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Achieving good Treatment and care facility

ABSTRACT

Chronic Kidney Disease is one of the major renal diseases that occur due to the negligence and avoidance of taking acute medical care and health care solution against the possibility of this growing mainly in the Northern side of the city of London. The key aim is to initiate health intervention among all the community patients, who are facing numerous diseases in respect of Chronic Kidney Disease, due to hypertension and growing level of diabetes where it needs to include diagnosis as well as dialysis within the intensive care unit under health programs to check.

However, there are limitations of the intervention strategy that will require closely proper policies, social and financial supports from the end of the government as well as advisory board collaboration that needs to diagnose minimum 200 approximate cases of renal failure as well as Camden community would need to have capital strength of £ 10 million each year. The intervention planning and identifying the stakeholders are effective where the major stakeholders are doctors, nurses and social workers as well as NHS, CQC, patients and government of the UK. The major intervention planning are such as heath promotional activities, digital health campaigns, preventive care, Health Screening Intervention program, use of patient Decision Aids and introducing virtual clinics in Camden in association with STP advisory board.

INTRODUCTION

Public Intervention has been defined as a progressive action that emphasizes on evolving movement focuses on improving issues of health in the overall population. There are lack of public health intervention practices for which the social communities fail to access the right treatment and care for improving their health and wellbeing. It is the responsibility of the health care organisations and mainly NHS to introduce different health promotional activities for supporting the communities with high quality treatment and continuous care. The chronic kidney diseases are increasing at a rapid rate over the countries of the UK and it from 8 to 9% of the total number of groups in the country and maximum observable in both male and female (Duke Global Health Institute. 2020). From the above statistics, it has been identified that Camden residents diagnosed to be affected by chronic kidney disease of closely 2.5% by the year 2016 and projected to go higher at 3.4% by the year 2030. In fact, it is found that 2.6million population living with CKD in UK (Camden.gov.uk. 2017).

Number of people affected

INTRODUCTION

Target Population in Camden

The target population is mainly the hypertension patients facing difficulties in kidney attack and insufficiency in having proper functioning of kidney. The geographic setting of Camden is in the Northern side of the city of London (Camden.com. 2020).

Consequences for Health

Based on this above projected statistics, Camden is having possibility of numerous types of life risks from various angles. People having high salt intake are vulnerable to CKD with growing level of Blood pressure (Camden.gov.uk. 2017).

Socioeconomic Impact

The growing rate of income deprivation in Camden town is closely 22.5% and employment is similar along with a health deprivation and disability rate of 13.5% as well as living environmental condition is closely 9.3% (iLiveHere - Britain's worst places to live. 2020).

Socioeconomic Impact
Approximate Spending in health care current and Future in Camden (Source: Camden.gov.uk. 2017)

From this estimation and spent cost closely £ 2.5 million in Camden health care institutions and against kidney transplantation they have spent already 7.9 million, which is estimated to go higher in the upcoming years of nearly 10 million approximately including overall cost (Camden.gov.uk. 2017).

Burden on NHS

Considering the above situation of growing diseases in number, CKD seems to be affecting large number of people where the pharmacies in Camden need to be improved under NHS Health Checks (healthwatchcamden.co.uk. 2017). Burden on NHS

Camden Public Health Care, 2017 (Source: healthwatchcamden.co.uk. 2017)
The percentage of health checks that is distributed in Camden so far gives an acknowledgement that NHS has better potential in distributing further health checks on all other areas of Camden. In fact, the ratios of GP practices are 79%, community 19% and pharmacy with 2% can be much better and effective, if it takes some better focus on pharmacies, it might be effective in controlling CKD rising in the area.

Aim and objectives:

The aim is to initiate health intervention planning among all the community patients, who are facing numerous diseases in respect of Chronic Kidney Disease, due to hypertension and growing level of diabetes, where it needs to include diagnosis as well as dialysis within the intensive care unit under health programs to check.

The objectives of this intervention would be:

To implement a Health Screening Intervention program. This is for age group above 50 years as well as people at young age

To Use of patient Decision Aids: This could be used for the purpose of getting the exact ratio of patients facing difficulties in critical areas. It mainly helps to empower the patient in the decision making practice for better treatment and care where the patients can express their thoughts, share their difficulties for developing a good care plan.

To create health promotional activities in Camden in association with STP advisory board

APPRAISAL

Critical review on public health approaches

It would be effective in implementing a review process through chronic diagnosis tests and enhancing the knowledge and awareness about renal failure and pain of kidney diseases. At the same time, it may also include process of counselling session under the guidelines and regulations of government.

According to an online review, Onlinedegrees.kent.edu (2020), it was identified that some of the plans were conducted by UK Renal Registry so that the community of Camden can pursue with a cost-effective care services as well as at low cost. In fact, it was also ensured that the approach to generate quality care level. However, this approach could not be so successful at its best for controlling the level of threats so far. Further, Commonwealthfund.org (2020), found that innovative health approaches like Slowing CKD progression by diagnosing End-stage renal disease (ESRD) has tremendous level of sustainability in the disease. On the contrary, it had also been thrashed by the argument that there cannot be a guarantee that patients will survive after that, as the stage of intervention is late and screening is not routine-wise and mostly asymptomatic in nature.

Environmental factors affecting public health Intervention

Primary Prevention: The key driver of environment is major health issues that are related to tension. High increase level of blood sugar, or being anaemic also that occurs mainly due to environmental changes in the surrounding community. For example, if there is change of climate, necessity of water and food habit change may increase the vulnerability to CKD and impact directly on health. Besides, it can also cause problems in driving additional problems like high risk of heart failure (Cdc.gov.2020).

For example, it was identified from CQC report that there have been number of patients affected in CKD in the hospitals without any supervision of health care checks in hospitals that came out as St. Pancras Hospital, which is under Royal Free NHS Foundation Trust (Camden New Journal. 2017). Based on these identified areas of concerns, driving factors, it became so necessary for the intervention and emphasising on public policies and agendas to be taken further. As per the Force field analysis, the major driving forces in the health and social care sector are such as technological advancement in health care, improvement in patient management, efficiency among the staff members, introduction of latest health care equipment for better treatment and care and digital health care services.

Public health agendas and policies:

If there is implementation of advanced policies and health agendas, there can be good chance and facility of making positive outcome on the growing impact of CKD further. Below are some of the process needs in all levels.

At Local and regional level

Policies in the local and regional levels always involved Mayor of London as well as in partnership with UN’s Sustainable Development association. This would provide opportunity to works for transplanting as well as supporting behind the daily estimation and budgetary measurements of socio-demographic index (Lancet, 2020). In this respect, if healthcare board and administrative members of the Camden Community and senior authority takes emphasis on giving prioritised facilities, it may be possible for the group of community members to look into clinical stream of operation. In the local and regional levels, for better health care intervention, it is required to take focus on making concentration on building medical shops and medical back up with advancements so that it may cover emergency support to the patients. Digital health promotional activities in the country is also necessary to be arranged where online health campaign, free check us and other activities further retain the patient in the community as well as raise awareness about the disease and preventive measures in the

social communities of London.

National Level policies

It is important to bring notice on financial segment and measures so that planning process and departmental decision-making processes can be completed by a virtual collaborated meeting that would include accounting planning and process for enhancing group activity. It will also require including investment team for back-up team for proceeding with the national level policy. The national level policy and the health care standard provided by Care Quality Commission are mandatory to be followed in order to develop health promotional planning and intervention strategy for increasing awareness in the social communities.

Global Level Policies and Agendas

Apart from all above, for monitoring and processing global level policy and agendas, it is necessary to concentrate on advisory board also for giving permission and to be informed well in advance about competitive policy. This can be effective partnership in terms of gaining some competitive advantage so that policies can be strengthened. Partnership working practice with cooperation of NHS, CQC and other health care authorities are hereby mandatory for developing good social care intervention planning for increasing concern among the patient about the preventive measures and health care services in long run.

Justification of choice

The collaborative approach would be suitable for making effective unattended areas of this disease control initiatives against certain number of health care units. It would be appropriate to find better outcome on the basis of stakeholders association in all aspects so that steps can be used with better outcome and agendas for reducing the impact of the disease. Partnership working practice as well as managing transparency and accountability are essential for developing health promotional practice in order to ensure public health intervention and where all the stakeholders such as doctors, nurses, social workers, health care staff, surgeon, general physicians and others as well, as the patients are also engaged with the care plan and health promotional and preventive actions in the social community.

INTERVENTION/STRATEGY

Details of Intervention:

Considering the above review on different approaches, some intervention plan has been initiated in respect of addressing the problem in detail.

Health Screening Intervention program

Screening program can be conducted for key vulnerable patients having typical chronic problems of renal risk so that they can have some strategic guidelines from specialised practitioners. It would also involve presence of NHS Trust as well as STP advisory Board under whose observation the intervention can be conducted in an effective way. It helps to conduct patient diagnosis efficiently and tale immediate action to treat the patients with the best quality health and social care services.

Health promotional campaign

The health promotional campaign is important in the recent years to raise awareness among the patients and other social communities where it is possible to engage the patients and improve their concern about the chronic kidney disease, so that they can understand the reason of such diseases, complications and preventive measures so that they can improve their living standard (Room, House and Square, 2017). It is considered as a health educational campaign and in the recent era of globalisation, digital health care services and online health promotion campaign are effective to be arranged for supporting the social communities with the best quality treatment and care.

Use of patient Decision Aids:

This kind of monitoring aid can be initiated by using decision-making maps along with shared decision aids as well in terms of having better understanding of the patients’ issues as well. In this process, it may include direct interactions between doctors and patients using the medium of events that may involve education and knowledge sharing sessions through a pattern of treatment. Hence, this can act as an alternative medium of finding the disease treatment options to some extent under patients’ end for feeling satisfaction level.

Introducing virtual clinics in Camden in association with STP advisory board:

By launching this particular intervention method, there can be a well accumulated option of providing some change in GP practices within the community of Camden. In other words, there would be patient engagement and experience in health care including the interrelationship between doctors and community residents on a regular basis. This might be beneficial in terms of having some self-management goal in everyone (Thinkkidneys.nhs.uk. 2020). In this respect, if some patent is need of alternative diagnostic tests, then it may require to get tested in advance.

Working with the Stakeholders and communication strategies:

In establishing the above long term intervention process, it is important to get involved into stakeholders and having effective communication program with them so that patients can be well treated or at least have recovery plan in hand in advance (Thinkkidneys.nhs.uk. 2020). It has been thought being inspired from a review, however; it is significant for this entire communication strategy to get into practical implications for changing policies when it is emergency for any kind of lack in advanced process of communication or connectivity breakage. However, through the involvement of NRS healthcare services studied from (2020), it was also taken this guideline that this committee workshop can be improved well.

Types of partnerships

The types of partnerships can be improved by involving a better communication process so that relationship can be improved from both the ends, from providers and receivers of treatments. Also, partnership has to be such a kind that is possible for make sure about supporting online facilities and mentoring instructions whenever needed on emergency purposes. That means, it should be informative as well as constant operating on continuous session of improving health care services within the Camden community overall growth prospects (Ray and Miller, 2017). It can also be supported by clinical specialists and some involvement of commissioning groups. The NHS and CQC are the major two stakeholders for best health promotional activities in London, where they try to intervene in the society with preventive measure of kidney diseases as well as CQC provides a scope to improve quality standard by giving ethical guidelines and treatment to the care workers. On the other hand, the pharmaceutical companies and investors are also efficient stakeholders to maintain operational efficacy and provide medicines and treatment time to time (Burckhardt, Nagin and Padman, 2016). The patients and their families are also considered to be a stakeholders group who try to collaborate and engage with the care givers for accessing the best care and treatment for chronic kidney diseases

Developing personalised Care Plans:

The implementation of personalised care-planning needs to be conducted with the help of kings fund association with National voices as well. In fact, this would include knowledge skills as well as clinical process idea and explanation about patients’ relationship between the staffs of health care units and the doctors and GP practitioners (Thinkkidneys.nhs.uk. 2020). It helps to engage the patients in the care plan so that they can share their health issues and experience with the care givers and it further improves the health intervention practices in the society.

It was observed that Camden has been widely affected by higher scale of CKD and mostly in the rank of 15. It is also observed that still now 25% patients still facing threat of not being

diagnosed yet. However, only 2.5% of them are deep-rooted that they have partially under control, as they have been diagnosed. Therefore, rest of 90% of people are still facing error and left unseen and unchecked.

Financial management:

For financial management, there is government aid for the patients and NHS is also efficient to provide high quality public health care at minimum or free of cost so that the individuals at London can access the best care for improving their standard of living (Denis and Pomey, 2018). There are also voluntary employees, charity homes and social care workers a, who are efficient to engage in the health promotional activities for maximising public health intervention in the society which also reduces the cost of intervention planning. The intervention planning can be conducted in a cost effective way where digital health promotional campaign is the tactic to engage a vast range of population in London and improve their standard of living by providing quality care and treatment.

Estimated Cost for intervention:

It may include closely £7.5 million in adding up the cost of specialist consultation while being in their own personal environment (Song et al. 2018). The system also treats the patients as per their stages of chronic kidney disease and ensures that the patient who is having severe manifestation of the disease is seen before the other patients. It may provide a medium for healthcare professionals to interact with each other as well to work on some of the clinical cases.

Pharmaceutical Cost:

The approximate cost of intervention for pharmacy is projected to have closely no less than £ 6.5 million, the overall global expenditure is beyond 7 million. Based on this projection, there is evidence that seems to be practical in terms of making it, as an approximate figure.

From an online audit (England.nhs.uk, 2020) in Camden, it has been seen that individuals with top level salary spend more than 2- 3% of their yearly clinical financial plan on the treatment of kidney illnesses and related infections. Those getting such exclusive requirement medicines structure to be very low rate out of the whole populace. When seen around the world, in the year 2010, individuals getting dialysis appear to be 2.62 million that have been required to twofold toward the finish of 2030 demonstrating the necessities money related and monetary necessities among individuals to get the treatment viably.

Measuring progress:

During the measuring progress, it is also essential to calculate the performance index of the health care professionals through observation on regular basis. In other words, this process cannot be ignored from being done, as it may create some balancing act of life style and regular habit of getting checked under caring services and especially those patients who are under substantial change of ageing as well as making assurance about its unmet demands. As it was influenced by Stel et al. (2017), that maintaining diseases like obesity or it is hypertension, issues associated with kidneys need to be effective measured and monitored on a regular basis. This is quite evident here to have the confirmation that having growing dependency on the division of CKD disease in terms of genetic disorders, it would be a great change after this manipulation on measuring services. Hence, the overall measuring progress can be calculated in an indicator of KPI or through a measurement tool in terms of having the right value and the target growth prospects in hand. Using a Delphi method, it can be conducted that might be suitable for having the estimated outcome in hand. This can be implemented by using the following way: Measuring progress Measuring progress Measuring progress

DISCUSSION

Case assessment with theoretical links:

The cost approximate figure needs to be alternatively planned and approached for avoiding sudden break down as well as an inadequacy in available knowledge about the public health requirements. In this respect, limited support, unavailability of social and financial resources often inhibits the enhancement of such an approach. In the case of CKD control also several barriers have been found to limit the progression of health intervention (Cdc.gov. 2020). As per CKD the theory of Social suffering, it has been rightly recognised that health issues produced from being driven by effective ailments and social forces everywhere, it is natural that quite to accept that it influences not only on a public but a public society (Get Smarter Blog. 2020). This also includes, forces of society like poverty, and many other problems associated with social forces. Also, it is ensured that limitations that are found in public health intervention can also be reduced by external support like health care policies as well as social norms.

Conclusion

Therefore, based on the above research and investigation and intervention strategic approaches taken, has made it possible for health intervention plan to be effective in terms of growing rate of CKD in the location of Camden. It has been majorly affected due to not having sufficient diet control measurement and finding its results. The overall intervention can be conventional and practical in terms of offering future prospects of health enhancement. The public health intervention planning is hereby efficient to raise awareness among the social communities, where the patients can take immediate actions and access the health care treatment successfully. Moreover, preventive measures and knowledge about the chronic disease can also be shared through health promotional activities, where the social communities can improve their health condition by accessing effective treatment and improving personal care and healthy lifestyle.

REFERENCES

Camden.com. 2020. Camden Geography - Information, Climate And Weather In Camden. [online] Available at: [Accessed 25 October 2020].

Cdc.gov. 2020. Chronic Kidney Disease Initiative | CDC. [online] Available at: [Accessed 23 July 2020].

Room, H., House, B.M.A. and Square, T., 2017. Camden Clinical Commissioning Group Governing Body Meeting Wednesday, 14 November 2018. General Practice, 18, pp.3-0.

Ray, K.N. and Miller, E., 2017. Strengthening stakeholder-engaged research and research on stakeholder engagement. Journal of comparative effectiveness research, 6(4), pp.375-389.

Bombard, Y., Baker, G.R., Orlando, E., Fancott, C., Bhatia, P., Casalino, S., Onate, K.,

Denis, J.L. and Pomey, M.P., 2018. Engaging patients to improve quality of care: a systematic review. Implementation Science, 13(1), p.98.

Burckhardt, P., Nagin, D.S. and Padman, R., 2016. Multi-trajectory models of chronic kidney

disease progression. In AMIA Annual Symposium Proceedings (Vol. 2016, p. 1737).

American Medical Informatics Association.

Duke Global Health Institute. 2020. Simple Public Health Intervention May Prevent Chronic Kidney Disease. [online] Available at: [Accessed 23 July 2020].

England, N., 2020. NHS England » Reducing Health Inequalities Resources. [online] England.nhs.uk. Available at: [Accessed 23 July 2020].

Onlinedegrees.kent.edu. 2020. Public Health Interventions | Kent State University. [online] Available at: [Accessed 23 July 2020].

Camden.gov.uk. 2017. Open Data And The Census - Camden Council. [online] Available at: [Accessed 24 October 2020].

Camden New Journal. 2017. ‘No Supervision’ At Dialysis Unit Revealed After Patient Tip- Off. [online] Available at: [Accessed 24 October 2020].

Commonwealthfund.org. 2020. Protecting Patients With Compromised Kidney Function During The Pandemic And Beyond. [online] Available at: [Accessed 24 October 2020].

healthwatchcamden.co.uk. 2020. [online] Available at: [Accessed 24 October 2020].

Song, M.K., Unruh, M.L., Manatunga, A., Plantinga, L.C., Lea, J., Jhamb, M., Kshirsagar, A.V. and Ward, S.E., 2018. SPIRIT trial: A phase III pragmatic trial of an advance care planning intervention in ESRD. Contemporary clinical trials, 64, pp.188-194.

Lancet, T., 2020. The Lancet Top-Cited Content. [online] Info.thelancet.com. Available at: [Accessed 25 October 2020].


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