Glasby - Understanding Health and Social Care (Third Edition)

UNDERSTANDING HEALTH
AND SOCIAL CARE

Third edition

Jon Glasby

First edition published in 2007, Second edition published in 2012, Third edition published in Great Britain in 2017 by

Policy Press University of Bristol 1-9 Old Park Hill Bristol BS2 8BB UK Tel +44 (0)117 954 5940 e-mail

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Policy Press and the Social Policy Association 2017

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ISBN 978-1-4473-3121-6 paperback
ISBN 978-1-4473-3120-9 hardcover
ISBN 978-1-4473-3122-3 ePub
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The right of Jon Glasby to be identified as author of this work has been asserted by him in accordance with the Copyright, Designs and Patents Act 1988.

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Health and social care are characterised by a large number of policy initiatives and new organisations, both of which lead to a large number of abbreviations and acronyms. Some of the more common health and social care abbreviations used in the book are set out below:

Many thanks to everyone who helped with ideas, references and comments for this third edition in particular to Saul Becker (as original series editor) and to Policy Press.

of this book reproduces some elements of a previous unpublished article that appeared in an in-house booklet of contributions compiled by Toynbee Hall (Toynbee Hall, ed, The settlement difference, London: Toynbee Hall) many thanks to Toynbee Hall for permission to reproduce this material.

of this book builds on an initial attempt to explore the management of health and social care partnerships published in the first edition of Healthcare management edited by Kieran Walshe and Judith Smith (Open University Press, 2006), and the chapter in this book reproduces a small amount of text from it (with permission), while also developing some of this initial thinking for a social policy and practitioner audience.

Thanks for permission for other reproductions go to: Pete Alcock ().

More than any other area of the welfare state, UK health and social care are big business and are everybodys business. Each year, they spend billions of pounds of taxpayers money, employ millions of staff, and work with millions of patients and service users. While this is true of other services as well, health and social care touch all our lives at so many times and in so many places. Overall, the NHS in England employs 1.4 million people and has an annual budget of some 116 billion. It deals with over one million people every 36 hours, with nearly 10 million operations carried out per year (up 45% in 10 years), nearly 23 million attendances at Accident and Emergency (A&E) (up 22% from a decade ago) and nearly 16 million people admitted to hospital (31% more than a decade ago) (NHS Confederation, 2016a). Adult social care in England has spending of around 19 billion (including 2.5 billion in user contributions), with 1.5 million workers, 5.4 million unpaid informal carers and nine per cent of adults in England limited a lot in day-to-day activities by illness, disability or old age (National Audit Office, 2014, p 4). Unlike the NHS, which has often been dominated by public sector provision, social care staff work in a wide range of public, private and voluntary sector organisations, spread across an estimated 17,300 organisations and 39,000 individual establishments. The private sector is by far the largest employer, employing over two thirds of people working in adult social care (Skills for Care, 2015, p 3).

And yet, health and social care touch peoples lives much more than the statistics alone imply. For some people, services are provided in an emergency, and the rapid availability of high quality ambulance, hospital and surgical services can quite literally be a matter of life and death. For others, contact with services is life changing whether through the birth of a new baby, a serious accident or illness, the death of a partner or increasing frailty in older age. For another group of people, the existence of a chronic or long-term condition means that health and social care become a fundamental part of their everyday routines, crucial to whether they are able to live chosen lifestyles or not. As a result of this, health care in particular is a key aspect of all our lives when asked which services were most important in making somewhere a good place to live, people in 82% of local authorities ranked health services as the first or second most important factor (Lyons, 2006).

On an even deeper level, some of these services are of central importance to us as a nation and in terms of our identity. In a rapidly changing world, it is hard to find things that help to define us and to sum up who we are and what we value about our society. However, if we asked the average man or woman on the street what made them proud about their country or what makes them British, the NHS is likely to figure highly and Nigel Lawson famously described the NHS as the closest thing the English have to a religion. More recently, there remains strong support for the principles of the NHS across all sections of British society, with 89% of people surveyed in the 2014 British Social Attitudes Survey agreeing that the government should support a national health system that is tax-funded, free at the point of use and that provides comprehensive care for all citizens (Gershlick et al, 2015, p 4). For reasons discussed later in this book, social care in the UK has a much more ambiguous image and history, and does not enjoy the same amount of loyalty or popularity.