Healthcare Systems in the UK

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Introduction

The government has remained committed to providing patients and the public high quality and compassionate care (Grosios et al. 2010). To achieve this, the central government develops health policy which offers guidance of health care delivery. Additionally, the government reviews these policies and legislations while developing new ones in order to create a more responsive and patient-centred NHS (Boudioni et al. 2017). This paper discusses how various national policies and legislation affect healthcare delivery. The paper considers the effect of the Health and Social Care Act 2012, the Equality Act 2010, NHS and Community Health Care Act 1990, the Care Act 2014, and the General Data Protection Regulation 2018 on delivery of healthcare.

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The Health and Social Care Act 2012

The Health and Social Care Act 2012 marked the introduction of legal duties regarding health inequalities in the UK health system. The duties of different health bodies including the Department of Health, Public Health England, and NHS England as well as Clinical Commissioning Groups have been specified in the act. Furthermore, the act emphasises the need for reduction of health inequalities between different population groups in England (Peckham et al. 2015). Additionally, the act influenced changes in the functions of local authorities in the healthcare system. These changes have significantly affected general practice and its role in public health. According to Glover-Thomas (2013), the introduction of the Health and Social Care Act 2012 required GPs to have greater public health knowledge and the practitioners to increase the provision of disease prevention and health promotion services. The act empowered the Health and Wellbeing Boards to make decisions about public health priorities for their geographic areas. This way, there has been a better understanding of local health demands which ensures that services respond to the needs of the public resulting to an increase the quality of care outcomes (Davies 2013). Clinical Commissioning Groups are represented in the Health and Wellbeing Boards, which implies that they are directly involved in decision-making as regards the allocation of public health resources. This degree of coordination between the Clinical Commissioning Groups and the Health Wellbeing Boards has significantly improved public health and disease prevention (Tritter and Koivusalo 2013). On the other hand, Coleman et al. (2014) write that the involvement of Clinical Commissioning Groups in public health decisions has compelled them to think more deeply about their communities, which increases patients’ access to streamlined services that are of high quality. The enactment of the Health and Social Care Act 2012 called for training for the clinical commissioning groups to equip them with management skills in order to achieve equal coverage and distribution of services which has seen an increase in professionalism in care delivery (Humphries 2013). In the same view, Sabey and Hardy (2013) state that the Health and Social Care Act’s (2012) introduction underscored the need to raise GPs’ level expertise and clinical knowledge so they could accurately identify and evaluate the needs of diverse patients. This raising of expertise resulted in an increase in the outcomes for quality of care. The enactment of the Health and Social Care Act 2012 emphasised the need for personalised care. According to Care Quality Commission (2012), personalisation is a social care approach where patients are allowed to choose and control the care they receive. By emphasising personalisation, it can be seen that the Health and Social Care Act 2012 shifted power and control from service providers to patients making service user a core part of care provision. Personalisation of care brought together different providers who work together to ensure services are customised for individual patients. This means that Health and Social Care Act 2012 has increased the level of teamwork and partnership in healthcare delivery.

The Equality Act 2010

The Equality Act 2010 legally protects patients from discrimination in healthcare settings. The act identifies the equality issues that healthcare providers should consider to make care services more accessible to all patient groups. These equality issues are referred to as the protected characteristics. The major equality issues are disability, gender reassignment, age, pregnancy and maternity, sex, marriage and civil partnership, race, and religion or belief as well as sexual orientation (Hepple 2014). The Equality Act 2010 enactment required the NHS to provide reasonable adjustments to their practices in order to make sure that all people regardless their characteristics have full access to health services. Particularly, the act requires health services to provide care in a way that does not discriminate against disabled persons. To meet the care need of disabled patients, the Equality Act 2010 required health services to make three major adjustments (Babiker et al. 2014). First, to change a service’s physical features for people with disabilities to easily access the service; for example, making buildings accessible to patients on wheelchair. Second, the act required health services to change their procedures so they are accessible by people with disabilities; for example, changing the timings, location, or length of appointment for disabled patients. Third, the act required health services to provide auxiliary services such as different formats of information to make it accessible to patients with disabilities. As observed, the provision of changes by healthcare providers to ensure healthcare delivery does not discriminate against people with disabilities have been highlighted by the examples provided. Kydd and Fleming (2015) state that the enactment of the Equality Act 2010 played an integral role to ensuring people with disabilities access information and communicate in a way similar to the non-disabled patients. On the other hand, O’Donnell et al. (2016) write that following the enactment of the Equality Act 2010, more people from the marginalised groups and the elderly have been able to receive care.

NHS and Community Health Care Act 1990

The health and local social service authorities are required, by this act, to agree community care plans indicating how need-based individual care plans are to be locally implemented. In this process, the relevant authorities in question should clearly show how continuity of care will be achieved, how services will be made more accessible, how nurse-patient relationships will be enhanced, how patients will be supported to achieve their goals, how patients will be made independent, and how patients and services will be advocated for (Toth 2010). The enactment of the NHS and Community Health Care Act 1990 is remarkable for encouraging direct participating of patients and service users in planning and management of care services. Following the enactment of this legislation, patients are more empowered and in control of their health, which requires care providers to listen to the needs of patients and service users before making any care interventions (Fenge 2011). On the other hand, Tritter and Koivusalo (2013) write that patient participation implies creating opportunities for patients to take part in decision making, which means that care providers should ensure the patient understands the objectives and their role in the care process. From this perspective, care providers must do more than assessing patients and developing care plans; they should make sure the patient is part of the care plan which requires care providers to inform and guide patients about disease and treatment and to involve patients and their families in development of care plans. In this process, the care provider must provide the patient information about the disease and the relevant care interventions, the pros and cons of each possible intervention and the expected outcome so that the patient can choose care option with informed mind (Tritter and Koivusalo 2014). Therefore, we can infer that the enactment of the NHS and Community Health Care Act 1990 has educational implication for patients by care providers.

The Care Act 2014

The Care Act 2014 focuses on adult social care; it puts adults in control of their care and support while clarifying the kind of care they should expect. The act empowers individual patients such that their wellbeing assessment and needs cannot be overlooked by healthcare providers (Toth 2010). Following the change in roles, the act implicates that healthcare professionals should inform patients of their eligibility determination and show patients how their care needs meet the eligibility criteria and the reasons for these needs. Where eligible needs are assessed, healthcare providers should provide patients the available interventions and involve them in care planning. Even when patients do not have eligible needs, healthcare providers are expected to provide patients with information on what support is available in the wider community and the preventive measures to take in order or delay or prevent condition progressing. Therefore, the Care Act 2014 subjects professionals to responsibility in eligibility decision making and patient involvement.

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The General Data Protection Regulation 2018

Some aspects of the General Data Protection Regulation (GDPR) 2018 significantly influences healthcare delivery. First, transparency is a key principle of GDPR which implies that healthcare professionals should process patients’ personal data in a way that patients can easily understand and make it more accessible to patients. In addition, the policy requires healthcare professionals to provide patients information about how the data will be processed at the point of data collection. Second, the data protection policy requires healthcare professionals to safeguard the fundamental rights and freedoms of patients. In this case, clinicians are supposed to limit access to patients’ data, use pseudonyms, encrypt patient’s information, train those involved in care delivery on data protection, and place strict time limits for erasure of personal data (Rumbold and Pierscionek 2017). This policy also implies that healthcare professionals should inform patients about disclosures that need to be made for patients to receive high quality care. This means that before a clinician shares patient’s data, he/she should inform the patient and seek consent. The GDPR also provides patients with information about their rights in data processing which implies that patients have some degree of control in collection and processing of personal data. Patients have the right to object use and disclosure of confidential information. In cases where patients prohibit clinicians from sharing confidential information, the care provided could be quite limited which requires the care provider to inform the patient how the decision affects care outcomes. At the baseline, healthcare practitioners cannot treat patients safely and offer care continuity without having and sharing relevant information about the patient’s condition and medical history. This implies that even though patients have the right to prohibit information sharing, it risks their health thus healthcare professionals must act in the best interest of the patient which at times may disrespect the wish to withhold information (Voigt and Von dem Bussche 2017). However, in the very rare cases where patients are reluctant to give consent to information sharing, healthcare providers should make additional efforts to gain consent. When the public good for sharing information without consent outweighs the issue of privacy, healthcare practitioners should share patients’ information but in a way that promotes the patient’s dignity. Therefore, the GDPR policy requires healthcare institutions to be more transparent and rigorous in documenting patients’ data which requires staff training in data management. Healthcare professional are also required to be conversant and act according to the codes of data protection which requires regular training and change in culture.

Conclusion

The aim of this paper was to discuss national policies and legislation that affect healthcare delivery. The paper explores the effect of Health and Social Care Act 2012, the Equality Act 2010, NHS and Community Health Care Act 1990, the Care Act 2014, and the General Data Protection Regulation 2018 on delivery of care. The Health and Social Care Act 2012 is more concerned with reduction of health inequalities thus requires the NHS to make healthcare more accessible to all geographic areas through fair allocation of health resources. The Equality Act 2010 seeks to eliminate discrimination in healthcare thus ensure all patient groups have full access to care. The act implicates that healthcare facilities make buildings more accessible to people with disabilities and provide information in a way that can be understood by all patient groups. The NHS and Community Health Care Act 1990 has promoted patient involvement on care delivery resulting in higher degree of patient independence. Similarly, the Care Act 2014 advocates for patient involvement in care planning and delivery. The General Data Protection Regulation 2018 seeks to promote patient privacy in the care process. It requires healthcare providers to be more sensitive to the privacy of patients when sharing patient information: they are required to obtain patient consent prior to data sharing. However, when the patient prohibits data sharing, which threatens life, healthcare providers have the right to overlook issues of privacy and share the data for higher quality outcomes.

References

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Kydd, A. and Fleming, A., 2015. Ageism and age discrimination in health care: Fact or fiction? A narrative review of the literature. Maturitas, 81(4), pp.432-438.

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Toth, F., 2010. Healthcare policies over the last 20 years: Reforms and counter-reforms. Health Policy, 95(1), pp.82-89.

Tritter, J.Q. and Koivusalo, M., 2013. Undermining patient and public engagement and limiting its impact: The consequences of the H ealth and S ocial C are A ct 2012 on collective patient and public involvement. Health Expectations, 16(2), pp.115-118.

Voigt, P. and Von dem Bussche, A., 2017. The eu general data protection regulation (gdpr). A Practical Guide, 1st Ed., Cham: Springer International Publishing.

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