, 2018).
Before moving on to the diseases, it is important to understand the meaning of epidemiology. According to WHO (2018), it is basically a study of determinants and distribution of health-related events and states which include disease and application of control measure to mitigate the effect of events and health-related issues.It helps in understanding the number of people having disease or any kind of disorders and how they are affecting economy and society.
Infectious disease are those health issues that are caused usually by microbes, such as parasites, fungi, bacteria, viruses, etc. They are called infectious because they can spread from one person to another by various mean like air, water, and physical contact (WHO, 2018). One of such disease is HIV (Human Immunodeficiency Virus) which is a contagious diseases that affects the immune system of a person, thereby making him vulnerable to the impact of other diseases or infection. It can transmit through blood, sexual contacts, breast milk, infected medical instrument, etc.
In the United Kingdom, the HIV epidemic is relatively small with an estimated 89,400 people in 2016 living with HIV. The HIV prevalence based on this count is 0.16 people in per 1000 people. 5,164 people were diagnosed with HIV in the year 2016 and it was noticed that it was a fall of 18% from 2015. Further, 4,363 newly infectious people were diagnosed in 2017. The main cause of such decline is decreasing in diagnoses among men who involve in sexual relations with other men and decline in diagnosis in heterosexual women and men who were born in a foreign country Gov.UK, 2018).
Non-Infectious Diseases or chronic disease are usually long duration diseases that are caused by various factors, such as physiological, environmental, genetic, and behavioural. These diseases include cancer, heart diseases, asthma, liver failure, kidney failure. People belong to all age groups can face these diseases (Rail, 2017).
One of the rising chronic disease is breast cancer in women. It develop in women when cells in women’s breast mutate and reproduce. They form a cluster and that result in a tumour (Borland, 2014). In 2015, almost 54,900 new cases of breast cancer were diagnosed which makes it around 150 per day. Such an incidence rate of breast cancer in the UK is seen in people aged more than 95 years. The most common causes seen for breast cancer are overweight and obesity, alcohol drinking, breastfeeding, and post-menopausal hormones. The incidence rate for breast cancer in the UK are expected to rise by 2% between 2014 and 2035 and such rate shall be 210 cases per 100,000 females by 2035. In the UK, breast cancer is found more in white females as compared to Asian or Black Females.
Disease prevention is a process through which a person suffering with some health related issues are treated in order to mitigate the disease and its risk factors. The treatment can be in the form of change in lifestyle, patient education and awareness, and drugs. There are various effective ways in which the risk of HIV and Breast Cancer can be reduced. The Public Health England (PHE) lead a national HIV Prevention Program (HPP) whose main aim is to support people who are most at risk and reducing the HIV infection incidence. The focus of the program is mainly upon prevention of transmission of HIV through a complementary combination of biomedical, behavioural and structural strategies. It considers factors specific to each strategy and is implemented at all levels such as community, individual and population. The healthcare authorities are also focusing upon using the new tools and techniques for increasing the effectiveness of the services provided in respect of prevention of HIV (Le Grand, 2018).
It is the duty of government to take every step to improve the access of a patient to preventative drugs for breast cancer. The initiatives are taken, and services provided by NHS for prevention of HIV are going in the right direction but need a little more effort in respect of awareness and funding (Bojke, et.al, 2017).
Various approaches and strategies followed by the authorities to control the incidence of diseases in communities are as follows:
Surveillance refers to the observations carried out in the close environment to keep a watch on the upcoming diseases. It is a tool used to analyze the environment and develop effective policies and programs for dealing with such upcoming diseases. The government of UK is creating a countrywide awareness programme and policies for preventing HIV and making people aware of this infectious disease.
Screening refers to the strategy used for controlling the diseases in the communities. It is a strategy in which the medical testing is done before observing any symptoms of the disease in an individual. It helps in determining the occurrence of HIV in individuals and taking appropriate measures for treatment of such individuals and prevent the spread of HIV.
Immunization is a technique through which an individual can be made immune to various infections. Vaccination is the technique used to immune an individual. It helps the individual in resistance of disease for which vaccination is given (Brett, et.al. 2014).However, there is not many immunisation or vaccinations have been developed to cure HIV in human.
Environment Control System: The environment Control System (ECS) enables the individuals to operate third party equipment and wide range of domestic appliances by remote control. People with disability are able to maintain independence using ECS. It can also help such people to reduce reliance on family members and carers for continuous help.HIV and breast cancer patients need regular assistance of family members. ECS can help in reducing that dependence.
Effectiveness of Above Strategies
In the development of life-threatening diseases in an individual, the early detection is the only defence available. As with the programs related to cancer screening, consideration is given to the risks of developing breast cancer as well as benefits, harm and cost involved for the screening intervention.
While primary prevention is related to reducing the risk factors associated with the cardiovascular events, primordial prevention is all about avoiding the growth of risks that should be handle with utmost care. Burden of disease is characterised as the measure of the health of people that aims at quantifying the gap between the ideal living condition and the existing situation where a person might suffer illness, disability, injury, and premature death. Burden of disease is the impact of a health problem which is measured by its morbidity, mortality, financial cost and other indicators. The aim of calculating burden of disease is to compare between the livings of a person if not affected by the disease up to old age and the living when affected by the disease, disability or premature death.
The identification of priority in diseases is of great importance so as to take preventive measures for controlling the spread of disease.
HIV is a disease which has several impacts on the on the people throughout the globe. This is a disease which must be prevented, and the health and social care settings must make it their priority to minimize the cause of this disease and safeguard people from its adverse effects. Following are certain prevention approaches followed by the healthcare setting in the UK for prevention of HIV:
Primary Prevention is the foremost measure used for prevention of disease. Under this approach, attempts are made to prevent the disease by educating people about the disease and its causes. There are various efforts made by authorities in the UK for prevention of HIV disease which includes several programs (British HIV Association, 2017).
Secondary Prevention is the approach under which the screening and detection of pathogens are carried out which acts as carriers for the disease. In the UK, a healthcare program has been introduced by NHS for the purpose of testing the blood of pregnant women. The main purpose of this program was to ensure that the women are not infected by HIV virus and in case the women are infected, then preventive measures and treatment are undertaken to ensure that the disease does not transfer to the offspring.
Tertiary Prevention: Under this approach, the main aim of the authorities is to take care of the patients that are suffering from various chronic diseases. During this step, the patients are also given palliative care. This is a care given to the patients including his family in both medical and emotional aspects for improving their life quality. This approach does not cure the disease of the patient but provides some relief from the illness.
Similarly, there are various programs and approaches followed by healthcare services providers for minimizing the spread of breast cancer.NHS Breast Screening Program is a program under which free breast screening is provided to the women aged 50 years or more and as a result, this program has lowered mortality rates among the age group of 55–69 years from breast cancer.
Prevalence of a disease is a statistical concept which refers to the number of cases which are present in a population at a particular time affected by a particular disease. This information helps the authorities to plan the services that are to be provided for countering the problems of disease. The prevalence rates help the healthcare service authorities to identify the needs and develop programs through which the disease can be prevented. Such epidemiological tools and approaches help in providing information about the reach of disease and in taking appropriate measures. For example, if the healthcare service authorities have known about the root cause of diseases and information in relation to the areas which are prone to disease, then they may be able to prioritize their actions to counter such diseases (British HIV Association, 2017).
When the healthcare authorities have prior knowledge on the cause and impact of diseases, they are able to use such information and knowledge to allocate resources accordingly. This helps them in prioritizing their tasks and in ensuring that the resources are used effectively and efficiently(Lewin, et.al., 2015).
The concept of partnership working is a collaborative relationship between the individuals and organizations. These have been explained below:-
Planning is a process through which the patients and individuals diagnosed with breast cancer and HIV could be prepared for their current disease and what is coming for them. They are aided on how their disease is required to be managed and deciding the best treatment and practices for the individual.
Facilities are provided by healthcare professionals to the patients. Such facilities may include immediate access to the leading consultants, advanced and personalised treatment. The individuals affected by breast cancer and HIV are offered various other services including access to tests, diagnosis, advice and treatment.
Funding of healthcare service providers is a designed mechanism to cover all the costs and manage all the needs of such providers. In countries like UK, there are various Health care service providers such as NHS which are partially funded by Government. The persons in need of such services are able to get access to the services through the funding amount as without funding there shall be no available services.
The term ‘Expertise’ relates to the knowledge and experience of health care service providers. They have enough expertise to provide the services to the patients and to ensure that the persons in need get appropriate treatment.
Amongst all the health diseases in the UK, the most common diseases are HIV and breast cancer. These diseases are the result of lifestyle choices of an individual.
HIV is themost common lifestyle choices of an individual which leads them to be vulnerable to HIVincludes following:
Smoking cigarettes is one of the biggest health risks for an individual.It increases the risk of cardiovascular diseases and cancer. When a person infected with HIV smokes, then his life expectancy decreases by almost a decade (Drummond, et. al., 2015).
Injecting Drugs is not only associated with the risk of acquiring HIV or other chronic diseases but also increase the likelihood of death of an individual as a result of infection related to AIDS.
Unsafe Sex is the most common cause of HIV as having vaginal or oral sex with someone who has HIV results in the transmission of disease.Therefore, it is always advisable to have sex using condoms, barriers and dental dams as they help in safe sex.
Healthy Lifestyle choices that may help in preventing such diseases:
Nutritious Diet: For the purpose of reducing the risk of infections it is important to ensure that the nutrition and dietary habits are appropriate. This will help an individual and reducing the risk related to health and help the people with HIV in leading a healthy life.
Exercises: All the people must ensure that they are indulged in physical activities so as to keep their physical and mental health at par.Regular exercises help in staying fit and maintain cognitive health (Wykes, et.al., 2015).
Work Culture: The work culture is a major contribution to the health issues. It is important for all the individuals to ensure that the dietary habits are taken care of. The most common factors that is found among the working people is stress. It is a major factor of sickness and therefore the individuals must take care of their stress levels.
Couples should get tested to check HIV status: In order to prevent the each other from getting HIV, it is recommended that they should get them tested prior to sexual contact or else they should use preventions like condoms to avoid direct contact. In addition to this, while injecting drugs for treatment, the syringe should be the new one.
It is important to understand the meaning of wellbeing for setting up its priorities. Well-being is the circumstances for an individual which are characterized by happiness, health, prosperity, and welfare.According to WHO (2014), wellbeing is characterized by a mental state of a person knowing one’s own abilities and potential to handle normal stressful conditions and stress.There are various priorities set for an individual in the context of his well-being and health. The health and wellbeing priorities have been classified into three: physical, social, and mental health priorities. The former is related to the abilities of a body to function properly. An individual who wants to achieve a physically fit body, he must obey various rules of physical body fitness including intake of a nutritious diet, proper management of weight, avoiding consumption of drugs and alcohol, regular exercises and such others. However, sometime these priorities may affect the mental priorities. These comprise emotional support and stress free life. When an individual is mentally sound, he is deemed to be mentally healthy. In the current era, individuals face various problems such as trauma and stress which makes them mentally ill. Such mental illness affects the functioning of the brain leading to an unhealthy mental state. The emotional needs of an individual must be fulfilled as a priority so as to ensure a healthy mind (Patel, et.al, 2016).
The social health priorities includes the prevalence of various chronic diseases in the community. An individual can be socially healthy by keeping himself and the community safe from various chronic diseases. Such social health can be achieved through various programs in which people are educated about the cause and effect of various diseases prevailing in the community (Hunter, 2016).
The Joint Strategic Needs Assessments (JSNAs) and Joint Health and Wellbeing Strategies (JHWSs) have the duties and powers for the health and wellbeing boards that is formed with the amendment of the local government and public involvement in health act 2007. This unit is formed to involve the local public and community in the leadership and delivery of the public services.The duty of the unit is to improve the social conditions of the place. They evaluate the demographics of the area and needs of the people of all age groups. The disadvantageous groups and people are taken care off and measures are taken to improve their condition. There priorities is to look after the local community and peopleby being there to understand their condition and have proper outcomes for the same.
Social care services: The policies and strategies of social care services have not limited the programs for avoiding causes of diseases but also extend to assisting the patients and their families in relation to the various health issues. It also includes providing health care equipment and financial support to patients in need of healthcare services (Murray, et.al., 2013).
Quality of services: The healthcare services providers are required to take feedbacks from patients regarding the services provided and such feedback is considered by the authorities for the continuous improvement of the quality of services provided (Jetten, et.al., 2012). The health care service providers must focus on improving the technology used to provide treatment for HIV and Breast Cancer.
Organisation of Service Provision: There are various organizations that provide health care services to the patients of HIV and Breast Cancer. The focus of these organizations is on reducing death in hospitals, particularly shortly after admission to the hospital.
Partnership Working: The health care service providers work in partnership with other organisations to provide the best services. All these organizations work in coordination with each other and therefore provide complementary services.
Complaints: All the health care organizations have the procedures of complaints and under this procedure, they take feedback from the patients of HIV and Breast Cancer who receive services from them and improve their services based on those feedbacks.
The services provided by the healthcare settings in the UK are effective and efficient, but they can improve their services by making policies and strategies that suit individuals according to their needs and requirements. The healthcare services providers may also consider entering in partnerships with other authorities and service providers for availability of better resources and equipment. This will help them in delivering services in a more efficient manner. The strategies and systems are explained below:-
Partnerships: The healthcare services providers may also consider entering in partnerships with other authorities and service providers for availability of better resources and equipment. This will help them in delivering services in a more efficient manner.
Complaints: The NHS complaints policy helps in investigating and monitoring the service standards provided to the service user. It helps the users to cure and diagnose the breast cancer. This raise the concern for ill-treatment and provide users a sense of value and justice and empowered them to have compensation.
Health Education: It is a crucial tool that can be very effective for community health. It comprises health practices that are helpful in changing attitude or knowledge of people regarding their lifestyle and health. In fact, health education is the basic foundation of public health programme.
Informed Choices: A choice by a patient about an indicative or restorative method, in light of the decision, which requires the choice to be willful and that the patient has the limit with respect to the decision, which lays on 3 components:
- Possession of a lot of esteems and objectives
- Ability to comprehend data and convey choices
- Ability to ponder and reason
CQC: The Care Quality Commission (CQC) is responsible for monitoring, inspecting, and regulating services in order to make sure that they fulfils the fundamental criteria and standards of safety and quality. It demonstrates the ideal care services based on the standards. It carry out inspection in homecare in England that includes nursing homes and residential.
There are some pros and cons of the aforementioned strategies and systems. For instance, the informed choices can help in screening the risks and uncertainties. In addition to this, it can also assist in following up plans that includes availability of support and counselling services. Conversely, there are some downside to informed choices. It may result in change for benefit: harmratio. The informed choice affects the evaluation of screening programme. In addition to this, the limitations of partnerships is that due to involvement of too many parties, the effectiveness and processes get slowed down. In addition to this, there are high chances of dispute. On the other hand, the advantages are that partnerships brings resources that can be employed in creating a better awareness program against Breast Cancer and HIV.Moreover, the partnerships speed up the process.
The UK government released the strategy for the breast cancer awareness and avoidance. The active is the five year forward view for taking the strategy for the cancer patients forward for the achievement of the world-class cancer outcomes.
Health Promotion: As per WHO (2018), health promotion motivates people to focus on their health and make some significant changes in their lives. These programs help them in inspiring them setting up goals and seeking benefits of transforming lifestyles. They promote life-changing behavior at work by offering wellbeing screening, mini event, and assistant programmes.
Physical Exercise and Sports: These measures are very effective in improving physical and mental health of people and their wellbeing. It encourages building the relationships and involve methods that can help in reducing obesity and mental stimulation.
Health Education: It is a crucial tool that can be very effective for community health. It comprises health practices that are helpful in changing attitude or knowledge of people regarding their lifestyle and health. In fact, health education is the basic foundation of public health programme.
Multidisciplinary Team: a multidisciplinary team is crucial and quintessential in testing breast cancer. They are required to improve the survival rates, enhancing the wellbeing of the service user.
It has been noticed from the data that Breast Cancer is one of the most common diseases in women living in the UK. Every year over 55,000 women get diagnosed and around 7500 get diagnosed with an earlier stage non-invasive cancer in the breast (Breast Cancer, 2018). It has been seen that breast cancer starts from a particular site of the body. In 2015, almost 54,900 new cases of breast cancer were diagnosed which makes it around 150 per day. Such an incidence rate of breast cancer in the UK is seen in people aged more than 95 years. The incidence of breast cancer is found to be lower in a group with lower income in the UK.
Breast cancer screening program promotes earlier screening for women between age group of 50 to 70 for mammogram and it is totally free of cost. In the first appointment, 50 to 53 old year women are invited to check-up every 3 year until they reach 70. The purpose of screening is to reduce mortality by deducing breast cancer in early stage.Through early stage identification, one can improve condition of the breast cancer and reduce serious consequences and improve their health. NHS Screening Programme England revealed that in the time frame 2016 to 2017, many women invited for breast cancer screening have been detected early stage cancer.
There are many downsides of the Breast cancer screening program. These include the radiation risk that can induce other diseases in the body. However, this risk is nothing in comparison to the benefits of early detection. In addition to this, there are chances of over-diagnosis too. On the other hand, the benefits comprise mortality reduction, improved health condition, and better diagnosis and that too in a planned manner.
The study of prevalence and incidence rates of diseases in the community is important as it helps in making strategies and policies to ensure that such communities are safe from the prevailing diseases. The services provided by the UK health and social care service providers are effective and efficient, but they must also focus upon providing more personalized services to the patients by involving their family and family in the process of their treatment. Further, the people in the UK must focus upon changing their lifestyle as it is the major cause of various diseases.
- Avert, 2017. HIV and Aids in The United Kingdom (UK). [Online]. Available at; https://www.avert.org/professionals/hiv-around-world/western-central-europe-north-america/uk [Accessed on 17 October 2018].
- Aveyard, H., 2014. Doing a literature review in health and social care: A practical guide. McGraw-Hill Education (UK).
- Bojke, C., Castelli, A., Grasic, K., Howdon, D.D.H., Street, A.D., Santana, R. and De Las Nieves, I., 2017. The productivity of the English NHS: 2014/15 update.
- Brett, J., Staniszewska, S., Mockford, C., HerronâMarx, S., Hughes, J., Tysall, C. and Suleman, R., 2014. Mapping the impact of patient and public involvement on health and social care research: a systematic review. Health Expectations, 17(5), pp.637-650.
- British HIV Association, 2017. UK national guidelines for HIV testing. Cancer.
- Cancer Research UK, 2017. Breast Cancer Statistics. [Online]. Available at: https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/breast-cancer#heading-Zero [Accessed on 17 October 2018].
- Drummond, M.F., Sculpher, M.J., Claxton, K., Stoddart, G.L. and Torrance, G.W., 2015. Methods for the economic evaluation of health care programmes. Oxford university press.
- Gov.UK, 2018. HIV in the United Kingdom. [Online], Available at: https://www.gov.uk/government/publications/hiv-in-the-united-kingdom [Accessed on 17 October 2018].
- Hunter, D.J., 2016. Desperately seeking solutions: Rationing Health Care.Routledge.
- Jetten, J., Haslam, C. and Alexander, S.H. eds., 2012. The social cure: Identity, health, and well-being. Psychology Press.
- Le Grand, J., 2018. The strategy of equality: redistribution and social services (Vol. 13).Routledge.
- Lewin, S., Glenton, C., Munthe-Kaas, H., Carlsen, B., Colvin, C.J., Gülmezoglu, M., Noyes, J., Booth, A., Garside, R. and Rashidian, A., 2015. Using qualitative evidence in decision making for health and social interventions: an approach to assess confidence in findings from qualitative evidence syntheses (GRADE-CERQual). PLoS Medicine, 12(10), p.e1001895.
- McGorry, P., Bates, T. and Birchwood, M., 2013. Designing youth mental health services for the 21st century: examples from Australia, Ireland, and the UK. The British Journal of Psychiatry, 202(s54), pp.s30-s35.
- Murray, C.J., Richards, M.A., Newton, J.N., Fenton, K.A., Anderson, H.R., Atkinson, C., Bennett, D., Bernabé, E., Blencowe, H., Bourne, R. and Braithwaite, T., 2013. UK health performance: findings of the Global Burden of Disease Study 2010. The Lancet, 381(9871), pp.997-1020.
- Patel, V., Chisholm, D., Parikh, R., Charlson, F.J., Degenhardt, L., Dua, T., Ferrari, A.J., Hyman, S., Laxminarayan, R., Levin, C. and Lund, C., 2016. Addressing the burden of mental, neurological, and substance use disorders: key messages from Disease Control Priorities. The Lancet, 387(10028), pp.1672-1685.
- Roser, M., and Ritchie, H., 2018. HIV/AIDS. [Online]. Our World in Data. Available at: https://ourworldindata.org/hiv-aids [Accessed on 20 October 2018].
- Williams, R., Aspinall, R., Bellis, M., Camps-Walsh, G., Cramp, M., Dhawan, A., Ferguson, J., Forton, D., Foster, G., Gilmore, I. and Hickman, M., 2014. Addressing liver disease in the UK: a blueprint for attaining excellence in health care and reducing premature mortality from lifestyle issues of excess consumption of alcohol, obesity, and viral hepatitis. The Lancet, 384(9958), pp.1953-1997.
- World Health Organization, 2015. World report on aging and health. World Health Organization.
- Wykes, T., Haro, J.M., Belli, S.R., Obradors-Tarragó, C., Arango, C., Ayuso-Mateos, J.L., Bitter, I., Brunn, M., Chevreul, K., Demotes-Mainard, J. and Elfeddali, I., 2015. Mental health research priorities for Europe. The Lancet Psychiatry, 2(11), pp.1036-1042.
- Pharoah, P.D., Sewell, B., Fitzsimmons, D., Bennett, H.S. and Pashayan, N., 2013. Cost effectiveness of the NHS breast screening programme: life table model. Bmj, 346, p.f2618.
- NAT, 2017. UK Investment in HIV Prevention. Available at: https://www.nat.org.uk/sites/default/files/publications/NAT_PREVENTION%20REPORT_V2.pdf [Accessed on 26 Oct 2018].
- Borland, S. (2014). Breast cancer patients failed by insensitive NHS doctors: Thousands says staff are uncaring or casual when breaking the devastating news. http://www.dailymail.co.uk/news/article-2577914/Breast-cancer-patients-failed-insensitive-NHS-doctors-Thousands-says-staff-uncaring-casual-breaking-devastating-news.html