Health Policy&n=
bsp; =
; &n=
bsp; Learning
Outcome 1
Assessing a care user’s needs: individual=
and
macro level
In the Principles of=
Health
Care Practice, you considered the stages involved in the care planning proc=
ess,
the role of multidisciplinary teams in primary and hospital based care, and=
the
role of the service user in making decisions about their current and future
care.
To some extent, this=
unit
continues where Principles of Practice left off. While Principles of Practi=
ce
considered the experience of individual care users, this unit focuses more =
on
the ‘macro level’ – what we might call ‘the bigger
picture’ of care provision, how care is provided in our society, how
decisions are made – for example, decisions about funding and future =
care
provision – and how legislation affects care provision.
To start, though, le=
t us
recap some of the principles of decision making at the level of individual =
care
users.
|
Case Study – making care decisions at t=
he
individual level Sinead is 24 years=
old.
She has a daughter, Jodie, aged 18 months, but separated from her partner
before Jodie’s birth. Sinead has suffered from depression and anxie=
ty
since her mid-teens; she was bullied at school and refused to go back,
missing her standard grade exams, and apart from a few months as a Skill
Seeker in a large office and occasional casual work, she has never had a =
job.
Sinead’s ex-partner, Jamie, is a heavy drinker. While he was not
physically abusive towards her, Sinead was afraid of him and eventually l=
eft
him with help from a local women’s organisation. Sinead has since b=
een
re-housed in a different area of the city but finds it difficult to go ou=
t on
her own. Sinead’s new flat is further away from her mother, who is
elderly and suffers from chronic arthritis. Sinead has no other close fam=
ily
in the city. She feels that things are getting worse and that she ‘=
has
no life’. She worries that she ‘will never be a good mum̵=
7;
and sometimes tells her mum that she thinks Jodie would be better off wit=
hout
her. |
1. =
In the pri=
mary
care team, who would be involved in planning Sinead’s care?
2. =
What are t=
he
stages of the care planning process, and how would these relate to
Sinead’s care?
3. =
How would =
Sinead
be involved in making decisions about her care? Who else might be involved,=
as
well as professionals and care workers?
4. =
If
Sinead’s illness were to deteriorate and she were to be admitted to
hospital, who would be involved in her care?
5. =
What types=
of
organisations might be involved in supporting Sinead? Don’t worry if =
you
are not sure about this – we will look at service provision in more
detail next week.
Assessing care needs at the macro level<=
/b>
You probably identif=
ied a
number of individuals and organisations of various sizes which might be
involved in providing care for Sinead. We can create a ‘map’ of=
the
care sector rather like the one below to show this:
![](3D"assessing_needs_files/image001.gif")
Clearly, who is invo=
lved
will depend on the needs and circumstances of the individual care user R=
11;
community based mental health care, as in Sinead’s case, would involve
quite different services to hospital based geriatric care, or provision for
those with physical disabilities.
We will look at diff=
erences
between care providers and the role of government and other decision makers
later in the unit. We will also look in detail at the structures and fundin=
g of
the NHS in Scotland.
Assessing needs at the macro level – Glas=
gow
City Council
So far, we have conc=
entrated
on assessing an individual’s =
care
needs. But how do the government and other funding bodies identify
‘need’ on a broader level – the needs of a community for
example, or of a group of people, such as “the Asian community in
Glasgow” or “young people aged 16 – 25 in Glasgow”?=
One of the main care
providers in Glasgow is the local authority – Glasgow City Council
– through its Direct and Care Services Department. To understand the =
size
of this department and some of the services that it is responsible for,
excerpts from their Business and Service Plan 2004 – 2007 are attache=
d at
the back.
Take a few minutes t=
o read the
first page, entitled ‘Purpose and Rationale’. Now look at the
following ‘Strategy/Initiatives’ pages.
Working in small gro=
ups,
discuss the following questions:
1. =
How much d=
oes it
cost per year to run Direct and Care Services?
2. =
How many s=
taff
are employed?
3. =
What types=
of
services are provided?
Glasgow City Council=
clearly
has a responsibility for a large amount of service provision, but how do th=
ey
know which services are needed? And how do they know whether the services t=
hat
they are providing are effective – that they are meeting the needs of=
the
service users?
Working in small gro=
ups,
discuss methods and sources of information that an organisation like Glasgow
City Council might use to assess the care needs of the city. A few examples=
have
been provided to get you started:
|
Questionnaires sen=
t out to
householders with electoral registration documents or Council Tax Bills
– asking how many people live in the house, and how many are under =
the
age of 5 Figures from other=
Council
Departments, e.g. …. Figures from the
government, e.g. …. Figures from the B=
enefits
Agency, e.g. …. Figures from the N=
HS, e.g.
…. Other examples =
230;.. |
The Council can also=
try to
evaluate how well their current service provision meets needs by
‘stakeholder consultation’.
Look at the last two=
pages
of the handout, which give details of ‘stakeholder consultation’
for Direct and Care Services. What do you think this means? Discuss in pair=
s.
- Who would be involved in ‘stakeholder
consultation’?
- Why do the Council need to evaluate their
services? What might happen if they didn’t do an evaluation?