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A-Z of Services
Alphabetical directory of health and social care resources.
A and E / A and E Department
See Emergency Department
Violation of an individual’s human and civil rights; action or deliberate inaction that results in neglect and/or physical, sexual,
emotional or financial harm. Abuse can be perpetrated by one or more people (either known or not known to the victim) or can take the form of institutional abuse within an organisation; it can be a single or a repeated act.
See also Adult Protection, Crime, Depression, Domestic Violence, Health, Loneliness, Mental
Health, Self harm, Well-being, Vulnerable Person.
The extent to which people are able to receive the information, services or care they need and are not
discouraged from seeking help. Issues involved include distance of travel; physical access (e.g. premises suitable for wheelchairs); communication (e.g. information in Braille/large print and other formats); and the provision of culturally appropriate services.
Accident and Emergency
See Emergency Department.
The promotion of safety and the prevention of accidents in all areas of life - at work, in the home, and on the roads, in
schools, at leisure and on (or near) water.
See also Ambulance Service, Emergency Department, Falls, Fire Services and Prevention, First Aid, Heating in the
Taking responsibility for one’s own actions and explaining them to anyone who asks (e.g. to stakeholders, the general public, colleagues, partner agencies and policy makers). Organisational accountability includes the statutory responsibility of the NHS and Social Services
Act of Parliament
When the Government, (or sometimes a backbench MP,) wishes to introduce new laws or revise existing law, draft legislation
is introduced into Parliament the form of a Bill. Bills are discussed in both the House of Commons and the House of Lords and may be amended. If both Houses agree to the proposals contained in a Bill it is sent for Royal approval. Once the Bill has
been given Royal Assent, the Bill becomes an Act of Parliament and a law of the land.
See also Bill, Government, Green Paper, Government, Law, Legislation, White Paper.
Support that encourages individuals to do as much for themselves as possible, to maintain their independence and abilities and
encourage people with disabilities to maximise their own potential and independence.
See also Intermediate Care, Long Term Conditions, Person Centred Approach, Rehabilitation, Self Care/Self Management, Single Assessment Process.
Activities of Daily Living
Tasks associated with the process of performing personal care, e.g. washing, bathing,
dressing, hair and skin care, eating and drinking, and other basic daily tasks, such as caring for the home environment.
See also Rehabilitation.
Hospital-based or emergency health services- sometimes referred to as secondary care. 'Acute' relates to
the care being short-term.
Medical and surgical treatment provided in hospitals. Acute services are managed by an acute trust.
See also Secondary Care.
A legal entity formed to provide health services in a secondary care setting.
Entry into a hospital bed or into a Care Home or Care Home with Nursing. The
admission may be planned from a waiting list, or be an emergency.
See also Emergency Department, Compulsory Admission.
Term used by health and social care agencies when assisting vulnerable adults who may need protection from neglect,
potential harm or abuse, or from actual abuse.
See also Vulnerable Person.
Advance Statements, Advance Directives
An advance statement, advance directives or living will allow people to state
what forms of treatment they would or would not like carried out should they become unable to decide for themselves in the future.
A proposal for an appropriate course of action.
See also Benefits, Information, Legal Services.
Taking action to help people to say what they want, securing their rights, representing their interests and obtaining services they
need. Advocacy is most effective when carried out by a person who is independent of the services being provided.
See also Long Term Conditions, Person Centred Approach, Single Assessment Process.
Action that adversely affects an individual because of their age.
See also Ageism, Anti-discrimination Policy, Anti-discriminatory Practice.
Discrimination against or unfair treatment of individuals on the basis of their age.
See also Age Discrimination
Name for any organisation responsible for delivering services and for which workers may work or act as volunteers.
Agenda for Change
NHS pay system which applies to over a million NHS staff with the exception of doctors, dentists and most senior managers.
The new standardised pay system aims to ensure fair pay and a clearer system for career progression. Staff will be paid on the basis of the jobs they are doing and the skills and knowledge they apply to these posts.
See HIV / AIDS.
The problems associated with alcohol are varied. People who drink heavily can experience social, psychological and health
problems as a result. Some people can become dependent on alcohol, either physically or psychologically.
Hazardous alcohol intake means drinking heavily enough to cause harm in the future. Harmful alcohol intake means that drinking is already causing harm.
Someone with alcohol dependence:
The terms problem drinker and excessive drinking are also often used. Binge drinking is defined as drinking eight or more units of alcohol in one session if you are a man, and more than six units in one session if you are a woman. Studies are
starting to reveal that drinking a large amount of alcohol over a short period of time may be substantially worse for your health than frequently drinking small quantities.
- has a strong desire to drink alcohol,
- has difficulty controlling their use of alcohol,
- persistently uses alcohol despite being aware of the harmful effects,
- shows increased tolerance for alcohol, and
- when without alcohol shows signs of withdrawal.
Binge drinking is becoming a big problem in the UK. Teenagers as young as 16, admit to binge-drinking and around 40% of patients admitted to A&E are diagnosed with alcohol-related injuries or illnesses.
See also Health, Substance Misuse, Stroke, Well-being.
A warning call, alarm or message which addresses concerns where urgent action may be needed to be provided by a health and social care
Allergy is the term used to describe an adverse (bad) reaction by the body to a particular substance. Most things that cause
allergies are not obviously harmful, and have no affect on people who are not allergic.
Any substance that triggers an allergic reaction is called an allergen. There are many different types of allergens; three of the most common are pollen, dust mites and nuts. Allergens contain protein, which is found in all living organisms, and it
is the protein that causes the reaction. Some drugs such as penicillin can also cause allergic reactions. They do not contain protein, but they can cause a reaction if they bind to proteins in the body.
An allergic reaction to the allergen happens when you come into contact with it. Contact may be with your skin, or with the lining of your lungs, mouth, gullet, stomach or intestine. If your body reacts badly to a particular substance, you are said
to be allergic to it.
Allergic reactions can cause a range of symptoms. Some can be quite mild, and some are serious, very occasionally resulting in death.
Allergies are very common and affect around one in four people in the UK at some time in their lives. Each year the numbers increase by 5%, with many more children being affected.
See also Asthma, Eczema, Hay Fever, Health, Well-being.
Allied Health Professionals
Umbrella term for Arts Therapists, Chiropodists, Dietitians, Occupational Therapists, Orthoptists, Paramedics,
Physiotherapists, Prosthetists and Orthotists, Psychologists, Psychotherapists, Radiographers, Speech and Language Therapists.
When an individual is made the responsibility of a named contact/ responsible care professional, co-ordinator, care manager,
case manager etc.
See also Coordination, Care Management, Case Management.
Alternative Provider of Medical Services (APMS) contracts
This is one type of contract Primary Care Trusts (PCTs) can
have with primary care providers. This contract is particularly designed to bring in new types of provision,
such as social enterprise and the voluntary sector.
See also General Medical Services (GMS) and Personal Medical Services (PMS) contracts
There are currently 13 ambulance services covering England, which provide emergency access to health care.
If you call for an emergency ambulance the calls are prioritised into three categories:
The control room decide what kind of response is needed and whether an ambulance is required. For all three types of emergency, they may send a rapid response vehicle, crewed by a paramedic, equipped to provide treatment at the scene of an accident.
- Category A emergencies - which are immediately life threatening
- Category B or C emergencies - which are not life threatening
The NHS is also responsible for providing transport to get people to hospital for treatment. In many areas it is the Ambulance Trust which provides this service.
See also Accident prevention, Emergency Department, Fire Services, First Aid, NHS Direct, Primary Care Trusts
Health Services where people do not stay in hospital overnight e.g. out-patients, x-ray, day surgery and medical diagnostics.
See also Day Case.
Policy (often known as an equal opportunities or diversity policy) put together as part of
a framework for good practice in organisations. Designed to prevent discrimination against individuals on the basis of difference: e.g. age, class, cognitive ability, culture, gender, health status, HIV
status, marital status, mental health, offending background, physical ability, place of origin, political beliefs, race, religion, sensory ability and sexuality.
See also Anti-Discriminatory Practice, Culture, Diversity Policy, Empowerment, Ethnicity, Ethnic Monitoring,
Person Centred Approach, Racism.
Action taken to prevent discrimination on the grounds of race, class, gender, disability etc. It should promote equality by introducing anti-discrimination policies in the workplace (i.e. care settings.) Also known as anti-oppressive practice.
See also Anti-Discrimination Policy, Culture Diversity Policy, Empowerment, Ethnicity, Ethnic Monitoring, Person Centred Approach, Racism.
The process by which an employee’s performance is reviewed periodically against the requirements of the job.
See also Personal Development Plan.
Arthritis is a general term for a number of painful conditions of the joints and bones. The main 2 types are,
Osteoarthritis is the most common form of arthritis. Cartilage between the bones gradually wastes away and this can lead to painful rubbing of bone on bone in the joints. It may also cause joints to fall out of their natural positions
(misalignment). The most frequently affected joints are in the hands, spine, knees and hips. Osteoarthritis mostly affects people aged between 40 and 60, it grows more common with age. Around 12% of people over 65 are affected.
Rheumatoid arthritis is the main type of inflammatory arthritis. It is a chronic condition identified by pain and swelling in the joints, leading to reduction of movement, and the breakdown of bone and cartilage. Affecting between 1% and 3% of
the population, it usually starts when people are between the ages of 30 and 50, and women are affected three times more often than men.
Arthritis is often associated with adults, but can also affect children.
See also Community Equipment Service, Health and Well-being.
Approach to working with people who do not engage effectively with traditional services. Health and social care staff
working with individuals in their own environment (at home or in another familiar environment such as the street) rather than at office or hospital appointments.
Communicating clearly, honestly and directly, without avoiding the issue or resorting to manipulative or aggressive behaviour.
The overall process for identifying and recording - the health and social care risks and needs of an individual and evaluating
their impact on daily living and quality of life, so that appropriate action can be planned.
See also Assessment tools,Care Management, Case Management, Common Assessment Framework for Adults, Comprehensive Assessment, Coordination, Contact Assessment, Holistic Assessment, Holistic Care Process, Long Term Conditions, Needs
Assessment, Overview Assessment, Single Assessment Process, Specialist Assessment.
Assessment Notification to Social Services (Section 2)
See Notification Arrangements.
Scales, questions and checklists brought together to support the assessment process. Following Single Assessment Process guidance, DH accredited, and many local, tools are being used nationally.
Assistive Technology (AT)
Related to helping people maintain their independence, for example, using equipment and adaptations in their homes.
Assistive technology includes innovations to assist with communication, equipment for people with a hearing disability, access for people with a visual disability, computer access for people with a learning disability, supporting people with
dementia, linking housing and assistive technology, mobility, and wherever possible assessing physical ability to inform design. Telecare and telemedicine enable individuals to be treated outside
hospital settings and, by assisting the work of GPs and community care teams, enable individuals with chronic illnesses or disabilities to live independently.
See also Community Equipment Services, Integrating Community Equipment Services (ICES).
Pre-judgement about an individual or situation. It should be part of anti-discriminatory practice not to make pre-judgements or
assumptions about the individuals we work with or our colleagues.
A very common long term condition that affects airways and breathing. Approximately one adult in 13 is currently
being treated for asthma in the UK.
Asthma affects the airways, the small tubes that carry air in and out of lungs. With asthma, the airways are sensitive and easily become swollen. When they are irritated they narrow, the muscles around them tighten, and there may be an increase in
production of sticky mucus or phlegm. This makes it harder to get enough breath, and causes wheezing, coughing and your chest may feel tight.
Asthma may be very mild, or it can be very severe. Most cases are somewhere in between. Even if asthma is mild, a regular visit to the GP to have it monitored is essential. The GP can prescribe the treatment most likely to help symptoms and
prevent asthma from getting worse.
The cause of asthma is not fully understood. It is partly an allergic condition. There is also a genetic connection between asthma, hay fever and eczema. This suggests that these three conditions can be inherited (they can run in families).
Sometimes certain triggers can bring on symptoms. Common triggers include house dust mite, animal fur, pollen, tobacco smoke, cold air, viral and bacterial chest infections.
See also Allergies, COPD - Chronic Obstructive Pulmonary Disease, Health, Health Forecasting, Smoking Cessation, Well-being.
People who have fled their home country, who have applied for asylum and are awaiting a decision to grant them refugee status.
Asylum seekers are entitled to health care and welfare benefits. When asylum seekers are recognised as refugees, they have the same rights as UK citizens.
See also Refugees.
Derived from an individual’s values, an attitude typically reflects a tendency to react to certain events in
certain ways and to approach or avoid those events that confirm or challenge the individual’s values. Attitudes also affect individual beliefs and behaviour.
The examination or review of a practice, process or performanc in a systematic way to establish the extent to
which they meet pre-determined criteria.
Independent public body responsible for ensuring that public money is spent economically, efficiently, and effectively in
the areas of local government, housing, health, criminal justice and fire and rescue services.
See also Commission for Social Care Inspection, Healthcare Commission.
Personal freedom - individuals should have their rights and individual choices respected and should be encouraged to be independent
and be involved in all decisions related to their care.
See also Capacity, Long Term Conditions, Person Centred Approach, Risk, Self Care/Self Management, Single
Entry to a hospital bed that would be unnecessary if alternative services were available
The capture of a full background history (not just medical information) is often required to gain a more holistic view
when assessing the needs of an individual with longer term, complex needs.
See also Assessment, Comprehensive Assessment, Family History, Long Term Conditions, needs, risk, risk
assessment, Single Assessment Process.
An imaginary line or standard by which things are measured or compared, e.g. the established baseline for a budget.
Basic Personal Information
See Contact Assessment.
Programme designed to identify and spread knowledge of examples of best practice - the "Beacon Service" -
highlighting innovative approaches to reduce inequalities and improve service provision.
A method used by public and voluntary sector organisations and companies to gauge their performance by
comparing it with the performance of other similar organisations. The Government encourages public sector bodies to compare their scores on various published performance indicators as a way of improving services.
See also Performance Assessment Frameworks, Performance Indicators.
Assistance, usually financial, provided by an agency to a person in need. An individual might be entitled to receive benefits if
they are on a low income or have certain costs to meet because of their personal situation.
See also Advice, Heating in the Home, Pensions
Loss or separation from a loved one. Bereavement affects individuals in different ways as they grieve.
See also Depression, Loneliness, Mental Health, Well-being.
Best Practice Process Design
Evaluation of current operational and clinical processes, which are then re-designed to achieve maximum benefit
to both the organisation and the people it serves. Best Practice Process Design is an important part of NHS Connecting for Health.
Programme that requires all local authority service providers, both internal and external, to assess the
efficiency and effectiveness of their services. Councils need to identify the best service provider to deliver each local service, whether this is the council itself or a private or voluntary sector organisation.
Better Care Higher Standards
"Better Care Higher Standards" is a publication agreed by the local social service
department and housing departments and the primary care trust. They inform the public what standards they can expect of community care services and what to do if things go wrong.
A Bill is a proposal for a new piece of legislation. Most important Bills are introduced to Parliament by a Government minister and
relate to public policy. If the Bill is approved by a majority of members of both the House of Commons and House of Lords, it will become an Act of Parliament and the law of the land.
See also Act of Parliament, Green Paper, Government, Law, Legislation,, White Paper.
Contract with another agency for its services over a fixed period - usually established when social
services are trying to assist a new service to develop. For example, many services such as respite care, day care and home care are arranged through a block contracting process.
See also Spot Purchase
A senior professional working within the NHS and local authorities to
ensure that the confidentiality of patient-identifiable information is maintained and that manual and IT systems are secure. Caldicott Guardians oversee issues such as confidentiality and security,
information clarity, rights of access and documentation accuracy.
See also Freedom of Information.
A disease caused by normal cells changing so that they grow in an uncontrolled way. The uncontrolled growth
causes a lump called a tumour to form. If not treated, the tumour can cause problems by invading normal tissues nearby or by causing pressure on other body structures. There are over 200 different types of cancer because there are over 200
different types of body cells. For example, cells that make up the lungs can cause a lung cancer. There are different cells in the lungs, so these may cause different types of lung cancer.
Cancers can cause different symptoms in different people because of where they are. A cancer may press on a nerve, or another body organ that is nearby. The place where the cancer starts also affects what treatment can be used because doctors have to
take into account the risk of damaging neighbouring organs.
See also Diagnosis, Health, Hospice, Medicine, Palliative Care, Smoking Cessation, Treatment, Well-being.
Organisational - All the resources available to an organisation, service or community, including people, money, equipment,
expertise, skills and information.
Personal - Capacity is also used when referring to an individual’s ‘mental capacity’ to understand. The Mental Capacity Act 2005 provides a statutory framework to empower and protect vulnerable people who are not able to make their own
decisions. It makes it clear who can take decisions, in which situations, and how they should go about this. It enables people to plan ahead for a time when they may lose capacity.
See also Consent, Mental Health, Person Centred Approach.
A discrete activity carried out by a health or social care profession for an individual e.g. a GP consultation, or an outpatient
See also Episode.
Care Event Report
Correspondence from one professional to another to highlight the key outcomes of a care event.
The Care Standards Act 2000, which came into effect in April 2002, classifies all types of residential homes as ‘care homes’. The
Act distinguishes those offering nursing care as ‘ care homes with nursing’.
Care Homes with Nursing
Under the Care Standards Act 2000, which came into effect in April 2002, all nursing homes are
called ‘care homes with nursing’.
See also Care Home.
For a Social Services Department, these are the processes undertaken when an individual’s care needs
are assessed and appropriate services are provided. Care management includes: making available information about possible help; determining the level of assessment to be undertaken once a person has been referred to the social services department;
assessing their needs; developing a care plan and a care package to meet their needs; implementing the care plan; and monitoring and reviewing the care plan.
See also Assessment, Care Package, Care Planning, Contact Assessment, Eligibility Criteria, Fair Access to Care
Services, Overview Assessment, Single Assessment Process, Specialist Assessment.
Services designed to meet an individual’s assessed needs as part of the care plan arising from their assessment. Consists of one or more services, which may be residential and/or community-based. Also known as a ‘package of care’. A cost is often attached if provided by social care, and hence needs to be approved by the budget
holder; may also require contributions from the individual.
Specifies treatment and care for a given condition based on nationally agreed guidelines, standards and protocols incorporating
best practice and evidence-based guidelines. Care pathways, which map out the care journey an individual can expect, are multi-professional; cross organisational boundaries; and can act as a prompt for care. They provide a consistent standard of
documentation which also provides the basis for ongoing audit.
See also Integrated Care Pathway (ICP).
Under the Single Assessment Process, a personalised care plan details the high level, integrated health and social care
requirements after a holistic assessment has taken place. Based on the summary of the risks and needs from the assessment, it should include details of the services to be provided, the assessed individual
and their carer(s) participation, the objectives, a review date and consent from the assessed person to share the plan with the care
The personalised care plan should also identify from the assessment the lifestyle and personal strengths of the person including their abilities, interests and wishes. It finishes with consent from the individual to share the care plan with the care
team and a review date. The care plan should be printed in a suitable format for the individual and their carer(s).
Lower level care plans, service plans and treatment plans might be a plan of activities associated with one or more needs, and care goals applied to a specific health or care service.
As mentioned in the January 2006 White Paper on Community Health and Social Care Services,
"An integrated health and social care information system will enable a shared health and social care plan to follow a person as they move through the care system."
"We will ensure that, ultimately, everyone who requires and wants one has a personal health and social care plan as part of an integrated health and social care record."
"Initially we will focus on offering integrated care plans to those individuals who have complex health and social care needs."
"By 2008 we would expect everyone with both long-term health and social care needs to have an integrated care plan if they want one."
"By 2010 we would expect everyone with a long-term condition to be offered a care plan."
"We will issue good practice guidance early in 2007."
See also Assessment, Care Planning, Case Management, Common Assessment Framework for Adults, Comprehensive Assessment, Continuity of Care, Coordination, Long Term Conditions, Overview Assessment, Participation, Person Held Record, Self Care/Self Management, Specialist Assessment.
Process based on an assessment of an individual’s risks and needs that determines the level and type of support required to meet those needs and the objectives and potential outcomes to be achieved. Care planning leads to a care plan being written for the individual
who should have fully participated in the care planning process.
Anybody involved "professionally" in the provision of health/social care and who is an employee of the agents
providing care services.
Care Programme Approach (CPA)
Formal process of assessing the needs of people with severe mental health problems. Under Single Assessment Process guidance, the Care Programme Approach (CPA) should be applied to older people with severe mental illness due to schizophrenia or other psychoses. The assessment of their needs should be based on SAP when
they are older people. SAP, plus critical aspects of CPA, should be applied to other older people with severe functional or organic mental health problems, who were they younger would be provided for under CPA. When individuals subject to CPA reach
old age, switches to SAP are not inevitable, and should only be made in the best interests of individuals and the continuity of their care.
See also Assessment, Care Plan, Care Planning, Care Management, Case Management, Comprehensive Assessment,
Continuity of Care, Coordination, Dementia, Long Term Conditions, Mental Heath, Mental Health Trust, Overview Assessment, Participation, Person Held Record, Self Care/Self Management, Single Assessment Process.
Care Record Service (CRS)
See NHS Care Record Service.
Care Services Efficiency Delivery (CSED) Programme
Set up to support the implementation of the recommendations of the Gershon Review. The CSED team works with Local Authorities in particular, also the NHS and service providers to develop and support initiatives to make adult social
care more efficient. The CSED initiatives, developed in collaboration with councils will support the implementation of the proposals in the Joint Health and Social Care White Paper Our Health, Our Care, Our Say.
See also Commissioning, Comprehensive Spending Review (CSR), Wanless Review
Care Services Improvement Partnership (CSIP)
CSIP is part of the Care Services Directorate at the Department of Health.
It was set up to support positive changes in services and in the well-being of people with mental health problems, people with learning disabilities, people with physical disabilities, older people with health and social care needs, children and families with health and social care needs and people in the criminal justice system with health and social care
The type of place where an individual receives care e.g. hospital, care home or in their own home.
The health and social care workers involved with the care of the person and their carer(s). This might include staff from the
independent, voluntary and private sectors.
See also Care Plan, Person Held Record.
Organisations to which the NHS, via a Primary Care Trust or other NHS trust, delegates health functions and the local authority delegates health-related functions.
Care trusts are a further extension of the Health Act 1999 Partnership Arrangements and can be formed either voluntarily or by direction. Intended to provide for a high level of integration between health and local authority
services, they are able to commission and provide integrated services covering health, social services and related functions.
See also Section 31 Partnership
Carers can be a parent, spouse, partner, child, relative or friend who provides regular and substantial unpaid care to someone who
is disabled, severely ill or frail.
See also Carers Assessment.
Carers by law have a right to an assessment if they look after a friend or relative who cannot manage
without their help. The purpose of a carer's assessment is for a carer to discuss with a Social Care assessor the help needed to continue caring and to help maintain the carer’s health and balance within their life, work and
family commitments. Social Care use the assessment to decide what help to provide.
The Carers (Equal Opportunities) Act 2004, states that
If a carer is aged over 16, their right to an assessment is not affected, even if the person they care for does not want to receive help from social services.
- carers are entitled to an assessment of their needs for services;
- place a duty on local authorities to consider a carer’s outside interests (employment, education or leisure) when carrying out an assessment
- and promote better joint working between social care and health, housing and education services to ensure support for carers is delivered in a coherent manner.
Carer’s have also a right to an assessment if they intend to look after someone. For example: if a friend or relative is in hospital and they expect a carer to look after them when they come back home.
If a carer looks after a disabled child they also have a right to an assessment. A carer does always have to be the child's parent, but must have parental responsibility for the child.
See also Capacity, Care Plan, Care Planning, Care Management, Care Programme Approach (CPA), Case Management,
Comprehensive Assessment, Continuity of Care, Consent, Coordination, Learning Disabilities/Difficulties, Long Term
Conditions, Mental Health, Overview Assessment, Participation, Person Centred Approach, Person Held Record, Self
Care/Self Management, Single Assessment Process.
Meeting attended by representatives from all the agencies involved with the person and their carer(s), including the
individual concerned, to plan the future provision of services.
Method of identifying vulnerable people who may not be in touch with health and social care services using either highly
specific local criteria or nationally validated criteria to assess the relative risk of functional decline. Key Messengers - people with good links to different local communities or groups - can be used to distribute information about services.
Historical account of an individual’s life and circumstances, including any significant events that may explain the problems the
individual is experiencing.
When an individual has numerous long term conditions and complex needs, their care becomes more difficult for them to manage.
Case Management is where a named coordinator, e.g. a Community Matron, actively manages and joins up care by offering, amongst others, continuity of care, coordination and a personalised care plan for vulnerable people most at risk.
See also Care Programme Approach (CPA), Common Assessment Framework for Adults, Comprehensive Assessment, Contact Assessment, Expert
Patient Programme, Holistic Assessment, Holistic Care Process, Long Term Conditions, Overview Assessment, Participation, Patients at Risk of Re-hospitalisation, Self Care/Self Management, Single Assessment Process, Specialist Assessment, Very High Intensity Users
(VHIU), White Paper on Community Health and Social Care Services.
Research exploring the behaviour and experiences of an individual, group, organisation, community, nation or event. Case studies
enable researchers to open up wider issues around their chosen subject.
A survey of all people and households in the country. It provides essential information from national to neighbourhood level
for government, business, and the community.
The most recent Census was in April 2001. Plans are being made to hold the next Census in 2011.
See also Ethnicity, Ethnic Groups, Religion.
Someone who is appointed to stand up for the interests of a particular user group: e.g. by ensuring that local services are
accessible and meet local needs, rooting out discrimination in access to treatment and services, and helping to implement National Service Frameworks.
A champion can be a senior staff member in health or social services; a councillor; or a representative of the group concerned, e.g. older people.
The process of evolution of ideas, practices, processes, and systems.
Change Agent Team (CAT)
Set up to help health and social care communities tackle the problem of individuals staying in
hospital longer than necessary (delayed transfers of care). Since then, its remit has grown and now provide advice and support on a wide range of issues that affect the care of older people.
The amount of money that the local Social Services Department may charge to the individual receiving a service.
See also Fairer Charging.
Organisations which have ‘charitable purposes’, may register with the Charity Commission to become a registered charity, a legal
status strictly regulated by charity law. Charitable purposes include the relief of financial hardship, the advancement of education or religion, and other purposes for the benefit of the community. Charitable status has certain tax and other advantages. Charities must operate for the public benefit and independently of Government or commercial interests.
See also Voluntary and Community Sector, Voluntary Sector.
A process that actively helps an individual seek and acquire alternative sources of information and learn about the options available.
Choose and Book
Part of the NHS Connecting for Health, the new Electronic Booking Service (“Choose and Book”) will
allow individuals, in partnership with health and care professionals, to book first outpatient appointments at the most appropriate date, time and place for the individual.
Chronic Disease Management
See Long term Conditions
Circles of Support/ Circle of Friends
Group of people who meet regularly to help somebody accomplish their personal objectives in life. The
circle acts as a community around the individual who, for whatever reason, cannot achieve what they want in life on their own and decides to ask others for help.
See also Learning Disabilities, Participation, Person Centred Approach.
The rights, duties and responsibilities of a good citizen, of any state.
See also Nationality.
See Person Centred Approach.
Information received or sent by a health organisation relating to an individual’s clinical care e.g. GP referral
The capturing and recording of clinical information normally at the point of patient present such as consultation,
A framework through which NHS organisations are accountable for continuously improving the quality of their services and
safeguarding high standards of care by creating an environment which encourages excellence in clinical care.
See Clinical Documentation
Qualified healthcare professionals - doctors, nurses and members of the allied health professions, e.g. dieticians, occupational
therapists, physiotherapists, podiatrists and speech and language therapists (also social workers/care managers if they are part of the team providing care).
See also Practitioner.
Regional clusters, which operated until 1st April 2007, were created to deliver local Information Technology solutions as part of the NHS Care Records Service.|
England was divided into five geographic areas to work together to take forward the procurement and implementation of the NHS Care Records Service at a local level.
These comprised of the: Eastern, North East, North West and West Midlands, London, and Southern clusters.
Since 1st April 2007, responsibility for local delivery of the National Programme for IT (NPfIT) has devolved to Strategic Health Authorities (SHA's). England has been divided into three Programme for IT regions each with its own Local Service Provider.
See Community Mental Health Team.
The process by which the words that describe care processes are turned into consistent, standard terms (called SNOMED) so that they can be read and used by computers.
See also NHS Care Record Service.
Multi-agency teams or individuals working together towards a common goal.
Commission for Social Care Inspection
The Commission for Social Care Inspection is the single, independent inspectorate for all social care
services in England.
See also Audit Commission, Healthcare Commission.
The process of specifying, purchasing and monitoring services to meet assessed needs.
Commissioning a Patient-led NHS
The purpose of this programme is to streamline strategic health authorities (SHAs),
strengthen primary care trusts (PCTs) and engage GPs with practice-based commissioning - all in the cause of improving services to patients. SHAs have submitted local proposals for consultation to the
Department Health and are being analysed against this criteria securing high-quality, safe services for patients;
In April 2006 it was formally announced by the Department of Health that the number of SHAs will be reduced from 28 to 10 and will ensure the NHS is structurally able to deliver the next stage of health reforms. It is hoped that
the new configuration of SHAs means they will be better placed to oversee and support the development of more strategic Primary Care Trusts and the move towards more NHS Foundation Trusts. In addition, through almost complete
co-terminosity with Government Office of the Regions boundaries, joint working between health and Local Government agencies will be improved significantly. The new Strategic Health Authorities will be established in July
- improving health and reducing inequalities;
- improving the engagement of GPs;
- improving public involvement;
- improving co-ordination with social services through greater ‘co-terminosity’ of PCT and local government boundaries;
- effective use of resources.
The number of Primary Care Trusts (PCTs) in England is being reduced from 303 to 152 in October 2006. It is hoped this reduction will result in: a closer relationship between health, social care and emergency services; improved
and better value services for individuals; better emergency planning with more resources to respond to major incidents and ensure service continues as normal; more money for frontline services.
Common Assessment Framework for Adults
As mentioned in the January 2006 White Paper on Community Health and Social Care
"A Common Assessment Framework is in place for children’s services. We have already developed a Single Assessment Process for older people’s services. Work is underway to build on this to develop a Common Assessment Framework to
ensure less duplication across different agencies and allow people to self assess where possible."
"An integrated health and social care information system for shared care is planned as part of the NHS Connecting for Health strategy. It is an essential requirement for effective care coordination."
See also Care Plan, Case Management, Common Assessment Framework for Children, Long Term Conditions, National e-SAP Project, Transformational Government, Whole System Long Terrm Conditions (LTC) Demonstrator Programme.
Common Assessment Framework for Children
A key part of delivering frontline services that are integrated and focused around the needs of
children and young people. The CAF is a standardised approach to conducting an assessment of a child's additional needs and deciding how those needs should be met. It can be used by practitioners across children's services in
The CAF will promote more effective, earlier identification of additional needs, particularly in universal services. It is intended to provide a simple process for a holistic assessment of a child's needs and strengths, taking account of the role of
parents, carers and environmental factors on their development. Practitioners will then be better placed to agree, with the child and family, about what support is appropriate. The CAF will also help to improve integrated working by promoting
co-ordinated service provision.
12 local areas formally trialled the CAF and the role of the lead professional during 2005-06. Over two-thirds of local authorities chose to use the CAF during the trial year and materials were issued in April 2005 to support implementation. The
Department for Education and Skills worked with the trialing groups to identify any early lessons, enabling them to share good practice and inform further development of the CAF materials. Following wide consultation, revised CAF materials have been
issued, including practitioners' and managers' guides, CAF form, pre-assessment checklist and supporting tools.
All local authority areas are expected to implement the CAF between April 2006 and the end of 2008.
See also Common Assessment Framework for Adults.
The successful transmission of information by or to or between people or groups through a common system of speech, writing,
symbols, signs, behaviour, or signals.
See also Interpreting,Interpreting and Translation Services, Translation.
A specific group of people, often living in a defined geographical area, who share a common culture, values and norms, are arranged in a social structure according to relationships, which the community has developed over a period of time.
Telephone and set (and pendant) linked to a control/call centre using standard telephone line. There may be a charge to the
See also Telecare.
Community Based Services
Services provided to support an individual living in their own home, or to support their carer.
Network of health and social care designed to enable an individual to remain independent and living in his or her own home.
Community Care Plan
Annual plan produced by Social Services Departments stating how community
care is implemented in their area over a three-year period.
Community Equipment Service
An agency who provides equipment that plays a vital role in enabling people with disabilities to maintain their
health and independence (e.g. pressure-relief mattresses, commodes, shower chairs, raised toilet seats, grab rails, liquid level indicators); equipment for people with speech problems, poor eyesight or hearing difficulties; and equipment for people
with mental frailty (including hypothermia sensors, gas escape alarms and ‘wandering detectors’).
See also Arthritis, Assistive Technology, Integrating Community Equipment Services (ICES).
See Case Management, Long Term Conditions, Single Assessment
Community Mental Health Team
Multi-disciplinary team made up of psychiatrists, social workers, community psychiatric nurses, psychologists
and therapists. Provides assessment, treatment and care in the community, rather than in hospitals, for people with severe and/or long-term mental health problems.
See also Care Programme Approach (CPA), Compulsory Admission, Mental Health Act Assessment, Mental Health Trust,Nearest Relative,Sectioning,Dementia, Single Assessment Process.
Term used to signify multiple illnesses.
See also Case Management, Long Term Conditions.
Represent certain clusters of skills, abilities and knowledge needed by Care Professionals to perform
roles/jobs in health and social care.
See also Joint Staff Development/ Training.
Ensures that complaints about care services are dealt with effectively and within an appropriate timescale. Complaints
procedures ideally include the auditing of any comments and complaints received; categorise the reason for the failure; are open about naming the worker responsible; and encourage collective discussion and problem solving before implementing the
solution. Evidence can be presented back to the team so that it can improve future practice.
See also Compliments.
Systematic feedback of praise received provides an important counterbalance to the official complaints
Comprehensive assessments replace overview assessments for the most vulnerable and frail
people who have many/complex needs and often will involve old age consultants/psychiatrists and their teams on behalf of, or working with, primary care and social care.
A Comprehensive Assessment describes a multi-disciplinary and multi-agency process whereby various specialist assessments of all or most of the domains of SAP are brought together with the information from any contact and overview assessments that may have triggered them. The idea is to provide a picture of an person’s health and social care needs which is both holistic and detailed.
Such an assessment is required only where the level of support and/or treatment is likely to be extensive and/or prolonged, such as a permanent admission to nursing care or intensive and/or complex home care packages.
See also Care Plan, Care Programme Approach (CPA), Case Management, Contact Assessment, Coordination, Long Term
Conditions, Overview Assessment, Single Assessment Process, Specialist Assessment.
Comprehensive Spending Review (CSR)
The Government intends to launch a second Comprehensive Spending Review reporting
in 2007, to identify what further investments and reforms are needed to equip the UK for the global challenges of the decade ahead. A decade on from the first Comprehensive Spending Review, the 2007 will represent a long-term and fundamental review
of government expenditure. It will cover departmental allocations for 2008-09, 2009-10 and 2010-11, with allocations for 2007-08 held to the agreed figures already announced at the 2004 Spending Review.
See also Care Services Efficiency Delivery (CSED) Programme, Gershon Review, Wanless Review.
Arranged via a hospital after a formal mental health assessment under the Mental Health Act 1983 has been carried out by
an approved social worker in conjunction with a doctor and a psychiatrist. Also known as Sectioning.
See also Mental Health Act Assessment, Mental Heath, Mental Heath Trust.
A disease or illness.
See also Health, Diagnosis, Long Term Conditions, Self Care/Self Management, Treatment
Respect for the privacy of information - one of the principles that underpin all health and social
care practice. Information about a person is generally held under legal and ethical obligations of confidentiality. With certain important exceptions, information provided in confidence should not be used or disclosed in a form that might identify
the person concerned without their consent.
See also Caldicott Guardians.
Connecting for Health
See NHS Connecting for Health.
Consent to share information
Agreement articulated by an individual with the care professional to share information about them with other
It is essential that people with higher support and communication needs are given the time and assistance they need to give their consent on issues that involve them.
- Explicit or express consent refers to a clear and voluntary indication of preference or choice, usually oral or in writing and freely given in circumstances where the available options and their consequences have been made clear (informed
- Implied consent refers to agreement signalled by the behaviour of an informed individual.
See also Capacity, Confidentiality.
Consent to Treatment
An individual has the right to refuse any treatment they do not wish. They have the right to receive full information
about the treatment, its purpose and possible side effects. If consent is not obtained the treatment cannot normally be given.
See also Capacity.
Actively seeking, listening to, and taking into account the views of local people before decisions are made.
See also Participation, Consent to share information, Consent to treatment.
The first "contact" - or meeting - between the person and health and/or social care agencies. Basic personal
information is collected or verified, the nature of the individual’s presenting concerns/difficulties established and a brief initial assessment is made of whether the person has potential wider health and social care needs. A referral can be made at
this stage or at the other stages of assessment.
See also Care Plan, Care Programme Approach (CPA), Case Management, Comprehensive Assessment, Long Term Conditions, Overview Assessment, Single Assessment Process, Specialist Assessment, Whole Systems Approach.
The ability to control the timing of urination or a bowel movement. Incontinence is the loss of control of the bladder or bowel.
See also Health.
Detail the arrangements made for the individual in the event that either the care coordinator is
unavailable or that part of the care plan cannot be carried out at short notice
Provision of health and social care over an extended time as the result of disability, accident or
illness, in order to meet both physical and mental health needs. Continuing care can be provided in a range of settings, including hospital, care home or hospice and the individual’s own home. Continuing care aims to provide
the right long-term support, to promote independence, prevent deterioration and maximise a person’s health and quality of life. Eligibility for full NHS continuing care is assessed using local eligibility criteria.
Continuity of Care
The importance of continuity of care for the person and their carer(s) throughout the Single Assessment Process cannot be
underestimated. Best practice indicates that, ideally, the same health and/or social care worker be involved with the person throughout the process. The aim being to limit the hand offs or handovers between health and social
care workers to a minimum.
See also Coordination.
From entry into the care system onwards, there should at least be a Named Contact or a Responsible Care Professional who acts as
a central point of reference for the individual and their carer(s).
There are best practice principles underpinning coordination. These include:
Coordination under SAP can usefully be broken down into two main tasks: Assessment Coordination and Care Coordination.
- being the main point of contact when working with the individual and their carer(s);
- serving as a source of information and advice for the individual and their carer(s); also to obtain advocacy services as appropriate;
- encouraging the participation of the individual and promoting a realistic level of supported self care/self management;
- coordinating the health and social care team to identify and meet the needs of the individual and their carer(s).
Case Management would take place for the most complex cases when comprehensive assessment is indicated and would normally cover all aspects of coordination.
Flexibility is be encouraged because the circumstances of the individual and their carer(s) might change at any time e.g. emergency care might be required during the assessment stage or further assessment(s) may well be required after the care
These terms should not be used to confuse the individuals who are assessed and receive services as care professionals should always use everyday language - never jargon.
If the summary of risks and needs from the assessment indicates a coordinating role, then the most appropriate Care Coordinator should be identified to oversee the planning and delivery of care at least
until the first review.
- To work with the individual and their carer(s) to ensure an appropriate, proportionate holistic assessment takes place and that specialist assessments are completed as necessary.
- Ensure assessment information is collected, evaluated and linked to the summary of risks and needs.
- Explain consent (to share information) to the individual and ensures that her/his wishes are followed within legal guidelines and reviewed.
- Ensure that eligibility decisions are made.
Continuity of care and the best interests of the individual should be key criteria for deciding who should carry out this role.
If the Review concludes that Care Coordination is no longer required, there should be a named contact or responsible care professional or Review Team assigned.
- To work with the individual and their carer(s) to ensure that the high level, integrated and personalised care plan is implemented.
- Monitor services and makes sure they are delivered effectively, on time and are achieving their objectives.
- Facilitate communication between multiple agencies and professionals and oversees discussion/meetings as appropriate.
- Maintain contact with the individual during periods in hospital and is involved in arrangements for discharge.
- Ensure that reviews are undertaken.
COPD - Chronic Obstructive Pulmonary Disease
This is a term used for a number of conditions; including chronic bronchitis and emphysema and
chronic obstructive airways disease, all of which can occur together. COPD occurs as a result of damage to the lungs, usually through smoking. The main symptom of having damaged lungs is difficulty with breathing. These breathing problems gradually
get worse and worse, resulting in decreased quality of life and even heart failure (a weakened heart that no longer pumps effectively). The symptoms of COPD can appear similar to those of asthma. However, whereas asthma can be controlled with
treatment, COPD causes permanent damage to the lungs. Once you give up smoking, you gradually reduce the chances of getting COPD - and you slow down its progress if you already have it. .
See also Asthma, Diagnosis, Health, Health Forecasting, Smoking Cessation.
Coronary Heart Disease
The heart pumps blood around the body carrying oxygen and other nutrients to the areas that need it. When this process
is interrupted, or does not work properly, serious illness and even death can result. The risk of heart disease is greater for people with poor diet, who smoke and do not exercise, and men, are more likely to suffer from it than women. A range of
tests and treatments, including drugs, heart bypass surgery and transplants, exist to alleviate symptoms or save the lives of sufferers.
See also Diagnosis, Health, Obesity, Smoking Cessation, Treatment, Well-being.
The process or interaction by which one person assists another to help themselves and to take action to make changes in their
life. Counselling is a way of relating and responding to another person so that they are helped to explore their thoughts, feelings and behaviour in order to reach a clearer self-understanding. This enables the person to find and use their strengths
and draw on their resources so that they can cope more effectively with their lives.
Court of Protection
The Court responsible for looking after the financial affairs of people who cannot legally do it themselves because of
lack of capacity. These include granting Enduring Powers of Attorney, making wills, and generally giving directions and orders for the management of the property and financial affairs.
See also Power of Attorney.
CPA (Care Programme Approach)
See Care Programme Approach.
A crime can be the action of violating or breaking the law, having the intention of doing so or helping others in the process. Crimes
are viewed as offences against society and as such are punished by the state.
See also Domestic Violence.
Relates to a way of life. All societies have a culture, or common way of life, which includes:
The different cultures in society reflect the richness of cultural diversity, where different people live and work together, but retain their individual identity.
- Language — the spoken word and other communication methods
- Customs — rites, rituals, religion and lifestyle
- Shared system of values — beliefs and morals
- Social norms — patterns of behaviour that are accepted as normal and right (these can include dress and diet).
See also Anti-Discrimination Policy, Anti-Discriminatory Practice, Diversity Policy, Empowerment, Ethnicity, Ethnic
Monitoring, Person Centred Approach, Racism.
Current Summary Record (CSR)
Part of the Single Assessment Process guidelines, this draws on information from a range
of sources to provide an up-to-date picture of the older person, their health and care needs and any services they receive.
The CSR has been defined by the Department of Health as the means by which case information on an assessed person is shared, subject to consent and confidentiality, among health and social care professionals.
It draws on information collected during the assessment process but also covers care plan information including support and services that are being provided. It can draw on other sources and should show changes in needs,
services and other circumstances between formal assessments.
See Person Centred Approach.
Facts and information. Qualitative data is descriptive and often describes attitudes, belief and feelings;
quantitative data is measurable and is expressed in statistical form.
Data Protection Act 1998 (DPA)
Enables individuals to access information of which they are the subject, e.g. someone’s own medical records.
See also Caldicott Guardians, Freedom of Information Act 2000.
Operation, treatment or tests undertaken in one day.
See also Ambulatory Care, Day Hospital.
Day Centre / Day care
Facility, run by social services, health or a voluntary organisation, that provides care, stimulation and activities
for people who need support during the day; and is thus also a valuable source of respite for carers.
Hospital where patients receive day care only, continuing to live at home.
See also Ambulatory Care, Day Case
Surgical procedure that does not involve an overnight stay in hospital.
See also Day Case.
The potential of areas such as evidence based medicine and information technology to actively support decision-making, both
to reduce errors and to increase the effectiveness and cost-effectiveness of healthcare. Decision support systems can be regarded as one way of expressing knowledge.
See also National Knowledge Service.
Hospital wards specialising in the care of a particular group of people.
Delayed Transfers of Care
The Community Care (Delayed Discharges) Act 2003 aims to reduce the time people stay in hospital after treatment
while waiting for social care services to be provided. From January 2004 local authorities had to reimburse acute trusts if social care assessments and services are the sole reason that hospital discharge
is delayed. Acute trusts are obliged to notify Social Services Departments of inpatients likely to need community care services.
See also Discharge, Notification Arrangements, Reimbursement.
Term used for different illnesses that affect the brain and diminish the ability to do everyday tasks. ‘Dementia’ should be used to
describe symptoms, not the condition itself. Symptoms include loss of memory; difficulty in understanding people and finding the right words; difficulty in completing simple tasks and solving minor problems; mood changes and emotional upsets.
See also Capacity, Care Plan, Care Programme Approach (CPA), Carers, Carers Assessment, Case Management, Dignity, Mental Heath, Mental Heath Trust, Participation, Person Centred Approach, Respect, Self
Care/Self Management, Single Assessment Process,
Changes in sex, size and other characteristics of a population over time.
A branch of medicine that involves diagnosis, prevention, and treatment of any disease concern about teeth, oral cavity, and
Department of Health (DH)
The central government department responsible for the administration of health and social care.
The terms 'depression', 'depressive illness' or ‘ clinical depression’ often refer to something very different from the common
experience of feeling miserable or fed up for a short period of time.
Depression is a state of low mood that is described differently by people who experience it. These feelings are severe enough to interfere with an individual’s life, and can last for weeks or months rather than days. On occasions people with
depression will complain of physical problems (e.g. headaches, stomach problems). Often described are feelings of sadness, despair and emptiness, sleep problems, loss of appetite, concentration and energy and loss of interest or pleasure in nearly
all things. Depression might also sometimes include suicidal thoughts. Depression can be experienced in other disorders, such as bipolar disorder (manic-depressive disorder).
See also Diagnosis, Health, Loneliness, Mental Health, Treatment, Well-being.
A chronic disease caused by too much glucose in the blood. An individual’s blood-sugar level can be too high if their body does
not make enough of the hormone insulin. Insulin is produced by the pancreas (a gland behind the stomach) and moves glucose out of the blood and into cells, where it is broken down to produce energy. If diabetes is not treated it can cause long-term
health problems because the high glucose levels in the blood damage the blood vessels.
There are two types of diabetes.
The main aim of treatment of both types of diabetes is to achieve blood glucose, blood pressure and cholesterol levels as near to normal as possible. This, together with a healthy lifestyle, will help to improve well-being and protect against
long-term damage to the eyes, kidneys, nerves, heart and major arteries.
- Type 1 diabetes develops if the body is unable to produce any insulin. This type of diabetes usually appears before the age of 40. It is treated by insulin injections and diet and regular exercise is recommended.
- Type 2 diabetes develops when the body can still make some insulin, but not enough, or when the insulin that is produced does not work properly (known as insulin resistance). In most cases this is linked with being overweight. This type of
diabetes usually appears in people over the age of 40, though in South Asian and African-Caribbean people it often appears after the age of 25. However, recently, more children are being diagnosed with the condition, some as young as seven. Type 2
diabetes is treated with lifestyle changes such as a healthier diet, weight loss and increased physical activity. Tablets and/or insulin may also be required to achieve normal blood glucose levels.
See also Coronary Heart Disease, Obesity, Stroke.
The process of identifying a disease from an individual’s signs and symptoms. In some cases a diagnosis may
only involve being assessed by a doctor and having a physical examination. In other cases, special investigations may be necessary.
See also Arthritis, Cancer, COPD - Chronic Obstructive Pulmonary Disease, Dementia, Depression, Diabetes, HIV/AIDS, Stroke.
Ensuring that a person receives the type of care that makes them feel respected as an individual and helps them develop or maintain
self-esteem and take pride in themselves. This should take place in every setting whether in the community or in the acute sector so that there is ‘Dignity on the Ward’.
See also Person Centred Approach, Privacy.
The main government online information access point.
See also NHS Direct Online.
A way for people who need social services to have more control over the service they receive. People
who are eligible for services (day care, personal care, respite care, equipment and adaptations) can opt to receive the money for the service from the local authority and purchase it themselves. In this way they can choose the
exact service they want, when they want it and who provides it. They can be made to disabled people aged 16 or over, to people with parental responsibility for disabled children, and to carers aged 16 or over in respect of carer services.
Councils have a duty to make a direct payment to people who can consent to have them. This means that direct payments should be discussed as a first option with everyone, at each assessment and each review.
The take-up of direct payments is now an indicator in the Commission for Social Care and Inspection's performance assessment regime, and contributes to the overall star rating of a local authority.
See also Individual Budgets, White Paper on Community Health and Social Care.
The Disability Discrimination Act 1995 defines disability as ‘a physical or mental impairment that has a substantial and long term
adverse effect on a person’s ability to carry out normal day-to-day activities’.
Most people and organisations now accept the ‘social model of disability’:
- disability arises from society’s negative treatment (social or environmental), and is not an inevitable consequence of impairment;
- the position of disabled people in society is a human and civil rights issue; and
society must be changed to allow full inclusion
Disabled Facilities Grants (DFG)
Grants issued by councils towards meeting the cost of providing adaptations and facilities (such as bath
grab rails) to enable disabled people to continue to remain independent in their own homes.
Discharge from Hospital
Being discharged from a hospital bed is a process, not an isolated event. It should involve developing and
implementing a multi-disciplinary care plan to facilitate the transfer of an individual from hospital to an appropriate setting. The patient and their carer(s) should be involved at all stages and be kept
informed by regular reviews and updates of the care plan.
Planning for hospital discharge is part of an ongoing process that should start prior to admission for planned admissions, and as soon as possible for emergency admissions. This involves building on, or adding to, any assessments undertaken prior to
admission. Effective and timely discharge requires the availability of alternative, appropriate care options to ensure that any rehabilitation, recuperation and continuing health and social care needs are identified and met.
See also Case Management Delayed Transfers of Care, Long Term Conditions, Single Assessment Process.
Discharge Notification to Social Services (Section 5)
See Notification Arrangements.
Open-ended interview to hear the views of a person who has been through a particular process or system. Information is
then fed back constructively to modify the process/system.
Unfair treatment based on prejudice. In health and social care, discrimination may relate to a conscious
decision to treat a person or group differently and to deny them access to relevant treatment or care.
See also Age Discrimination, Anti-Discrimination Policy, Anti-Discriminatory Practice, Culture Diversity Policy, Empowerment, Ethnicity, Ethnic Monitoring, Person Centred Approach, Racism.
A state of ill health when a part (or parts) of the body does not function properly, e.g. because of accident or injury, infection or
inflammation, inadequate diet, allergic reaction or congenital disorder.
See also Health, Medicine.
The forcible denial by one person (or group) of the rights and choices are of another person (or group). Includes withholding
relevant information and excluding them from decision-making about emotional, physical, intellectual, social, economic or cultural aspects of their lives.
See also Abuse, Discrimination, Empowerment, Participation, Person Centred Approach, Self Care / Self
An individual’s loss of contact with care services.
Loss of the feelings of shame or embarrassment that normally help to control an individual’s action. Disinhibition can result
in inappropriate or improper behaviour.
A state in which individual loses his or her awareness of time and place.
Diversity refers to the wide range of people’s characteristics; age differences, race, gender, physical ability, sexual
orientation, religion and language. Increasingly it also embraces background, professional experience, skills and specialisation, values and culture and social class.
See also Age discrimination, Anti-discrimination policy, Anti-Discriminatory Practice, Culture, Discrimination, Diversity Policy, Ethnicity, Person Centred Approach, Racial Group, Racism.
Policy, often known as an equal opportunities or anti-discrimination policy, put together as part of
a framework for good practice in organisations. Serves as a deterrent to discrimination against individuals on the basis of difference - e.g. age, class, culture, gender, health status, HIV status,
marital status, cognitive ability, mental health, offending background, physical disability, place of origin, political beliefs, race, religion, sensory ability or sexuality. Gender, race and disability policies are supported
See also Age discrimination, Anti-discrimination policy, Anti-Discriminatory Practice, Culture, Ethnicity, Person Centred Approach, Racism.
Do Once and Share (DOAS)
A programme to engage clinicians and the public with an interest in a particular area (such as epilepsy, lung cancer
or the Single Assessment Process) in activity required for the successful implementation and explanation of NHS Connecting for Health technologies and to minimise unknowing and unnecessary duplication of effort .
To achieve this there have been a set of DOAS projects, the outputs of which will feed into the design, development and implementation of the national programme. The DOAS programme ensures the needs of each specialty are being taken into account,
whilst retaining the commitment to provide a record that focuses on the needs of the individual who may have more than one disease and involvement with more than one specialty.
The DOAS Single Assessment Process project had four main main aims,
The initial DOAS SAP project was completed in May 2006.
- Bring together the different Programmes for IT to develop a common care pathway for SAP, building on on the process mapping work already carried out by London and the South.
- Show the lessons learnt from electronic SAP implementations so far.>
- Help to build a national SAP network around the Centre for Policy on Ageing SAP website
- Produce a clearer definition for comprehensive assessment (including the Link between Single Assessment Process and Long Term Conditions
Categories that make up the holistic assessment of the single assessment process. An example of a
domain is ‘personal care and physical well-being.’ Sub-domains are components of a domain: the sub-domains of ‘personal care and physical well-being’ include ‘personal hygiene, including washing, bathing, toileting and grooming’, ‘dressing’ and
Domestic violence is a pattern of controlling and aggressive behaviours from one adult, usually a man, towards another,
usually a woman, within the context of an intimate relationship.
Victims of domestic violence suffer on many levels - health, housing, education - and lose the freedom to live their lives in the way they wish, and without fear. Research shows that domestic violence
Victims can call a national help line - 0808 2000 247.
- accounts for 16% of all violent crime
- has more repeat victims than any other crime (on average there will be 35 assaults before a victim calls the police)
- claims the lives of two women each week
- costs in excess of £23 billion a year.
See also Crime.
Assistance provided to a person in their home, including home care, equipment and adaptation, and
Illegal drugs are drugs that have been banned, by law, for use in this country. It is illegal to possess or supply banned drugs.
Some illegal drugs have been categorised as prescription-only, meaning that they may only be used if prescribed by a doctor, but are illegal to use, possess, or supply, in any other circumstances.
Drug misuse or abuse, are the terms used to describe the use of illegal, prescription-only, or over-the-counter drugs, for purposes other than intended by the manufacturer or a doctor.
Taking drugs in quantities not intended by the manufacturer or a doctor can also be defined as drug misuse or abuse.
See also Health, Substance Misuse, Well-being
They are the way some people, including children, cope with all sorts of problems, including:
Eating disorders are also linked with depression and drug misuse although, in some young people, the reasons for the development of an eating disorder are far from clear. Anorexia nervosa (characterised by
avoidance of food) or bulimia nervosa (usually involving fasting, bingeing and vomiting) are often the outward sign of inner distress.
- long-term term illness or disability
- family strife or a death in the family
- pressure at school, including bullying
- being the target of abuse
- pressure to diet and be slim
- lack of self-esteem
See also Diabetes, Health, Obesity, Well-being.
A skin condition, which can result in dry, red and flaky skin. The skin may feel hot and very itchy and scratching can lead to the
skin becoming damaged and infected. Eczema is not contagious. Eczema is also known as dermatitis, a term used to describe inflammation of the skin.
There are two main types of eczema - atopic and contact. The commonest type is atopic eczema. It tends to develop in childhood, sometimes just after birth. Many children grow out of it as they get older but it can flare up again when they're adults.
This type tends to run in families and is more likely if someone also has other atopic conditions such as asthma or hay fever. The tendency to develop atopic eczema is inherited but is strongly influenced
by environmental factors. Atopic means an extra sensitivity to substances (allergens). The most common allergens are house dust mites, feathers, pollen, cat or dog fur and sometimes foodstuffs e.g. cows milk, eggs or nuts.
The other common type is contact eczema, which usually affects adults. It's caused by contact with something that the person is allergic to - for example, nickel - or that irritates the skin, for example, detergents. Many other substances cause
contact eczema, such as soaps and perfumes.
Other less common types are seborrhoeic eczema, which affects the scalp and eye-lashes as a severe form of dandruff; and discoid eczema, which causes circular patches of eczema over the body.
See also Allergy
Education and Learning
Education is the activity of educating or instructing or teaching, an activity that imparts knowledge or skill. It is
the gradual process of acquiring knowledge or the knowledge acquired by learning and instruction. Learning is the process of acquiring information and knowledge.
See also Employment, Leisure and Recreation.
18 Weeks Delivery Programme
By December 2008, the whole patient journey will be managed and measured as one. For the first time, Primary Care Trusts (PCTs) will be responsible for ensuring all of the local health providers move patients as quickly as possible through the different stages towards treatment.
See also Care Pathway, Integrated Care Pathway.
A patient admitted from a waiting list for a planned clinical intervention, involving at least an overnight stay.
See also Emergency Admission.
Electronic Transfer of Prescriptions (ETP)
Enables GPs/prescribers to send prescriptions electronically to (high street) pharmacies.
Set of standards or rules governing access to each particular non-NHS service.
See also Fair Access to Care Services.
Deals with accidents and often with the initial assessment of acute illness. Also known as A and
E, A&E, A and E Department and Casualty
See also Accident Prevention, Ambulance Service.
Emergency (nonelective) Admission
An unplanned admission to hospital at short notice because of clinical need or because alternative care is
not available; and involving at least one overnight stay.
See also Elective Admission.
One person’s awareness of the emotional state of another person and their ability to share an experience with them.
An activity or service performed, usually for another, especially for payment or reward or as an occupation.
See also Education and learning.
The way in which a health or social care worker encourages an individual to make decisions and take control of their own life.
Empowerment is a process that builds a person’s self-esteem and confidence in their ability to make decisions.
See also Disempowerment, Participation, Person Centred Approach, Self Care/Self Management,
Methods used by health and social care workers to support the people they work with and encourage them to be as independent as
See also Independence, Re-ablement.
End of Life Care Programme (EoLC)
National initiative with the key objective to offer all individuals nearing the end of life, regardless of
their diagnosis, the choice and access to high quality end of life care. The initiative is a ’Nurse-led’ project, based within Strategic Health Authorities, enabling the principles of end of life care for cancer individuals to be spread into other
disease groups by widening the pool of staff trained in palliative care.
See also Hospice Care, Palliative Care, Wills.
Enduring Power of Attorney (EPA)
Used by an individual who has been diagnosed as having, or as likely to develop, a mental illness (e.g.
severe schizophrenia) or a degenerative brain disease leading to mental incapacity (e.g. Alzheimer’s disease) and who wants someone else to manage their financial affairs now or in the future. Unlike an ordinary Power of Attorney, an enduring power
of attorney can come into effect or continue in force after an individual loses their mental capacity.
See also Power of Attorney.
Promoting the active involvement of the individual in communication. It requires consistency between oral and non-verbal
behaviour that respects the individuals’ experience, expertise, culture, history and religion.
See also Assessment, Care Plan, Comprehensive Assessment, Long Term Conditions, Overview Assessment, Single
Assessment Process, Specialist Assessment.
The sum of the total of the elements, factors and conditions in the surroundings which may have an impact on the development,
action or survival of an individual, whether it is in their own home or in their wider community.
See Enduring Power of Attorney
An incident or care event that is part of a progression or a larger sequence.
Equal Opportunities Policy
A descriptive term for policies intended to give equal access to an environment or benefits,
such as education, employment, health care, or social welfare to all, often with emphasis on members of various social groups which might have at some time suffered from discrimination. This can involve the hiring of workers and other such practices. Social groupings generally emphasised in such a way are those categorised by aspects of gender, racial group, or religion.
See also Age discrimination, Anti-discrimination policy, Anti-Discriminatory Practice, Culture, Diversity, Diversity
Policy, Ethnicity, Person Centred Approach, Racism.
The quality of being the same in quantity or measure or value or status.
Equity of Care
Providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographical
location and socio-economic status.
Electronic implementation of the Single Assessment Process.
See National e-SAP Project.
Moral codes of practice concerned with: behaviour (moral conduct), e.g. unprofessional behaviour such as direct discrimination; legal, religious, social and personal concerns (moral issues); and debates within society, e.g. euthanasia versus prolonging the life of a terminally ill person.
Oversees moral codes of practice in health geographical area.
Everyone has an ethnic origin and identity: this is an important part of ‘who we are’. The majority population in the UK is
often simply described as ‘White British’, but this hides a lot of diversity of religious practice, and the national origins of ancestors. In the Census in 2001, Irish groups lobbied for addition of a
‘White-British: Irish’ category. Most people are now familiar with these Census categories, which are used for ‘ethnic monitoring’ across the NHS and elsewhere: there are four major headings and 16 main
Increasingly, there are many people of ‘Mixed’ origins - and their needs should be considered in view of the multiple heritages they can belong to.
- White - includes British, Irish, and ‘Other’ - such as Polish.
- Asian - Indian, Pakistani, Bangladeshi and ‘Others’ — such as Tamil, or sub-regions such as Kashmir and Mirpur. There are many minority ethnic groups on the sub-continent of India, so it is best to explore the specific needs of people by their religion (e.g. Sikh, Muslim) or their language (Urdu, Gujerati etc).
- Black - Caribbean, African and ‘Other’. There are people of Indo-Caribbean origin and again it may be useful to look for specific national or language origins (Nigerian, Somali, Arab).
- Chinese and Other: groups (such as Vietnamese, Kurdish, Iraqi) should be searched for by name: some such as Turkish and Cypriot groups are of European origin but are not always seen as ‘White’.
Ethnicity includes many aspects contributing to identity and to health care needs, including genetics, migration history and its effects on social activity. A group of diverse ethnic origins with specific needs which should also
not be forgotten is people of Refugee or Asylum Seeker origin. The needs of people from other Migrant populations, such as the Gypsy or Traveller communities, also should be considered.
See also Age Discrimination, Anti-Discrimination Policy, Anti-Discriminatory Practice, Culture, Discrimination, Diversity, Diversity Policy, Equal Opportunity Policy, Person Centred Approach, Racism.
Process used to collect, store and analyse data about people’s ethnic backgrounds. Ethnic monitoring data can be used to
highlight possible inequalities, investigate their underlying causes, and assess and prevent adverse impact.
See also Age discrimination, Anti-discrimination policy, Anti-Discriminatory Practice, Culture, Diversity Policy, Ethnicity, Person Centred Approach, Racism.
A sense of cultural and historical identity based on belonging by birth to a distinctive cultural group.
See also Age discrimination, Anti-discrimination policy, Anti-Discriminatory Practice, Culture, Discrimination, Diversity, Diversity Policy, Ethnic Monitoring, Equal Opportunity Policy, National Library for Health - Specialist Library for Ethnicity &
Health, Person Centred Approach, Racism.
European Computer Driving Licence (ECDL)
A training course in basic IT skills available to all NHS staff to help them prepare for new ways of
working and increase confidence in their use of IT. ECDL is an internationally recognised qualification that has been adopted as the NHS standard and also by some social care agencies.
Judging the value of something by making a comparison.
The information on which judgements should be made. When providing evidence you should clearly differentiate between what is fact,
what is opinion, what is based on research and knowledge based practice.
The best current research information available based on a systematic analysis of the effectiveness of a treatment, service or
any other intervention and its use, in order to produce the best outcome, result or effect. In practice this means an approach to service provision development centred on ensuring that individuals are given the most effective
and appropriate provision as indicated by currently available research findings.
See Disempowerment, Social Exclusion.
Expert Patient Programme
Self-management programme giving people the confidence, skills and knowledge to manage their condition/needs better
and be more in control of their lives.
See also Long Term Conditions, Participation, Person Centred Approach, Self Care/Self Management.
Extra Care Housing
A style of housing and care for older people that falls between sheltered housing and the
accommodation and care provided in a traditional residential home. Extra Care Housing is potentially an important element in an integrated approach to the housing, health and social care needs of an ageing population. Also
known as very sheltered housing.
See Fair Access to Care Services.
Fair Access to Care Services
Eligibility criteria, used by Social Services Departments to
determine whether a person is eligible for services provided by them. The framework is based on an individual’s needs and associated risks to independence, and includes four eligibility bands - critical, substantial, moderate and low. When placing
individuals in these bands, councils should not only identify immediate needs but also needs that would deteriorate for lack of timely help.
Method by which a Social Services Department assesses the expenditure incurred as a direct result of a
person’s disability. Areas considered in the assessment process include assistance and services; laundry; clothing; diet; equipment; adaptations, transport and heating. Self-assessment results are then
matched with the result of the needs assessment.
See also Charges.
As part of the National Service Framework for Older People, health and social care agencies should take action
to prevent falls and reduce fractures and other injuries in their population. People who have fallen should receive, when necessary, effective assessment and treatment and, with their carers, advice on prevention through a
specialised falls service.
See also Accident Prevention.
A record of an individual's current and past illnesses, and those of their parents, brothers, sisters, children, and other
family members. A family history shows the pattern of certain diseases in a family, and helps to determine risk factors for those and other diseases.
See also Assessment, Comprehensive Assessment, Background History, Long Term Conditions, needs, risk, risk
assessment, Single Assessment Process.
Fire Services and Fire Prevention
There are fifty separate fire brigades in England and Wales. Together with the brigades in Scotland and
Northern Ireland, they form the British Fire Service. Other organisations also maintain independent fire brigades, such as the British Airports Authority and the Defence Fire Service that provides cover at military and MoD sites.
See also Accident Prevention, Ambulance Service, Emergency Department, Heating in the Home.
Emergency care given immediately to an injured person before professional medical help can be provided. The aim is to prevent the
condition worsening, protect from further harm, aid recovery and preserve life.
See also Ambulance Service, Accident Prevention, Health, Well being.
Seasonal Flu (also known as influenza) is a disease of the lungs and upper airways caused by infection with a flu
The main symptoms are a high temperature that comes on quickly, and general aches and pains. Other symptoms include a loss of appetite, nausea and a harsh dry cough. The symptoms will usually peak after two to three days and you should begin to feel
much better within five to eight days, although a cough and general tiredness may last for two to three weeks.
Flu usually occurs during the winter months (from October to April in the UK). Complications such as a chest infection can affect elderly people or people with certain medical conditions. This can result in serious illness and can be
A flu vaccination is available from a GP if an individual is 65 or over or they have any of these problems (however old they are):
a serious heart or chest complaint, including asthma
A GP may also advise a flu jab if an individual has serious liver disease. If an individual lives in a care home they should also be in touch with their nurse or the manager. Main carers for older or
disabled people should ensure that the person they look after is vaccinated (if recommended) and also seek advice from the GP as to whether they, as a carer, should also be vaccinated.
- serious kidney disease
- lowered immunity due to disease or treatment such as steroid medication or cancer treatment
See also Immunisation, Infectious disease, Swine Flu.
Swine flu is the common name that has been given to a new strain of Flu (influenza A H1N1). It may be similar to the 1918 'Spanish
Flu' and is called swine flu because it is thought to have originated in pigs, but this is not known for certain.
A vaccine has not available as yet because the virus strain has not been identified.
Symptoms are generally mild, with most people recover within a week, even without special treatment.
However, a small number of patients will develop more serious illness. Many of these people have other underlying health conditions, such as heart or lung disease, that put them at increased risk.
Swine Flu symptoms can include:
As with any sort of influenza, how bad and how long the symptoms last will depend on treatment and the patient’s individual circumstances.
- weakness and fatigue
- aching muscles and joints
- sore throat
- runny nose
Some groups of people are more at risk of serious illness if they catch swine flu. It is vital that people in these higher risk groups get anti-viral drugs and start taking them as soon as possible — within 48 hours of the onset of symptoms.
Health authorities are still learning about the swine flu virus, but the following people are known to be at higher risk:
People suffering from the following illnesses are also at increased risk:
- pregnant women
- people aged 65 years and older
- young children under five years old
The National Pandemic Flu Service
- chronic lung disease
- chronic coronary heart disease
- chronic kidney disease
- chronic liver disease
- chronic neurological disease
- Immunosuppression (whether caused by disease or treatment)
- Diabetes mellitus
- patients who have had drug treatment for asthma within the past three years
People with swine flu symptoms who contact the National Pandemic Flu Service will be given a unique access number and told where their nearest antiviral medication collection point is.
They should then ask a ‘flu friend’ - a friend or relative who doesn't have swine flu - to go and pick up their antiviral medication.
The ‘flu friend’ must show their own ID as well as that of the patient. The authorisation number and ID information will be checked to ensure it matches the information provided when the assessment of symptoms was completed.
Anyone who suspects they have swine flu must not go to their GP or Accident and Emergency.
However, people should contact their doctor direct rather than using the National Pandemic Flu Service if:
- they have a serious underlying illness,
- they are pregnant,
- they have a sick child under one year old,
- their condition suddenly gets much worse, or
- if their condition is still getting worse after 7 days (5 for a child)
See NHS Foundation Trusts.
Freedom of Information Act 2000 (FOIA)
Each public authority must comply with requests for access to information that it holds, unless an
exemption from disclosure applies. Public authorities will normally have a maximum of twenty working days to respond to a request. However there are circumstances when this time limit can be extended or the request refused.
See also Caldicott Guardians, Data Protection Act 1998 (DPA)
Classification of human sexuality
General Medical Council (GMC)
The statutory body responsible for licensing doctors to practise medicine in the UK. It
protects, promotes and maintains the health and safety of the public by ensuring proper standards in the practice of medicine.
General Medical Services (GMS)
Personal medical services provided by general medical practitioners (i.e. GPs), for example: giving
appropriate health promotion and wellbeing advice; offering consultations and physical examinations; offering appropriate examinations and immunisations. This is one type of contract
Primary Care Trusts (PCTs) can have with primary care providers. It is a nationally negotiated contract that sets out the core range of services provided by family doctors (GPs) and their staff.
See also Alternative Provider of Medical Services (APMS) contracts and Personal Medical Services (PMS) contracts, Quality and Outcomes Framework.
General Social Care Council (GSCC)
Body which regulates the social care workforce in England. It registers social care
workers and regulates their conduct, education and training
An independent review of public sector efficiency commissioned by the Government and conducted by Sir Peter Gershon. The
report, Releasing resources to the front line, was published in July 2004. To support implementation, the Department of Health established the Care Services Efficiency Delivery (CSED) Programme.
See also Comprehensive Spending Review (CSR), Wanless Review.
See General Medical Council.
NHS terms and conditions applicable to General Medical Services.
A government is an organisation that has the power to make and enforce laws. In its broadest sense, "govern" means the power to
administrate, whether over an area of land, a set group of people, or an association.
See also Act of Parliament, Bill, Direct Gov, Green Paper, White Paper.
Consultation document issued by the Government which contains policy proposals for discussion and debate
before a decision is taken on the final policy options. Following the consultation the Government will normally publish firmer recommendations in a White Paper.
See also Act of Parliament, Bill, Government, Government, White Paper.
Term used when a person is passed from one health and social care worker to another.
See also Seamless Service.
Hay fever, also know as seasonal allergic rhinitis, is a very common in the UK. It’s an allergy to grass or
hay pollens and generally happens during the spring and summer. Grass is in pollen (in flower) from May to July and is the most common cause of hay fever.
During the spring (March to May), pollens from trees are the most common cause of hay fever. Some people get hay fever into the autumn months as well. This is rarer and is usually caused by weeds such as nettles and docks, late flowering plants and
Hay fever symptoms can be similar to a cold, and include a runny nose and eyes and repeated sneezing attacks. As with all allergies, the symptoms happen as a result of your immune system overreacting to a normally harmless substance — in this case,
pollen. When the body comes into contact with pollen, cells on the lining of your nose, mouth and eyes release a chemical called histamine that triggers the symptoms of an allergic reaction.
You’re more likely to get hay fever if there is a history of allergies in your family, particularly asthma or eczema. Hay fever usually begins in the early teens and peaks when you’re in your twenties.
Research shows that many people become less sensitive to pollen as they get older, and by the time they reach their mid-forties, hay fever may no longer be a problem.
A state of complete physical, social and mental well-being and not merely the absence of disease or
Health is a resource for everyday life, not the object of living. It is a positive concept emphasising social and personal resources as well as physical capabilities.
See also Medicine, Well-being, World Health Organisation.
Health Act 1999 Partnership Arrangements (Health Act flexibilities)
Legislation to enable health and local authority partners to work together more effectively were outlined in Section 31 of the 1999 Health Act. These partnership arrangements were for health bodies, such as Strategic Health
Authorities, Primary Care Trusts, together with any health-related local authority service such as social services, housing, transport, leisure and library services, community and
many acute services.
This can be done by
See also Care Trust.
- Pooled funds - the ability for partners each to contribute agreed funds to a single pot, to be spent on agreed projects for designated services
- Lead commissioning- the partners can agree to delegate commissioning of a service to one lead organisation
- Integrated provision - the partners can join together their staff, resources, and management structures to integrate the provision of a service from managerial level to the front line
Health Act Flexibilities
Introduced in the Health Act 1999. Pooled budgets and the delegation of functions are
standard practice for all health and local authorities in planning, commissioning and delivering intermediate care and community equipment services
See Health Act 1999 Partnership Arrangements
Health Action Plan
A Health Action Plan is a personal plan about what an individual with a learning disability can do to be healthy. It
details the actions needed to maintain and improve the health of the individual, and any help needed to accomplish these. It is a mechanism to link the individual and the range of supports they need if they are to have better health. Health Action
Plans need to be supported by wider changes that assist and sustain this individual approach.
See also Circles of Support, Disability, Individual Budgets, Learning Disabilities, Person Centred Approach, Valuing people.
Health and Social Care Communities
Term used to describe the bodies that deliver statutory and non-statutory health and social care services:
primary care trusts, acute trusts, local authorities and organisations in the independent sector and voluntary sector.
Health and Social Care Information Centre
The Health and Social Care Information Centre works to co-ordinate and streamline the collection
and sharing of data about health and adult social care.
The Health and Social Care Information Centre is a special health authority that became a statutory body on 1 April 2005.
The authority took on some of the information related functions of the former NHS Information Authority and some statistics and information management functions of the Department of Health including social care.
The authority is tasked with three main strands of work:
Making information more accessible
- Reducing the burden
- Strengthening the capacity for informed decision making
Health Delivery Plan
Document that sets outs the local health strategy in a financial year for the health and social care system in a
The natural environment affects health. Health forecasts help individuals and professionals know when and where there is a
risk of illness. Through this understanding, preventative action can be taken such as to help prevent hospital admissions and manage hospital workload.
See also , Allergies, Asthma, COPD - Chronic Obstructive Pulmonary Disease, Heating in the Home
The process of enabling people to increase control over and improve their health.
Health Protection Agency
An independent body that helps protect the health and well-being of the
population. The agency plays a critical role in protecting people from infectious diseases and in preventing harm when hazards involving chemicals, poisons or radiation occur. They also prepare for new and emerging threats, such
as a bio-terrorist attack or virulent new strain of disease.
See also Immunisation.
The independent inspection agency for both the NHS and private and voluntary healthcare. They have a statutory duty to
assess the performance of healthcare organisations, award annual performance ratings for the NHS and coordinate reviews of healthcare by others.
See also Audit Commission, Commission for Social Care Inspection, Performance Ratings.
A secure place on the internet where people can access and store their personal health information.
See also NHS Care Record Service, NHS Connecting for Health, NHS Direct, Person Held Records.
See Sensory Disability.
See Coronary Heart Disease.
Heating in the Home
Keeping warm at home in winter is a key contributory factor to being healthy and feeling well.
See also Accident Prevention, Fire Services and Fire Prevention, Health Forecasting, House and Home, Well-being, Winter
HIV (Human Immunodeficiency Virus) infects and gradually destroys an infected person's immune system, reducing their protection
against infection and cancers. Initially, someone living with HIV may show no symptoms of HIV infection as their immune system manages to control it. However, in most cases the immune system will need help from anti-HIV drugs to keep the HIV
infection under control. These drugs do not completely rid the body of HIV infection. Treatments since the mid-nineties have dramatically improved the life expectancy for those diagnosed with HIV in the UK.
AIDS is short for Acquired Immune Deficiency Syndrome. AIDS is not a single disease or condition. Instead, it is a term that describes the point when a person’s immune system can no longer cope because of the damage caused by HIV and they start to
get one or more specific illnesses. People do not actually die from AIDS; they die from the cancers, pneumonia or other conditions that may take hold when their immune system has been weakened by HIV. The term AIDS is now very rarely used. It is more
usual to talk of late-stage or advanced HIV infection.
See also Diagnosis, Health, Sexually transmitted infections (STIs), Well being.
Holistic Assessment/Holistic Care
When health and social care professionals assess the domains/sub domains of the Single Assessment Process (including the physical, emotional, mental health, spiritual, environmental, social, sexual, financial, cultural needs of an individual). An awareness of diversity issues including of an individual’s
history, culture, beliefs and identity is essential; not least when working with Black and Minority Ethnic people. The use of interpreters, speaking to individuals and their carers in their own language with sensitivity and
respect, is a key element of Holistic assessment. A holistic assessment should also identify abilities, strengths and preferences. The person’s perspective, views and self assessment should be
encouraged. Conclusions on risks and needs then are made for the care planning stage.
See also Assessment, Care Plan, Care Programme Approach (CPA), Case Management, Comprehensive Assessment, Holistic Care Process, Long Term Conditions, Overview Assessment, Participation, Self Care/Self Management, Single
Assessment Process, Specialist Assessment.
Holistic Care Process/Model
Caring for the whole person with many/complex needs whatever their age, illness or disability.
People with many/complex needs are classified into levels (e.g. enhanced Care Programme Approach - CPA) and categories (e.g. Common Assessment Framework - CAF, Single Assessment Process - SAP).
They are served under a holistic care process consisting of Entry into System, Assessment, Care Plan, Care Delivery and Review/Discharge.
Central to this process is the holistic assessment, under numerous headings (domains/dimensions), of risks and associated needs (physical, emotional, mental health, spiritual, environmental, social,
sexual, financial, cultural needs of an individual.. An awareness of diversity issues including of an individual’s history, culture, beliefs and identity is essential; not least when working with Black and Minority Ethnic
people. The holistic assessment should also identify abilities, strengths and preferences. The person’s perspective, views and self assessment is encouraged in the joint work with their assessor.
The risks and needs are then addressed by joint planning of the care with the person, their carer(s) and relevant professionals to commission the services which are expected to achieve agreed outcomes as
documented in the individual’s personalised health and social care plan.
Throughout this process, the individual is allocated a known contact to provide continuity of care and security to co-ordinate their assessment(s), and, when appropriate, their care planning and services, encouraging supported
self care /self management.
Regular reviews take place to ensure that the care plan is succeeding, that changes are not missed and that the individual is discharged from care when they no longer need services.
See also Assessment, Needs Assessment, Single Assessment Process.
Care services provided to an individual in their own home by a care worker paid to provide care as part of their employment. Also
known as domiciliary care.
Not having a home. Even if an individual has a roof over their head they can still be homeless. This is because they may not
have any rights to stay where they live or the home might be unsuitable for them.
Prejudice against a homosexual person on the basis of sexuality.
Care for a terminally ill person and also for their carers, provided at home, in day care and in the
hospice itself. Hospices provide a range of services - pain control, symptom relief, skilled nursing care, counselling, complementary therapies, spiritual care, art, music, physiotherapy, reminiscence, and bereavement support. Multi-professional teams, including volunteers, provide care based on need and personal choice, and strive to offer freedom from pain and to help achieve dignity,
peace and calm.
See also End of Life Care, Palliative Care.
House and Home
A house is a dwelling that serves as living quarters which provides shelter for an individual or individuals. Home is a word
that a person identifies with a place they live, spend much of their time, or feel generally comfortable with. While a house (or other residential dwelling) is often referred to as a home, and is home to many people, the concept of "home" is broader
than a physical dwelling.
See also Care Home, Care Homes with Nursing, Heating in the Home, Homelessness, Sheltered Housing.
Refers to the characteristics, personality, cultural values or perspectives that an individual most strongly
relates to; a sense of self.
A very important way to protect individuals and the community from serious disease. After clean water,
vaccination is the most effective public health intervention in the world for saving lives and promoting good health. Vaccination is now used to refer to all procedures for immunisation. Immunisation is the process of protecting individuals from
infection through passive or active immunity.
See also Flu, Health, Health Protection Agency, Well-being
See Social Inclusion.
The ability to carry out activities that support one’s own lifestyle and to control the care given by others.
See also Enablement, Reablement.
Person-centred approach to social care that offers the individual choice and flexibility to make decisions about the
support and care they need so that they can take control of their life.
See also Long Term Conditions, Self Care Self Management, Single Assessment Process.
Non-statutory agencies (i.e. those agencies that have not been created by Government Acts with the specific purpose of
providing services under that Act, and hence are not part of local or central government) that provide health and social care services. They may be privately run (i.e. on a commercial basis) or be run by a voluntary, charitable or not-for-profit
See also Health and Social Care Communities, Social Care, Voluntary Sector.
Person requiring health and care services.
See also Person Centred Approach.
Although direct payments have helped to transform the lives of many people, it can sometimes be
difficult for people to make full use of them because of the degree of responsibility involved in managing all aspects of a budget, for example in becoming the employer of a care assistant. Direct payments only cover local authority social care
Individual budgets will bring together separate funds from a variety of agencies including local authority social services, community equipment, Access to Work, independent living funds, disabled facilities grants and the Supporting
Individuals who are eligible for these funds will then have a single transparent sum allocated to them in their name and held on their behalf, rather like a bank account. They can choose to take this money out either in the form of a direct payment
in cash, as provision of services, or as a mixture of both cash and services, up to the value of their total budget. This will offer the individual much more flexibility to choose services which are more tailored to their specific needs.
There will be 13 Individual Budget pilots for older and disabled people in 2006. These pilots will run for between 18 months and two years and, if successful, will form the spearhead of a national implementation that could begin as early as 2009/10.
See also Direct Payments, Person Centred Approach, Self Care/Self Management, Support, White Paper on Community Health and Social Care
An infectious disease or communicable disease is a disease that can be spread directly or indirectly from one living thing
to another . The disease is caused by a biological agent such as by a virus, bacterium or parasite, in contrast to a physical cause, such as burns or a chemical cause such as intoxication.
Examples of infectious diseases are Chickenpox, Flu (Influenza), Measles and Tuberculosis.
See also Health, Health Protection Agency, Immunisation, Well-being.
Informing people what is happening throughout the process of care. Clear information helps relieve stress, provide choice and
supports people in decision-making and their Self Care/Self Management.
See also Advice, Advocacy, Coordination.
Information Management and Technology (IM&T)
This term covers the use and management of information through all forms of organised systems,
whether based on human endeavour, paper methods or information technology.
Information Sharing Protocol
Documented rules and procedures that govern how far one organisation may disclose information about a person to
another. The protocols relate to the security and confidentiality of the information and to data destruction.
A term that encompasses all forms of technology used to create, store, exchange, and use information in its various forms.
See also NHS Connecting for Health.
Hospital patient who remains in hospital overnight.
Partnerships in which health and social care staff share information appropriately and work together to ensure that people
receive the support and care they need to remain independent in the community.
See also 18 Weeks Delivery Programme, Integrated Service.
Integrated Care Pathway (ICP)
A tool and a concept that embed guidelines, protocols and locally agreed, evidence-based, person centred, best
practice, into everyday use for the individual. In addition, and uniquely to ICP’s, they record deviations from planned care in the form of variances.
See also Care Pathway.
Integrated Continence Service
Identifies, assesses and cares for people with incontinence. Also helps people to maintain continence.
Service taking a person-centred approach and seeking to meet a person’s social and emotional needs as well as their
physical and medical ones.
See also Integrated care.
Integrating Community Equipment Services (ICES)
Department of Health funded initiative across health and social care to develop
community equipment services in England and remove unnecessary barriers for individuals and modernise services.
See also Assistive Technology, Community Equipment Services.
Links between two or more organisations
See Step-Down Unit.
A short period (normally no longer than six weeks) of intensive rehabilitation and treatment to enable people to return
home following hospitalisation; or to prevent admission to a long term Care Home; or intensive care at home to prevent unnecessary hospital admission.
See also Rehabilitation.
A global network of interconnected computers and other devices, which can communicate with each other using a set of agreed
low-level rules, the transmission control protocol / internet protocol (tcp/ip). The data to be transmitted is split into packets which include the address of the sending and receiving computers. Every computer on the public internet has a
unique numeric address, its ip address. For a computer on a private network the uniqueness may be acheived through network address translation (NAT) at the point where the private intranet interfaces with the
public internet. Intervening routers find the best path for the packets of data from the sending to the receiving computer.
The internet Domain Name Service (DNS) provides a computer's numeric ip address from it's mnemonic computer and domain name eg www.cpa.org.uk
Higher level rules provide for particular activities over the internet.
- FTP (File Transfer Protocol) provides for the exchange of computer files.
- HTTP (Hypertext Transfer Protocol) provides for the serving and linking of distributed, collaborative, hypermedia information systems and is the basis of the World Wide Web.
- SMTP (Simple Mail Transfer Protocol) provides for the sending of e-mails.
See also Information Technology, NHS Connecting for Health, Mobile communicating, Portal.
The conversion of one spoken language into another, enabling communication between people who do not share a common language.
Local health and social care agencies will have links with interpreting and translating services.
Interpreting and Translation Services
Effective communication between the individual and their workers and agencies participating in their
health and social care is crucial. An interpreter should be asked to assist if this is likely to improve the quality of communication. Relatives or friends should not be expected to interpret.
A group of privately interconnected computers and other devices which exchange information using the same sets of rules as those
used on the public internet. While accessible to each other and usually also able to access the public internet, the computers on an intranet lie behind a firewall which prevents them being reached from the internet
Joint Staff Development/Training
The single assessment process sets out a strategy for joint staff
development for localities to follow. It emphasises that professionals should be equipped to carry out person centred care, be skilled at joint working and be knowledgeable about the health and social care concerns of the
individuals assessed and cared for.
Joint Visiting Teams
Local partnerships between The Pension Service, their respective local
authority and a range of local providers. They increase older people's access to benefits and services by signposting or referring according to identified needs. Joint visiting teams work to establish
a network of local professionals from the health, social care, statutory and voluntary sectors.
See also Advice, Pensions.
The working together of staff from organisations, such as local authorities, acute
trusts and primary care trusts to identify and solve local problems.
See also Joint Staff Development/Training.
See Case Finding.
See National Knowledge Service
The body of rules and principles governing the affairs of a community and enforced by a political authority.
See also Act of Parliament, Bill, Green Paper, Government, Legislation, White Paper.
A leader is the appointed head of a group, team or organisation. A leader is someone who inspires, who makes decisions that affect
the organisation in a positive way and who can pull together a diverse team to work toward a common goal. Leadership qualities include; knowledge, vision. trust, integrity, standards, decisiveness, assertiveness and the ability to achieve desired
outcomes. The successful leader is a person who understands herself /himself, the organisation, the environment in which they operate and the people that they are privileged to lead.
See also Management.
Learning Disabilities / Difficulties
Many people who have this condition prefer the term 'people with learning difficulties'.
A learning disability affects the way someone learns, communicates or does some everyday things. A person has a learning disability all through their life. There are many different types of learning disability. They can be mild, moderate or severe.
There are many different causes of learning disability. Often it is not possible to say why someone has a learning disability. But most learning disabilities are caused by the way the brain develops - before, during or soon after birth.
Two of the most common causes of inherited learning disability are Fragile X syndrome and Down's syndrome (Inherited means that it is passed down from parents to child in their ‘genes’). These are not different types of learning disability. But
people who have these conditions are likely to have a learning disability.
Some people with a mild learning disability do not need a lot of support in their lives but others may need support with all sorts of things, like getting dressed, going shopping, or filling out forms. Some people with a learning disability also
have a physical disability. This can mean they need a lot of support 24 hours a day. A learning disability does not stop someone from learning and achieving a lot in life, if they get the right support.
See also Circles of Support, Disability, Health Action Plan, Individual Budgets, Person Centred Approach, Valuing
Services which provide the information, advice and legal help required to deal with a wide range of everyday problems. Legal
services provide access to legal aid and the services provided by solicitors and others in the legal profession. Legal services are provided by a variety of organisations including Citizens Advice Bureaux locally and the Legal Services Commission
See also Advice, Benefits, Information.
Written laws made by parliament.
See also Act of Parliament, Bill, Green Paper, Government, Law, White Paper.
Concept emphasised by NHS Connecting for Health in terms of only accessing an individual’s
personal data where there is an appropriate link between a care professional and the individual concerned. Individuals who are uncomfortable with having their information shared with other health and social care professionals
will be able to keep information in a 'sealed envelope.
See also NHS Care Record Service, Registration Authority, Role Based Access Control (RBAC), Smartcard.
Leisure and Recreation
Activity that promotes the refreshment of health or spirits by relaxation and enjoyment. Time when you are not working
or doing other duties. Time spent for personal pleasure.
See also Education and learning.
Length of Stay
Time spent in hospital from admission to discharge, based on the number of
nights in hospital.
Outined in the White Paper 'Our Health, our care, our say: a new direction for community services'. It is
proposed these will be available at ‘critical’ points in people’s lives. It will consist of two parts. First is initial self assessment to be available online or in paper format, with the option to share the assessment electronically and as part of
an electronic care record. The second part, if the person is at risk, will consist of a discussion with a health trainer who can give the appropriate advice and support. The Life Check will be based on range of risk factors e.g. obesity, mental
health, smoking and awareness of family history.
See also Common Assessment Framework for Adults, Information, Information Prescription, Long Term Conditions, Single Assessment Process.
Link-Age Plus pilots will be one-stop-shops for people aged 50 and over. They will enable people to access a whole range of
services such as help with housing and access to transport, health services, employment advice and information about volunteering
Link-Age Plus has involved older people in the design and delivery of the project to make sure it meets the needs of people in their local communities.
The Link-Age Plus pilots are part of the Government’s Opportunity Age strategy for older people, and the cross-Government action plan to tackle the social exclusion of older people published in a report from the Social Exclusion Unit in January 2006.
The pilots have been developed in partnership with older people, local and central government, local and national organisations and the voluntary sector. Eight pilots launched 3 July
2006 in Tower Hamlets, Devon, Gateshead, Gloucestershire, Lancaster, Leeds, Nottinghamshire and Salford.
DWP has set aside £10 million over two years to support the development of Link-Age Plus. This is in addition to resources provided by local authorities and their local partners. Link-Age Plus will be overseen by a steering group drawn from a range
of central government, voluntary sector and local government organisations including the Social Exclusion Unit, Age Concern, Help the Aged, Citizens Advice,
Department of Health and Local Government Association.
See also Sure Start in Later Life, Transformational Government.
Living well in later life: A review of progress against the National Service Framework for Older People
Jointly produced by the Healthcare Commission, the Audit Commission and the Commission for Social Care Inspection in March 2006. It assessed the Government’s progress in the first five
years of its 10 year National Services Framework (NSF) for Older People plan. The plan was introduced to ensure local health and social care services met the needs of people over the age of 50.
The three inspectorates found significant improvement in:
The review identified five key challenges for the next phase of the NSF implementation, ensuring dignity in care, improving services for old age mental health needs, falls and medicines management, and improving partnership working.
This report recommended the full implementation of the single assessment process across NHS and Local Authority partners.
See also Dementia, Discharge from Hospital, Care Homes, Care Home with Nursing, Change, Commission for Social Care Inspection, End of Life Care, Intermediate Care, Mental health
, Rehabilitation, Single Assessment Process, Wanless Review, Well-being, White Paper on Community Health and Social Care Services.
Local Area Agreement (LAA)
A three-year agreement that sets out the priorities for a local area in certain policy fields as agreed between
central government, represented by the Government Office, and a local area, represented by the local authority and Local Strategic Partnership (LSP) and other partners at local level. The agreement is made
up of outcomes, indicators and targets aimed at delivering a better quality of life for people through improving performance on a range of national and local priorities.
Local Authority/ Local Council
See also Social Services Department, Strategic Health Authority.
Elected body responsible for providing public services such as education, housing and social services within a particular area. Most urban areas, including London, have unitary authorities — one council provides all local government services. Other
areas have a two-tier system, with a county council and district councils; in these social services are run by the county council. Elected councillors decide the policy framework for the work of the local authority within the framework of the
Local Delivery Plan (LDP)
A plan that every Primary Care Trust (PCT) prepares and agrees with its Strategic Health Authority (SHA) on how to invest its funds to meet its local and national targets, and improve services. It allows PCTs to plan and budget for delivery of services over a three-year period.
Local Service Provider (LSP)
Responsible for making sure the new systems and services delivered through NHS Connecting for
Health meet Programmes for IT requirements and are implemented efficiently.
Nationally, the Local Service Providers are
The Fujitsu contract was terminated in May 2008. (News link)
See also National Programme for Information Technology (NPfIT)
Local Strategic Partnership (LSP)
Bring together representatives of all the different sectors (public, private, voluntary and community) and
other partnerships. They have responsibility for developing and delivering the Sustainable Community strategy and Local Area Agreements (LAAs).
Loneliness is a state of feeling cut off from and longing for others, due to lack of contact (physically, emotionally, etc.) with
people (whether acquaintances, friends, or loved ones). Loneliness is not to be confused with solitude (where a person may appreciate the time to think and reflect without distraction.)
See also Mental Health, Well-being.
Long Term Conditions
Illnesses which lasts longer than a year, usually degenerative, causing limitations to one’s physical, mental and/or
social well-being. Long Term Conditions includes Diabetes, COPD, Asthma, Arthritis, Epilepsy and Mental Health. Multiple long term conditions make care particularly complex, and a
small number of individuals and conditions account for a disproportionate amount of health care use (especially hospital care). 60% of adults in England report a chronic health problem; 8.8m people have long term illness that severely limits their
day to day ability to cope. According to the World Health Organisation, Long Term conditions will be the leading cause of disability by 2020.
See also Advocacy, Care Plan, Case Management, Common Assessment Framework for Adults, Comprehensive Assessment, Continuity of Care, Coordination, Expert Patient Programme, Holistic Assessment, Holistic Care Process, Medicine,
Information Prescriptions, Neurological Conditions, Participation, Self Care/Self Management, Single Assessment Process, Very High Intensity Users (VHIU, White Paper on Community Health and Social Care Services, 'Year of care' approach.
A means of moving an individual or an object by lifting, carrying, pushing, pulling or sliding using appropriate equipment.
Such tasks should only be undertaken after appropriate training.
See also Health, Occupational Health, Well-being.
Map of Medicine
Aims to make the vast amount of knowledge held within the NHS available to all health care professionals. The Map of Medicine
is based on over 250 different patient journeys. These are symptom-based and aspire to map out the steps to be taken by the clinician, starting with the initial presentation of the individual.
See also Care Pathway, Integrated Care Pathway (ICP).
Meals on Wheels
Deliveries of pre-cooked meals to the homes of people who are housebound and/or are unable to prepare meals and/or cook for
See also Social Services Department.
Medical Model of Health
Model or philosophy of health based on the premise that all illness has a biological/physiological cause, and can
therefore be cured by medical/biochemical intervention, e.g. drugs, surgery.
See also Social Model of Health.
System that determines how individuals and the health service use medicines. Effective medications management focuses
on the individual. It includes, for example, asking the person if their medicine has any side effects, talking to carers about any concerns they may have, and giving advice about how to dispose of medicines safely.
A further development has been the new Community Pharmacy Contractual Framework (2005) will enable pharmacists to provide repeat dispensing; offer advice to improve public health such as healthy eating, stopping smoking and regular exercise; dispose
of unwanted medicines; and provide medicine use reviews for those with long-term conditions.
See also Health, Long Term Conditions, Single Assessment Process, Specialist Assessment.
A branch of health science concerned with maintaining health and restoring it by treating disease. Medicine is both an area of knowledge (a science), and the application of that knowledge (by the medical profession and other health professionals such as nurses). The various specialised branches of the science of
medicine correspond to equally specialised medical professions dealing with particular organs or diseases.
How an individual thinks, feels, and acts when faced with life's situations. This includes handling stress, relating to other
people, and making decisions.
A mental health problem is a psychiatric disorder that results in a disruption in a person's thinking, feeling, moods, and ability to relate to others. The more extreme forms can be very disturbing both for the individual concerned and for those
around them. However, while mental health problems can lead to considerably disruption and difficulty, many people find ways of managing their needs and are able to lead fulfilling and active lives.
Many people with mental health problems will also be supported informally by friends and relatives, or receive treatment via their GP. When an individual has high levels of risk and particularly complex needs, they may be referred to the specialist
mental health service provider for assessment, treatment or support. People referred to a specialist mental health service provider may receive an assessment from a psychiatrist, psychologist, mental health nurse, social worker or occupational
therapist and, if they need further treatment or support, they may be offered medication, psychological therapies, occupational therapies or social support.
See also Care Programme Approach (CPA), Compulsory Admission, Health, Loneliness, Mental Health Act Assessment, Mental Health Trust, Nearest Relative, Sectioning, Single Assessment Process, Wellbeing.
Mental Health Act Assessment
Formal Assessment under the 1983 Mental Health Act. Hospital admission does not always follow as the least
restrictive alternative should be considered. However where a person’s mental state is seen to be a risk to their own health or safety or for the protection of others, compulsory admission to hospital may well be needed for
assessment and/or treatment. The application completed is by the Approved Social Worker based on the recommendations of two Doctors. The Mental Health Act 1983 governs the admission of people to psychiatric hospital against their will, their rights
while detained, discharge from hospital, and aftercare. The Act applies in England and Wales.
See also Care Programme Approach (CPA), Mental Heath, Mental Heath Trust, Nearest Relative, Sectioning.
Mental Health Trust
Provides treatment and care for patients who are mentally ill. The services may be provided from a hospital or in the
See also Care Programme Approach (CPA), Mental Health, Mental Health Act Assessment, Nearest Relative, Sectioning.
A process by which a more experienced person (the mentor) assists someone less experienced by offering advice, support and
encouragement and becoming a role model.
See also Joint Staff Development/Training, Shadowing.
A structured set of data being passed from one computer system to another, being part of an interface which may or may not be
Being able to work with Information Technology, whenever, and wherever, required. This might include using a mobile
device (such as a Laptop, Tablet PC, PDA, Smartphone or Digital pen) when undertaking an assessment in an individual’s home.
See also Information Technology. Internet, NHS Connecting for Health, Single Assessment Process, World Wide Web.
The Government’s plans for modernising social care were set out in the 1998 White Paper, ‘Modernising Social Services’.
Its key messages were that social services should promote independence, should be delivered with greater consistency, should be convenient and focused on the specific needs of the individual.
See also NHS Plan.
Ensuring the continuing quality and effectiveness of the services provided to meet an individual’s needs and identifying whether
and how the individual’s needs have changed.
See also Care Plan, Care Programme Approach (CPA), Case Management, Continuity of Care, Coordination, Long Term
Conditions, Self Care/Self Management, Single Assessment Process, Review,
MRSA (Methicillin-Resistant Staphylococcus Aureus)
A type of bacteria that lives harmlessly on skin and in the lining of the mouth and nose
(mucosa) of about one third of healthy people. It can, however, cause infection once it enters the body through a cut or abrasion. Staphylococcus Aureus is a very common cause of boils, impetigo and abscesses — even serious infections like
septicaemia (blood poisoning) and heart-valve infection. MRSA includes several strains (types) of the Staphylococcus Aureus germ that are not killed by the usual antibiotics.
See also Diagnosis, Health, Health Protection Agency.
Services or activities which involve staff drawn from a range of organisations, such as statutory agencies (health, social
services, education etc) and voluntary groups.
Assessment of an individual’s needs that actively involves professionals from different disciplines in
collecting and evaluating assessment information.
See also Assessment, Comprehensive Assessment, Holistic Assessment, Long Term Conditions, Overview Assessment, Single Assessment Process.
N3 - The National Network
The new fast, broadband communications network for the NHS. N3 is delivered by BT and will replace the existing
private NHS network, NHSnet.
See also NHS Care Records Service, NHS Connecting for Health.
National Electronic Library for Health (NeLH)
Programme working with NHS libraries to develop a digital library for NHS staff, patients and
the public. The NeLH website will be changing over the coming year as it transfers its content to the National Library for Health. The National Electronic Library for Mental Health is the equivalent service for mental health.
See also National Library for Health - Specialist Library for Ethnicity & Health, National Knowledge Service, Social Care Online.
National e-SAP Project
NHS Connecting for Health and the Electronic Social Care Records Implementation Board jointly
oversee this project which is tasked to develop a consistent national framework, for Health and Social integration specifically and for information exchange generally. When complete, implementation plans can then be agreed and resource implications
identified at both national and local levels.
The project is closely aligned with the work being undertaken by the developing Common Assessment Framework for Adults and Personalised Care Plans.
A national consultation and survey were carried which then led to the next stage of the project which involved involves the development of an implementation plan and business case for e-SAP.
See also: Common Assessment Framework for Adults, Long Term Conditions, NHS Care Record Service, NHS Connecting for Health, Single Assessment
Process, Whole system long term conditions (LTC) demonstrator programme.
National Health Service
National Institute for Health and Clinical Excellence (NICE)
An independent organisation responsible for providing national guidance on the
promotion of good health and the prevention and treatment of ill health.
National Knowledge Service
Ensures that both individuals and clinicians can have access to best current knowledge wherever and whenever its
needed. The National Knowledge Service covers clinical practice, healthcare, social care, and public health. The National Knowledge Service is an important part of the NHS Care Record Service.
See also NHS Connecting for Health.
National Library for Health - Specialist Library for Ethnicity & Health
The best currently available evidence about the specific needs of health care for minority ethnic groups.
See also Ethnicity, National Library for Health (NLH)
National Library for Health (NLH)
A work in progress to develop an integrated library service for the NHS. Their current website is the first
phase in the development of the National Library for Health, and integrates electronic content from the national collections. Later developments include plans to add electronic resources from regional and local collections, so that ultimately, NHS
staff can use the NLH website as the gateway to all the resources that are available to them.
See also National Electronic Library for Health, National Knowledge Service, Social Care Online.
National Minimum Standards (NMS)
Standards set by the Department of Health for a range of services, including care homes, domiciliary care agencies and adult placement schemes. The Commission for Social Care Inspection (CSCI) must consider the NMS in assessing social care providers’ compliance
with statutory regulations.
National Patient Safety Agency (NPSA)
An NHS agency which aims to improve the safety and quality of care through reporting, analysing and
learning from adverse incidents and 'near misses' involving NHS patients.
National Programme for Information Technology (NPfIT)
The National Health Service (NHS) needs modern Information Technology (IT) to help it to provide high quality services to patients. The National Programme for IT in the NHS (NPfIT) was set up to provide such services, using centrally managed procurement to provide impetus to
the uptake of IT and to secure economies of scale. It constitutes the largest single IT investment in the UK to date, with expenditure on the Programme expected to be £12.4 billion over ten years from 2003-4 to 2013-14.
It’s key aim is to give healthcare professionals in the NHS access to patient information safely, securely and easily, whenever and wherever it is needed.
It is doing this by:
See also NHS Connecting for Health, Programmes for IT.
- creating an NHS Care Records Service to improve the sharing of patients' records across the NHS with their consent
- making it easier and faster for GPs and other primary care staff to book hospital appointments for patients
- providing a system for the electronic transmission of prescriptions
- ensuring that the IT infrastructure can meet NHS needs now and in the future.
National Service Frameworks (NSF)
Documents setting out national standards for the best ways of providing health and social care services for
particular diseases or population groups, e.g. older people.
See also Living well in later life.
An aspect of a individual's identity conveying rights and duties, and defined by a specific legal relationship between an
individual and a state, through birth or naturalisation, which is recognised by that state. Article 2 of the European Convention on Nationality defines ‘nationality’ as ‘the legal bond between a person and a state’ which ‘does not indicate the
person’s ethnic origin’.
See also Citizenship.
The Mental Health Act 1983 defines a list of certain people who can be treated as the ‘nearest relative’ of an individual. A
‘nearest relative’ has a number of important powers and functions, including the right to discharge an individual who has been formally detained in hospital, make an application for a person to be admitted for assessment, treatment or guardianship
and also to object to applications for treatment or guardianship being made by a social worker.
See also Compulsory Admission, Mental Health Act Assessment, Mental Heath, Mental Heath Trust, Next of Kin. Sectioning.
What an individual requires to achieve and maintain health and well being. Areas of needs include: physical, emotional, mental health,
spiritual, environmental, social, sexual, financial and cultural.
See also Care Plan, Domains/Sub-Domains, Risks.
A process by which health and social care professionals assess and then make conclusions on risks and needs. The assessment
sets out what is necessary for an individual to maintain their life at a certain standard.
See also Assessment, Care Management, Case Management, Domains/Sub-Domains, Holistic Assessment, Holistic Care,
Long term Conditions, Single Assessment Process.
See Abuse, Adult Protection.
There are a wide variety of neurological diseases. These include common disorders such as migraine, epilepsy and strokes, less common ones such as Parkinson’s disease and multiple sclerosis and relative rarities such as myasthenia gravis. Many neurological diseases affect the young and economically active including epilepsy, multiple
sclerosis, traumatic brain injury and many of the inherited disorders. The neurodegenerative conditions, such as Parkinson’s disease, Alzheimer’s disease and motor neurone disease largely affect older people. With an aging population their incidence
is increasing. On the bright side our ability to treat them is improving.
What these conditions have in common is the potential for causing great disability. This may be intermittent as in migraine or epilepsy, permanent as in stroke or head injury or progressive as in multiple sclerosis and other
neurodegenerative disorders. Many of these conditions are Long Term Conditions which an individual will live with for many years. Individuals may need the help of a wide range of professionals who may be based in a variety of
organisations spanning health, social care and other sectors.
See also Dementia, Well-being.
Next of Kin
The term next of kin is widely used, but there is no statutory definition. In practice the general rule has been to recognise
spouses and blood relatives as next of kin.
See also Nearest Relative.
Comprehensive health system provided by the state and free at the point of delivery.
NHS Care Records Service
This will be an electronic store of over 50 million health and care records which can be accessed by health and
social care professionals, provided they have legitimate relationships, where and when they are needed. It will also give individuals secure internet access to their own health record.
See also HealthSpace, N3 - The National Network, NHS Connecting for Health, Spine.
NHS Connecting for Health
This is the agency that is responsible for the National Programme for IT, which promises to
modernise information and communications technology across the NHS and to provide the tools to help streamline healthcare services. It will establish a communications infrastructure to ensure that all computer systems can share
information, so that the right information is in the right place at the right time.
See also Local Service Providers, NHS Care Records Service, Programmes for IT, Spine.
NHS Data Dictionary
A collection of data items, their structure and definitions which are used within the NHS.
A 24-hour nurse-led telephone helpline contactable through a single national number: 0845 4647. It provides health
information and advice to callers with the aim of helping them look after self manage at home or if they need further professional help, directing them to the right service at the right time.
NHS Direct Online
NHS Direct online is the gateway to health advice and information on the internet. It includes an easy-to-use guide for
treating common symptoms at home and links to thousands of sources of help and advice.
See also HealthSpace.
NHS Foundation Trusts
A new type of NHS organisation. Independent public benefit corporations which are not-for-profit.
NHS Life Check
See Life Checks.
A website providing a gateway to, and register of, networks operating within the UK National Health Service.These networks are
intended to connect people and places to ensure that the good things that are happening in the NHS are known by and influence as many people as possible.
The Register of Networks maps
- What networks exist
- What unique knowledge and expertise they hold
- What connections they can make
Unique number identifying a patient. Eventually this number will be the key identifier in health and social care
Ten-year plan for the modernisation of the health service published in July 2000 with the aims of providing more choice, introducing
new services, reducing the time patients wait for appointments, and moving healthcare closer to people’s homes.
See also Modernisation Agenda.
Hospital or other organisation that operates as an independent commercial unit within the NHS.
NHS Walk-in Centre
See Walk-in Centre.
Notification Arrangements to Social Services
Part of the system designed to reduce the number of delayed transfers of
care under the Community Care (Delayed Discharges) Act 2003. NHS bodies have to make two notifications to the appropriate social services departments. The first, an Assessment Notification (Section 2), gives notice of the
patient’s possible need for services on discharge. Following this notification, social services departments have a minimum of three days to carry out an assessment and arrange care.
The second, a Discharge Notification (Section 5), gives notice of the day on which it is proposed to discharge the patient. These notifications should be part of existing or good practice information flows and are designed to ensure prompt
communication as part of the planning process, not to replace care plans.
See also Delayed Transfers of Care, Discharge, Reimbursement.
See National Programme for IT
See National Service Frameworks.
Care home that provides nursing care (with, generally, at least one registered nurse on duty). Under the
Care Standards Act 2000, which came into effect in April 2002, nursing homes were renamed ‘ care homes with nursing’.
See also Residential Home.
Obesity is excess body fat for a given height and gender. It happens when more calories are taken into the body than are burnt up in
a given period of time. Once adulthood is reached, everyone has a fairly steady rate of calorie burn-up, called the metabolic rate. This is higher in people who are regularly physically active. This means that someone who works in a very physical
job, such as a building-site labourer, may need as many as 4000-5000 calories per day to keep an even weight. This contrasts with an office worker who uses a car and doesn’t exercise, who may need only 1500 calories per day.
If calories in food energy are greater than the calories used every day, the excess energy is stored by the body as fat. This is important as a protection for the body against times of starvation. In developed countries, starvation is rare except in
extreme circumstances, so this insurance against hard times is hardly ever needed. Food is plentiful, and a lot of available food is much higher in calories than the human body was originally designed to cope with. The result is that eating more than
the body needs is easy. Obesity has become one of the most serious medical problems of the western world.
See also Coronary Heart Disease, Eating Disorders, Health, Stroke, Well-being.
In care planning, the "goal" is the end point (i.e. the final achievement aimed for). "Aims" are the
priorities set (i.e. what the plan is). "Objectives" specify how the aims will be achieved (i.e. how the outcome is mapped).
Routine assessment(s) of an individual’s condition.
The effect of work on your health and about making sure that you are fit for the work that you do.
See also Health, Manual Handling, Well-being.
Department for Work and Pensions strategy for "meeting the challenges of ageing in the 21st century" published in March
The strategy sets out a coherent framework for developing policies, and the principles that the Government believes must underpin progress. It represents the first ever cross-government strategy that looks specifically at the issues facing British
society as people live longer, healthier lives. The strategy addresses issues such as enabling people to extend their working life, supporting active ageing in our communities and giving people more choice and independence in how they use the
services at their disposal.
The Government’s key principles for Britain’s future society are:
Key to achieving this change will be a restructuring of local services to meet the needs of older people. This strategy also announces the piloting of ‘Link-Age Plus’ which will provide an even more fully integrated service
with local and central government working with local partners and groups to provide people with the services that suit them.
- Age and employment - The aspiration is for a million more older people in work. We will achieve this not by forcing people to work longer, but by helping older people who want to stay in or get back to work. This will mean: legislating
against age discrimination in the work-place; reforming Incapacity Benefit to support people back to work; and, giving the option of a lump sum, which could be worth up to £30,000 where people choose to take their state pension five years later.
- Active ageing in the community - Promoting active ageing through such measures as free off peak, local area bus travel so that older people can get about, providing more financial support for those who want to study, and tackling fear of crime
which can act as a barrier to social inclusion
- Independence and security - Promoting services which support independence and well-being, such as extending individual budgets to older people so that those who need care or other support can have choice and control over their package of support
instead of having one-size-fits-all services thrust upon them.
See also Single Assessment Process, Transformational Government.
The result or visible effect of an event.
Services provided in the evenings, at night and at weekends.
An individual visiting hospital for treatment without being admitted.
Holistic heath and social care assessment in which domains/sub-Domains of the single assessment process should be explored in order to identify risks, describe needs and to trigger any additional specialist assessments required. The assessment should be carried
out in a conversational style, following the person’s concerns rather than methodically working through each domain/sub-domains and its questions in sequence.
See also Care Plan, Care Programme Approach, Case Management, Comprehensive Assessment, Contact Assessment, Coordination, Single Assessment Process, Specialist Assessment.
Package of Care
See Care Package.
Improving the quality of life of an individual facing life-limiting illness and that of their family. Pain is prevented or
relieved by the early identification and holistic assessment and treatment of the pain itself and of other related physical, emotional, social and spiritual needs.
See also Bereavement, Cancer, End of Life care, Hospice Care.
See Patient Advice and Liaison Service.
More intense and interactive form of consultation that encourages greater involvement in exploring
issues and therefore an increased sense that people are sharing in the process of decision-making.
See also Disability, Learning Disability, Patient Advice and Liaison Service (PALS), Volunteering,
See Partnership Working.
See Partnership Working.
Different organisations such as social services departments, the NHS, and
the voluntary sector working together to achieve a common aim. The partnership ideal is one of independent and equal partners working together closely within a common framework.
See also Care Trusts, Health Act 1999 Partnership Arrangements (Health Act flexibilities), Section 31 Partnership Arrangements.
Partnerships for Older People Projects (POPP)
The Department of Health's Older People and Disability Division is leading a programme
'Partnerships for Older People Projects' (POPP). The strategic aim of the programme is to test and evaluate (through pilots to be established during 2006/07 and 2007/08) innovative approaches that sustain prevention work in order to improve outcomes
for older people.
DH are providing £60m funding to council-based partnerships to set up innovative pilot projects to:
The strategic aim of 'Partnerships for Older People Projects' is to test and evaluate innovative approaches that enable a sustained focus on prevention. It is expected that partnerships will demonstrate improved outcomes in:-
- provide person-centred and integrated care for older people
- encourage investment in preventative approaches which promote health, well being and independence for older people
- providing more low level care and support in the community with a view to preventing or delaying the need for higher intensity and more costly care
- reducing avoidable emergency admissions to hospital
- supporting more older people to live at home or in supported housing such as sheltered or Extra-care housing rather than in long-term residential care
See also Partnership Working.
See Person Centred Approach.
Patient Administration Systems
Hospital and Community based computer systems for administration of clinics and wards.
Patient Advice and Liaison Service (PALS)
Service supporting patients, carers and relatives, representing their views
and resolving local health difficulties speedily.
See also Patient and Public Involvement (PPI) Forums.
Patient and Public Involvement (PPI) Forums
The Commission for Patient and Public Involvement in Health’s role is to make sure the public is
involved in decision making about health and health services in England. There are 572 Patient and Public Involvement (PPI) Forums, one for each NHS Trust in England. They are working with all sectors of the community and finding out what people
really think about health in their local areas.
See also Patient Advice and Liaison Service (PALS).
Patient Centred Care
See Person Centred Approach.
See Care Pathway.
Patients at Risk of Re-hospitalisation (PARR)
As part of the long term conditions agenda, the King's Fund has been commissioned by Essex
Strategic Health Authority on behalf of the 28 strategic health authorities, the Department of Health and the NHS Modernisation Agency to develop a software tool for use by Primary Care Trusts (PCTs) to
systematically identify individuals who are at high risk in the future of readmission to hospital via emergency admissions.
Once PCTs have identified their high risk individiuals, referred to as Very High Intensity Users (VHIUs), they will be offered care using a case management approach to provide more proactive, co-ordinated
and joined-up care in community settings. Delivery of care for these individuals will be led using a Case Manager, usually a community matron. Evidence at home and abroad has shown that intensive, on-going and personalised case management for
individuals with multiple or single complex conditions can improve their quality of life and outcomes, thus dramatically reducing emergency hospital admissions.
The Parr tool it is freely available (please see web sites).
Payment by Results (PbR)
Aims to provide a transparent, rules-based system for paying NHS trusts for the services that
they provide. Payment will be linked to activity. The Government hopes that this system will ensure a fair and consistent basis for hospital funding. Under the reforms to NHS Financial Flows, instead of being commissioned through block agreements as
happened previously, hospitals (and other providers) will be paid for the activity that they undertake.
See Primary Care Trust.
See Personal Development Plan.
Plan, Do, Study, Act: a model for testing ideas that might need improvement. Starts with small changes that can build into larger
service improvements through successive quick cycles of change.
Each local authority area has a visiting service delivered by the Pension Service Local Service. They
visit vulnerable older people to gather evidence to assess their entitlement to benefits. Visits are arranged by the Pension Service, or by direct referrals from any source.
See also Advice, Joint Visiting Teams, Pensions.
A pension (also known as superannuation) is a retirement plan intended to provide an individual with a secure income for life. The
common use of the term is to describe the payments an individual receives upon retirement.
See also Advice, Benefits.
Performance Assessment Frameworks
A structure for health and social care organisations to review their performance.
See also Audit Commission, Commission for Social Care Inspection, Healthcare Commission, Performance Indicators, Performance Ratings.
Ways of measuring particular aspects of what an organisation does and comparing its performance against targets.
See also Audit Commission, Commission for Social Care Inspection, Healthcare Commission,Performance Assessment Frameworks, Performance
Performance ratings for NHS Acute Trusts, Primary Care Trusts and Mental Health Trusts in England carried out by the Healthcare Commission. This is done through the Annual Health Check. It scores NHS trusts on many aspects of their performance, including the quality of the
services they provide to patients and the public and how well they manage their finances and other resources such as their property and staff. These scores are based on a range of information gathered throughout the year. This includes information
collected through various service reviews and inspections, as well as the data collected by other organisations, such as the Commission for Social Care Inspection, the Mental Health Act Commission and the Criminal Records Bureau.
Social Services also receive performance ratings. These are formulated from evidence from published performance indicators, by the Commission for Social Care Inspection (the
single, independent inspectorate for all social care services in England), review of plans and in year performance information from both the Commission for Social Care Inspection and the external auditors for each council. Separate judgments for both
adults’ and children's services are included.
See also Audit Commission, Performance Assessment Framework, Performance Indicators.
Person Centred Approach
Person centred approaches are ways of commissioning, providing and organising services rooted
in listening to what people want, to help them live in their communities as they choose. These approaches work to use resources flexibly, designed around what is important to an individual from their own perspective and work to remove any cultural
and organisational barriers. People are not simply placed in pre-existing services and expected to adjust, rather the service strives to adjust to the person.
Under Person Centred Care, Standard 2 of the NSF for Older People, people should participate and be treated as individuals, receiving appropriate and timely support/care that meets their needs.
For people with learning disabilities, Person Centred Planning is a process for continual listening and learning, focussing on what is important to someone now and in the future, and acting upon this in alliance with their
family and friends. This listening is used to understand a person’s capacities and choices.
The importance of a Person Centred approach has also been reinforced with its inclusion in the NSF for Long Term Conditions (2005); with the movement towards dignity in a hospital setting; and an
increasing awareness of how important it is when working with people who have dementia, concentrating on what they can do, not on what they are not able to do.
Health and social care agencies are increasingly using ‘individual’ or ‘person’ or ‘citizen’ as a term in place of traditional, organisational specific terms such as customer, client, service user and (when appropriate) patient.
See also Case Management, Care Plan, Continuity of Care, Coordination, Dignity, Expert Patient Programme, Mental Health, Participation, Privacy, Self Care/Self Management, Single Assessment Process, Valuing People,.
Person Held Records
Information held by the assessed individual containing records from health and social care professionals involved in the
See also Care Plan, Participation, Self Assessment, Self Care/Self Management, Single Assessment Process.
Personal Demographics Service (PDS)
Application of the national Spine. Demographic information for every individual
covered by the NHS in England, e.g. address details, held nationally and accessible through local systems,
The Personal Demographics Service (PDS) is an essential element of the NHS Care Records Service (NHS CRS) which will underpin the creation of an electronic care record for every registered NHS patient in England by 2010.
See also NHS Care Records Service, NHS Connecting for Health, Personal Spine Information Service (PSIS).
Personal Development Plan (PDP)
Plan setting out the training and work experience a care professional requires helping them to do their job
See also Appraisal, Joint Staff Development/Training.
Personal Medical Services (PMS)
Allows GPs to enter into a more flexible contract with their health authority. PMS aims to improve access to and the quality of services within primary care; recruit and retain GPs in areas of greatest need; develop new ways of delivering services; reduce bureaucracy; and help integrate services.
Personal Spine Information Service (PSIS)
Application of the national Spine. The national repository that holds personal health information
for an individual, e.g. drug allergies, details of operations and/or conditions, medication history, pathology, radiology and other results - and a summary of contacts with care providers.
See also NHS Care Record Service, NHS Connecting For Health, Person Demographics Service (PDS).
Personalised Care Plans
See Care Plan
Animals kept for companionship or other, non-economic, reasons. There is a wide body of evidence that pet ownership can be beneficial
for human health.
Picture Archiving and Communications System (PACS)
A system enabling images such as X-rays and scans to be stored and sent electronically so
that doctors and other health professionals can access the information.
See also NHS Care Record Service, NHS Connecting For Health.
Plan of Care / Care Plan
See Care Plan.
In the acute sector this means care provided typically in hospital or following referral from a primary
or community health professional. The care is therefore intended rather than taking place on an emergency basis.
See also Secondary Care.
See Personal Medical Services.
Funding contributed to by health authorities, primary care trusts and local
authorities to meet the needs of a specific group, e.g. older people. Pooled budgets were introduced under the Health Act 1999.
See also Health Act Flexibilities.
See Partnerships for Older People Projects.
Term used to describe an internet web site that is or intended to be the first place people see when using the World
Wide Web (www). Typically a "Portal site" has a catalogue of web sites, a search engine, or both. A Portal site may also offer email and other services as their main "point of entry" (hence "portal") to the Web.
Action taken to promote the best interests of the person. See also Discrimination.
State of being deprived of the essentials of well-being such as adequate housing, food, sufficient income,
employment, access to required social services and social status.
See also Benefits, Social Exclusion, Social Policy.
Power of Attorney
Legal document allowing someone else to manage another person’s affairs, or specific elements of their affairs, on their
behalf. If the individual has a physical illness or an accident resulting in physical injury and they want someone else to look after their affairs, they should create an ordinary power of attorney. However, an ordinary power of attorney should not
be used if the individual has been diagnosed as having, or likely to develop, any mental illness or degenerative disease that can lead to mental incapacity; this is because an ordinary power of attorney automatically comes to
an end if you lose your mental capacity.
See also Enduring Power of Attorney.
Practice Based Commissioning
Enables GP’s to commission care and other services that are directly tailored to the needs of their patients.
Practices can keep up to 100 percent of any savings made by agreement with the local Primary Care Trust (PCT).
See also Commissioning a Patient-led NHS
Term used for qualified social workers/care managers and other professionals from health and social care.
See also Clinician
The wishes, views and choices of individuals about their language and communication, beliefs, personal care, where they wish to
live, how their independence and potential can be maximised and how they should be treated.
Services provided by family doctors, dentists, pharmacists, optometrists and ophthalmic medical practitioners, together with
district nurses and health visitors. Primary care teams are grouped within primary care trusts.
Primary Care Trust (PCT)
Local NHS organisation responsible for the provision of primary care and community based health services (also secondary care) and the commissioning, administration and performance management of healthcare within a defined geographical area. PCT’s work closely with clinicians and practitioners
and other organisations such as acute trusts and local authorities, particularly social services.
Put more simply, it is the care provided to the public when they first have a health problem. They must also make sure that all other health services are provided, including hospitals, dentists, opticians, mental health services, NHS Walk-In Centres,
NHS Direct, patient transport (including Emergency Departments), population screening, and pharmacies. All of these services are managed by your local Primary Care Trust (PCT).
PCT’s work with local authorities and other agencies that provide health and social care locally to make sure that their local community's needs are being met. They must make sure there are enough services for people within their area and that these
services are accessible.
The number of PCT’s in England was reduced from 303 to 152 in October 2006. It is hoped this reduction will result in: a closer relationship between health, social care and emergency services; improved and better value services for individuals;
better emergency planning with more resources to respond to major incidents and ensure service continues as normal; more money for frontline services.
See also Ambulance Trusts, Commissioning a Patient-led NHS, 18 Weeks Delivery Programme, Patients at Risk of Re-hospitalisation, Practice
Based Commissioning, Strategic Health Authority.
Prison Health is a partnership between the Prison Service and the Department of Health working to improve the standard of
health care in prisons. The aim is to provide prisoners with access to the same quality and range of health care services as the general public receives from the NHS. Budgetary responsibility for prison health has been transfered from the Prison
Service to the Department of Health. In addition a timetable of April 2006 has now been agreed for full devolution of commissioning responsibility to Primary Care Trusts (PCTs).
Extremely important issue for the people social care and health care professionals work with in the community and in hospital. A good
practice example is a quiet area on a ward where confidential matters can be discussed without anyone else overhearing.
See also Consent, Dignity, Person Centred Approach.
Organisations and individual proprietors that own and run services for a profit, including care homes
for older people, clinics and hospitals, nursing agencies and domiciliary care services.
Series of connected steps or actions to achieve an outcome.
A way of visually showing the workings of a system to help develop understanding of a person’s experience at various stages
of their health and social care journey.
The outcome of process mapping. Changes should focus on the individual’s care and experience, not on
the needs of staff, departments or organisations.
Prediction of the course and probable outcome of a disease.
Programmes for IT
A protocol is a rule which guides how an activity should be performed.
See also Information Sharing Protocol.
Organisations or care staff that supply services.
See Health Protection Agency, Immunisation.
Budget-holding body that buys health or social care services from a provider on behalf of local people or
individuals with specific needs.
Quality and Outcomes Framework
As part of a new NHS contract, introduced in 2004, GP practices are rewarded for achieving clinical and
management quality targets and for improving services for people within a Quality and Outcomes Framework. It sets out a voluntary system of financial incentives for improving quality within the General Medical Services contract
for GP payments.
A group of people defined by race, colour, nationality and ethnic or national origins. All racial groups are protected from
unlawful racial discrimination.
See also Anti-discrimination Policy, Anti-discriminatory Practice, Culture, Diversity Policy, Empowerment, Ethnicity, Ethnic Monitoring, Person Centred Approach, Racism.
Belief (conscious or unconscious) in the superiority of a particular race, leading to acts of discrimination
and unequal treatment based on an individual’s skin colour or ethnic origin or identity.
See also Anti-discrimination Policy, Anti-discriminatory Practice, Culture, Diversity Policy, Empowerment, Ethnicity, Ethnic Monitoring, Person Centred Approach.
See Referrals, Assessments and Packages of Care.
The active process of regaining skills, confidence and independence.
Under the Single Assessment Process, there is a requirement to periodically re-assess the risks and needs
of individuals as part of a review.
Request to a health or social care agency for assistance or specific action. Under the Single Assessment Process, a referral would usually be sent with basic personal information and assessment information already gathered to trigger a specialist assessment. Individuals
may self refer or re-refer themselves as their care needs change.
Referrals, Assessments and Packages of Care (RAP)
Department of Health statistical return, covering the services
provided or purchased as part of care packages principally for supporting people living in their own homes. The returns also collect information on referrals to social services and the assessment
A refugee is someone who:
Refugees are entitled to benefits.
- has a well-founded fear of persecution for reasons of race, religion, nationality, membership of a particular social group, or political opinion;
- is outside the country they belong to or normally reside in; and
- is unable or unwilling to return home for fear of persecution.
See also Asylum Seekers.
The individual 'local' organisation that is responsible for maintaining the list of system users and verifying their
identities to government standards, before issuing a smartcard. Arrangements are in place for social care professionals to be registered through NHS organisations, normally PCT's.
See also N3 - The National Network.
A multidisciplinary process which supports the individual to achieve their maximum potential to function physically, socially
and psychologically through support and intervention.
See also Activities of Daily Living, Intermediate Care, Telecare, Telehealth.
The Community Care (Delayed Discharges) Act 2003 introduced new obligations for health and social care partners in England
relating to hospital discharge arrangements.
This includes a financial obligation for local authorities to reimburse acute trusts if social care assessments and necessary social care services are the sole reason that hospital discharge is delayed.
Acute trusts will be obliged to notify social services departments of inpatients likely to need community care services.
See also Delayed Transfers of Care, Discharge, and Notification Arrangements.
The term religion - sometimes used interchangeably with faith or belief system - is commonly defined as belief concerning the
supernatural, sacred, or divine, and the moral codes, practices and institutions associated with such belief. In its broadest sense some have defined it as the sum total of answers given to explain humankind's relationship with the universe. In the
course of the development of religion, it has taken a huge number of forms in various cultures and individuals.
See also Community, Culture.
Care home that does not provide nursing care. Under the Care Standards Act 2000, which came into
effect in April 2002, all homes, including residential homes, are defined as ‘care homes’.
See also Nursing Home.
Listening to and treating people considerately in day-to-day situations, trying to understand individual values, views, opinions and preferences. Dignity involves the earning or the expectation of personal respect or of esteem.
Short-term care for a person to allow their carer a break from caring.
Formal re-evaluation of an individual’s assessed risks, needs and personalised care plan at an arranged time. Informal reviews should take place as required.
See also Care Management, Case Management, Continuity of Care, Coordination, Long Term Conditions, Monitoring,
Re-Assessment, Self Care/Self Management, Single Assessment Process.
The rights that individuals have to:
- be respected
- be treated equally and not be discriminated against
- be treated as an individual
- be treated in a dignified way
- be protected from danger and harm
- be cared for in a way that meets their needs, takes account of their choices and also protects them
- access information about themselves
- communicate using their preferred methods of communication and language
The government's practice of restricting a budget it gives organisations (such as local authorities and hospitals), so that that
budget cannot be used for any other than the purpose for which the money was raised.
Any social (e.g. domestic violence), economic (e.g. poverty), biological (e.g. inheriting a breast cancer gene), behavioural
(e.g. smoking) or environmental (e.g. poor housing, pollution) factor that is associated with or can cause an increased risk of a particular disease, injury or physical or mental illness.
A systematic approach to reducing loss of life, financial loss, loss of staff availability, safety, or loss or reputation.
Risk, Risk Assessment
When the holistic assessment is completed, the assessor and the individual should consider and
evaluate conclusions on the risks and needs. This evaluation should take full account of the likely outcome if assistance were not to be provided.
The evaluation of risk should focus on the following aspects that are central to an individual’s independence: autonomy and freedom to make choices; health and safety including freedom from harm, abuse
and neglect, taking wider issues of housing circumstances and community safety into account; the ability to manage personal and other daily routines; and the involvement in family and wider community life, including leisure, hobbies, unpaid and paid
work, learning and volunteering.
Assessors should also consider risks faced, not only by the person assessed, but by those close to them, such as carers (and to staff and society) They should consider which risks cause serious concern and which may be
acceptable or can be viewed as a natural and healthy part of independent living.
See also Adult Protection.
Role Based Access Control (RBAC)
Everyone accessing the NHS Care Record Service will be subject to RBAC. It will
include what information can be accessed, how a system user can access it and the system user’s role. A single system user will be able to have multiple role profiles (e.g. if doing two different jobs with different access requirements). Staff
accessing the system will need a smartcard and pin number which will contain information on their level of access.
See also Legitimate Relationship, Registration Authority.
See National Patient Safety Agency (NPSA).
See Single Assessment Process.
The booking of all necessary resources (people, places, equipment, investigations, interventions and events) associated with the
diagnosis, treatment and care management of the patient.
A streamlined health and social care pathway, from the initial contact to closure with an individual,
with as few hand-offs as possible.
Hospital Care resulting from a referral by a health professional in primary
See also Planned Care.
Section 31 Partnership Arrangements
Set up to obtain the best public services, which will protect and improve people’s health and wellbeing. Section 31 arrangements, in the Health Act 1999 partnership arrangements, have been developed to give the NHS and local
authorities the flexibility to be able to respond effectively to improve services, either by joining up existing services, or developing new, co-ordinated services, and to work with other organisations to make this happen.
See also Care Trust
Under the Mental Health Act 1983. Typically Section 2 for Assessment and Section 3 for Treatment.
See also Care Programme Approach (CPA), Compulsory Admission, Mental Health Act Assessment, Mental Heath, Mental Heath Trust, Nearest Relative.
An assessment that is completed by the subject of the assessment without the immediate professional involvement. This may
range from structured questionnaires distributed by and returned to professionals for interpretation and further action where required, to systems that define need from the individual’s perspective and facilitate care planning by the individual
Self Assessment is a process in which an individual determines his or her level of knowledge, skills, risks and needs.
People with long term health and social care needs often have been assessed by local social services on their eligibility (FACS) for equipment, fittings and home care.
August 2006, 11 Self Assessment pilot projects have given people the option to self assess their need for home care and equipment and help determine whether self assessment schemes are a feasible option for individuals with long term health and
social care needs. A number of the pilots also focus on groups in the community whose needs can be difficult to meet, such as minority ethnic groups and people living in rural areas.
The self assessment pilots will run until the end of September 2007.
See also Assessment, Care Plans, Case Management, Common Assessment Framework for Adults, Comprehensive Assessment, Community Equipment Service, Contact Assessment, Direct Payments, Fairer Charging, Holistic Assessment, Holistic
Care, Individual Budgets, Long Term Conditions, Overview Assessment, Person Centred Approach, Referral, Self
Care/Self Management, Single Assessment Process, White Paper on Community Health and Social Care Services.
Self Care/Self Management
With the appropriate support, many people can learn to be active participants in their own health and social care, living with and managing their conditions and meeting their own needs. This can help to prevent complications, slow down deterioration and even avoid getting
further conditions and increased needs. The majority of people with long term conditions fall into this category - so even small improvements can have a huge impact. The development of direct payments and
individual budgets for social care can be seen as important developments in the area of self management.
See also Care Plan, Case Management, Coordination, Expert Patient Programme, Long Term Conditions, Participation, Person Held Record, Self Assessment, Single Assessment Process.
The capacity of an individual to manage their own affairs, make their own judgments, and provide for themselves.
Self Harm / Self Injury
When an individual damages or injures their body on purpose. Self harm/self injury is a way of expressing deep
emotional feelings or problems that build up inside.
See also Abuse, Depression, Health, Loneliness, Mental Health, Suicide, Well-being.
See also Tendering.
An individual receiving health and/or social care services.
See also Person Centred Approach.
Prejudice or discrimination based on gender.
Sexually transmitted disease (STD)
See Sexually Transmitted Infection.
Sexually transmitted infection (STI)
Infections that can be passed on through sexual contact. Anyone who has sex can get an STI. You don't
need to have lots of sexual partners. Both men and women can get, and pass on, STIs.
Most STIs are easily treated, but treatment should be started as soon as possible. For some infections, such as HIV, there is currently no cure and the treatment can be complicated. If left untreated many STIs can be painful and
uncomfortable or, at worst, cause permanent damage to your health and fertility.
See also Health, Well-being.
Accompanying a professional involved in providing health and social care on a typical working day in order to learn about their
knowledge, tasks, priorities, problems and pressures.
See also Joint Staff Development/Training.
Theoretical framework that promotes good practice by providing a common set of values and principles
within which to work.
Accommodation (usually one-bedroom flats/studio apartments) for older people who can live independently with the assistance
of a scheme manager or warden. Laundry facilities and a communal lounge are generally provided.
See also Extra Care Housing.
A short break, sometimes known as respite care, is when a carer and individual get a chance to spend some
time apart. This gives the carer a break from the caring role. It also gives the individual the chance to experience new opportunities.
Single Assessment Process
Standardised holistic assessment framework across health and social care so duplication is
minimised and an individual receives timely and proportionate assistance appropriate to their risks and needs. The Single Assessment Process aims to put individuals at the centre of their own assessment and subsequent personalised care planning. Originally brought in for older people, it is increasingly being used as the framework for other adult groups.
See also Advocacy, Assessment, Assessment Tools, Care Plan, Care Programme Approach (CPA), Case Management,
Common Assessment Framework for Adults, Comprehensive Assessment, Contact Assessment, Continuity of Care, Coordination, Domains/Sub Domains, Holistic Care Process, Joint Staff Development/Training, Long Term Conditions, Overview Assessment, Participation, Person Centred Approach, Self Care/Self Management, Specialist Assessment, Transformational Government, White Paper on Community Health and Social Care Services.
Single Point of Access(SPA)
Central point across a range of services to which referrals are sent.
Credit card type issued by a Registration Authority which, together with a PIN, is the only way a system
user can log onto the NHS Care Record Service system.
See also NHS Connecting for Health, Role Based Access Control (RBAC).
The effort it takes to stop smoking tobacco products. With nicotine an addictive substance, many people find it hard to
stop smoking without help.
See also Asthma, Health, Well-being.
SNOMED CT has been adopted as the NHS Standard for clinical terminology. A common computerised language that will be used by NHS Care Records Service to facilitate electronic communications between professionals in clear and unambiguous terms.
See also NHS Connecting for Health, Coding
Care provided to support an individual’s social as opposed to health care needs, whether by statutory or non-statutory
Social care is one of the major public service areas. At any one time, up to 1.5 million of the most vulnerable people in society are relying on social workers and support staff for help. Social care services also make a major contribution to
tackling social exclusion. Currently, modernising social services is a national priority, and to have the greatest effect this must happen in conjunction with the modernisation of the NHS.
Social care comes in many forms. Adults can be supported in the community through home care, sitting, meals and day services or through residential or nursing home care. Children and families are supported at home through a wide range of child
protection, social work, early years and other services. Sometimes fostering, adoption and residential care services may be an option.
Social care services are provided for people who need help to live their lives as independently as possible in the community (either at home or in care settings), people who are vulnerable and people who may need protection . Each
Local Authority will tailor its services to meet the needs of local people. It does this within a framework of duties, responsibilities and national standards laid down by central Government.
See also Assessment, Care Trust, Single Assessment Process, Social Services, Social Service Departments, White Paper
on Community Health and Social Care Services.
Social Care Online
Information and research on all aspects of social care. Content is drawn from a range of resources including journal
articles, websites, research reviews, legislation and government documents, and knowledge from the general public.
See also National Electronic Library for Health (NeLH), National Knowledge Service
Socially excluded people or areas that suffer from a combination of factors including unemployment, high crime, low incomes,
poor housing and transport, mental health problems, being a refugee or an asylum-seeker.
See also Social Inclusion.
Policies designed to promote equality of opportunity and minimise social exclusion. Social inclusion
aims to tackle the problems as a whole rather than the individual elements.
See also Person Centred Approach.
Social Model of Disability
Social Model of Health
Model or philosophy of health based on the premise that illness has sociological and psychological causes, and can
therefore be cured either by structural changes within society or by psychological intervention (e.g. by tackling poverty and social exclusion and/or help through the talking therapies).
See also Medical Model of Health.
The study of social welfare, its relationship to politics and society and the range of responses to social need.
See also Social Exclusion, Poverty.
Personal social services is one of the major public services and describe a wide range of support that help people to carry
on in their daily lives.
They are provided by Local Authorities and by the independent sector and voluntary sector. Local Authorities with social services responsibilities have a statutory responsibility to
ensure that the social care needs of people are met.
- services for children such as adoption, fostering and protection
- help for people with mental health needs
- support and care services for older people
- support for people with a disability and people with learning disabilities.
The term social care is increasingly now being used instead of social services. This reflects the greater involvement of the independent sector andvoluntary sector in the provision of social care services and the continuing role of of the statutory
sector as commisioners as well as providers of support and care. Social services functions in many authorities no longer stand alone, but are increasingly combined with housing, education and the NHS.
Local Authorities are expected to provide accessible information about their services. Once an individual has been in contact with their Local Authorities social services they will be able to find out if they, or their carer, are eligible to receive
social services help. An assessment may follow to determine the level of need and to identify services that can be provided. Where services are to be provided it is usual for someone from the social services to visit the
individual at home (or wherever they are being supported) and to work out with them what is the best way to meet their needs.
See also Assessment, Care Trust, Single Assessment Process, Social Service Departments, White Paper on Community Health and Social Care
Social Services Department
A statutory agency and department of a local authority, providing needs
assessments to determine an individual’s eligibility for assistance and ascertain how support can be given to meet eligible needs. Also provides and purchases a range of residential, day and domiciliary care packages to
support people in need.
See also Assessment, Community Care Plan, Single Assessment Process, Social Care, Social Services, White Paper on
Community Health and Social Care Services.
See Single Point of Access.
Under the Single Assessment Process, specialist assessment offers a way of exploring specific
needs, in detail, and may be triggered by a contact or overview assessment. Specialist assessments, and associated scales, should be carried out by the most appropriate health and social care
A specialist assessment may not require a formal assessment tool, though some professionals will have access to specific specialist tools. At the end of the assessment, the professional needs to be able to communicate their findings both to the
assessed individual and to other professionals, particularly the identified Coordinator. This, in turn, will assist in the development of an overarching care plan for the assessed person.
See also Care Plan, Care Programme Approach, Case Management, Contact Assessment, Comprehensive Assessment, Coordination, Long Term Conditions, Medication Management, Overview Assessment, Single Assessment Process.
Specialist Library for Ethnicity & Health
See National Library for Health - Specialist Library for Ethnicity & Health
Service specialising in the care of particular groups, or conditions, of people.
See Comprehensive Spending Review (CSR).
The name given to the national database of key information about an individual’s health and care and forms the core of the NHS Care Records Service. It will include information like NHS number, date of birth, name and address, and clinical information such as allergies, adverse drug reactions and major treatments.
See also NHS Connecting for Health, Personal Spine Information Service (PSIS), Person Demographics Service (PDS).
Care purchased by a Social Services Department from an independent supplier who provides a service (e.g.
specialist home care) after an assessment of need has taken place.
See also Block Contract.
Person or organisation with a direct interest in a service or practice.
See Performance Rating.
Agencies of central or local government (e.g. local authorities, health authorities) set up by Parliamentary Acts.
See also Health and Social Care Communities, Independent Sector, Voluntary Sector.
Unit providing an interim placement for a person awaiting a long-term home of their choice.
Strategic Health Authority (SHA)
Statutory agency responsible for strategic planning and performance management of health services in their
area. Strategic health authorities were formed in April 2002; there were 28 in England.
In July 2006 the Department of Health reduced this number to 10 to ensure the NHS is structurally able to deliver the next stage of health reforms.
Strategic Health Authorities are responsible for:
Strategic Health Authorities manage the NHS locally and are a key link between the Department of Health and the NHS.
See also Commissioning a Patient-led NHS, Practice Based Commissioning.
- Developing plans for improving health services in their local area
- Making sure local health services are of a high quality and are performing well
- Increasing the capacity of local health services - so they can provide more services
- Making sure national priorities - for example, programmes for improving cancer services - are integrated into local health service plans
Strategies used by human resource departments to manage stress in their workforce.
There are two types of stroke.
There are also events which might be called strokes or might be called cerebrovascular accidents, which have similar results to strokes. An example of this would be an aneurism in the brain. This is a swelling of an artery, which balloons outwards
and can damage or destroy brain cells as it does so.
- The most common are ischaemic strokes, caused by a blockage in an artery which affects blood flow to, or within, the brain. A TIA, or Transient Ischaemic Attack, is a mini-stroke that may last for less than one minute with the effects
disappearing in less than 24 hours. A TIA should be taken seriously as it may presage a full stroke.
- A haemorrhagic stroke, also called a brain haemorrhage is where there is a bleed in the brain.
The damage to the brain caused by a stroke is caused by oxygen starvation in the case of an ischaemic stroke. In the case of a brain haemorrhage, the pressure of the escaping blood damages or destroys brain cells.
Taking illegal drugs or medicine without medical supervision or, in the case of alcohol, consuming enough to put at risk
physical or mental health.
See also Alcohol Misuse, Drug Misuse.
The act by an individual to intentionally kill himself/herself. The suicide rate has been falling since 1991, but there are still
more than 5,000 suicides in the UK each year, many of whom are men aged between 15-44. ‘Attempted suicide’ (also known as parasuicide, or deliberate self-harm) is the act of unsuccessfully trying to kill yourself, or hurting
yourself intentionally. This is much more common than completed suicide and there are at least 140,000 cases each year in England and Wales.
Depression is the most common reason why someone may have thoughts of suicide and
most suicides are linked to depression in some way. If an individual is feeling depressed or suicidal it is important that receive immediate assistance through the people closest to them, their GP or other relevant resources.
See also Abuse, Bereavement, Mental Health, Loneliness, Health, Rape, Self Harm, Well-being.
A process in which a health and social care manager supervises a member of staff to meet organisational, professional and
personal objectives. Objectives can include competent, accountable performance, continuing professional development, and personal support to assist in their post. Supervision can also be done on a group, team or peer basis.
Includes all sources of living that enable an individual to live with dignity and respect
in the community. Support encompasses housing, food, clothing, health, nursing, and medical needs, along with access to social activities.
See also Individual Budgets, Person Centred Approach, Self Care/Self Management.
An organised network of people with something in common who give and receive help, advice, friendship and emotional support.
Supporting People Programme
A programme involved with how the funding and planning of housing related support services are delivered in an
individual’s home. It funds, for example, staff based in hostels for homeless people and support workers in group homes for people with learning disabilities. One way in which this type of service is provided is that through
sheltered housing wardens. Wardens help with day-to-day needs, but do not provide personal care. The aim of the programme is to assist people to continue to live independently and, where possible, to progress to a more
A government programme to achieve better outcomes for children and parents through increased availability to childcare, improved
health and emotional development for young people, and better parental support. Now being developed for older people, to tackle exclusion in later life - as stated in the report; A Sure Start to Later Life: Ending Inequalities for Older People.
See also Social Exclusion, Sure Start to Later Life.
Sure Start to Later Life
Final report from the Social Exclusion Unit, published on 26 January 2006, detailing government plans to alleviate
the exclusion, poverty and isolation experienced by older people based on the Sure Start model created for children and families. The aim is to locate a single, accessible gateway to wide ranging services
in the community, where potential problems are identified quickly and prevented from becoming worse. A pilot programme called 'Link-Age Plus' will test out the Sure Start approach for older people. The model will also be piloted
through other programmes including Partnerships for Older People Projects, Local Area Agreements and supported by the White Paper on Primary and Community Care.
See also Sure Start.
The extent to which new ways of working and improved outcomes become the standard, the thinking and attitudes behind them are
fundamentally altered, and the systems surrounding them are transformed.
A group of people, each of whom possesses particular expertise; each of whom is responsible for making individual decisions; who
hold together a common purpose; who meet together to communicate, collaborate and consolidate knowledge from which plans are made; actions determined and future decisions influenced.
A combination of equipment, monitoring and response that can help individuals to remain independent at home. It can include basic
community alarm services able to respond in an emergency and provide regular contact by telephone as well as detectors which detect factors such as falls, fire or gas and trigger a warning to a response centre. Telecare can work in a preventative or
monitoring mode, for example, through monitoring signs, which can provide early warning of deterioration, prompting a response from family or professionals. Telecare can also provide safety and security by protecting against bogus callers and
See also Assistive Technology, Activities of Daily Living, Community Equipment Service, Rehabilitation, Telehealth, Telemedicine, Whole System Long Term Conditions (LTC) Demonstrator Programme.
The delivery of health related services and information via telecommunications technologies. Telehealth is an expansion of the
functionality of Telemedicine and encompasses prevention, treatment, cure and health promotion aspects. Telehealth is generally used as an umbrella term to
describe all the possible variations of health care services using telecommunications.
See also Assistive Technology, Activities of Daily Living, Community Equipment Service, Rehabilitation, Telecare, Whole System Long Term Conditions (LTC) Demonstrator Programme.
The practice of medical care using interactive audio visual and data communications, this includes the delivery of medical care,
diagnosis, consultation, and treatment, as well as health education and the transfer of medical information.
See also Assistive Technology, Activities of Daily Living, Community Equipment Service, Rehabilitation, Telecare, Telehealth, Whole System Long Term Conditions (LTC) Demonstrator Programme.
Process of bidding to develop and run services. Inviting organisations to bid is also referred to as tendering. The service to be
developed is usually described in a service specification.
Language used in health and social care. Department of Health guidelines for implementing the Single Assessment Process require agencies to agree a common terminology for assessment and other care processes
Complex or highly specialist health care that is provided in Tertiary Care centres (usually in regional or national centres of
Term used to describe the range of institutions which occupy the space between the State and the private sector. These include
small local community and voluntary groups, registered charities both large and small, foundations, trusts and the growing number of social enterprises and co-operatives.
Third sector organisations share common characteristics in the social, environmental or cultural objectives they pursue; their independence from government; and in the reinvestment of surpluses for those
See also Religion, Social Exclusion.
Under the Single Assessment Process, assessment should take place at an appropriate and suitable time for the
individual and their carer(s).
Term used in hospitals when following the individual along their care pathway. Monitoring the patient’s progress can help to identify unnecessary delays and create continuity of care.
The single assessment process set out a strategy for joint staff development for localities to follow. It
emphasised that staff should be equipped to carry out person centred care, be skilled at joint working and be knowledgeable about the health and social care concerns of the individuals
assessed and then supported.
See also Case Management, Joint Staff Development/Training, Long Term Conditions .
Transaction and Messaging Spine (TMS)
The message handling application element of the national Spine.
When the care of an individual is passed from
See also Person Centred Approach, Single Assessment Process.
- one professional to another and/or
- one agency to another and/or
- one location to another.
The Government published ‘Transformational Government - Enabled by Technology’ in November 2005. The strategy is
about transforming public services as citizens receive them and demonstrating how technology can improve the corporate services of government so more resources can be released to deliver ‘frontline’ services.
The strategy sets out how effective use of technology to deliver services designed around the needs of citizens and businesses can make a real difference to people’s lives.
The Prime Minister commissioned this strategy to seize the opportunity provided by technology to transform the business of government. Technology has a major part to play in the solutions to each of three major challenges which globalisation is
setting modern governments - economic productivity, social justice and public service reform. Only a strategic view will enable the United Kingdom to use technology decisively and effectively across government to meet its national objectives.
In particular, the strategy is directed to provide overall technology leadership in three key areas:
- The transformation of public services for the benefit of citizens, businesses, taxpayers and front-line staff.
- The efficiency of the corporate services and infrastructure of government organisations, thus freeing resources for the front-line.
- The steps necessary to achieve the effective delivery of technology for government.
See also Link-Age Plus, Single Assessment Process.
Refers to temporary care provided to an individual who is not able to be placed in their home or the permanent setting of
their choice but who still requires a supportive, and appropriately staffed, environment to live in. It can be used, for example, while someone is awaiting major adaptations to their own home.
See also Intermediate Care.
The written conversion of one language to another. Local health and social care agencies will have links with interpreting and translating services.
See also Interpreting.
Transport and travel
Transport provides an essential link to friends, family and the wider community - a vital lifeline to maintaining
independence. Research has shown that a lack of mobility can prevent older and disabled people from participating in social activities and lead to low morale, depression and loneliness. It can also impact upon others, such as carers, social services
and health agencies.
Any injury, whether physically or emotionally inflicted
Health care that is intended to relieve illness, injury, mental health problems etc.
See also Disease, Diagnosis, Health, Mental Health, Wellbeing.
Treatment Centres provide fast pre-booked surgery and diagnostic tests for patients. They often, though not exclusively,
concentrate on procedures with the highest historic waiting times for treatment, for instance in orthopaedics and ophthalmology.
See Care Plan.
A system of sorting individuals into groups depending on how ill they are. A process in which things are ranked in terms of importance
or priority. Normally used regarding allocating scarce resources during medical or other emergencies
Unified Assessment Process (UAP)
The equivalent, in Wales, of the Single Assessment Process.
Social care needs that are not met either because there are not enough resources or because the services are not of a sufficiently
Additional review undertaken when an individual’s circumstances have changed.
See Person Centred Approach.
Feedback process that facilitates the incorporation of the views and ideas of individuals and carers into
See also Discovery Interview.
Involving individuals in the planning and development of the services they use. There is a need for a range of models of
involvement, depending on the level of activity that participants wish to commit. What is important is that the choice is there, and that the involvement - or partnership - is real. User involvement should relate clearly to a
decision that the organisation plans to make, and is open to influence. It should be made clear what individuals may or may not be able to change.
See also Expert Patient Programme, Long Term Conditions, Participation, Patient Advice and Liaison Service (PALS), Patient and Public
Involvement (PPI) Forums, Person Centred Approach, Self Care/Self Management, User Audit.
The foundation of an individual’s thoughts, feelings, beliefs and attitudes.
See also Shared Values.
Government plan setting out how services for people with learning disabilities can be improved so that
they can lead as independent a life as possible.
See also Circles of Support.
Very High Intensity Users (VHIU)
Using data proactively, to identify those individuals who are most at risk of unplanned hospital admission,
unnecessary long lengths of stay and having poor medicines management. Then making sure they receive appropriate assessment and services.
See also Case Management, Long Term Conditions, Patients at Risk of Re-hospitalisation and Single Assessment Process.
Very Sheltered Housing
See Extra Care Housing.
See Sensory Disability.
Organisations, often registered as charities, which operate on a non profit-making basis, to provide help and support. They
may be local or national, and they may employ staff, or depend entirely on volunteers.
See also Independent Sector, Statutory Sector.
Someone who gives their time to an organisation as a worker or helper without payment.
Individual who is at risk of abuse or harm due to life circumstances, for
example, a homeless person or a frail older person.
Walk-in-centres offer quick access to a range of NHS services including free consultations, minor treatments, health
information and advice on self-care. They are designed to allow easy access and have convenient opening hours, including early mornings, late evenings and weekends.
Wanless review of social care in the UK
A review of social care provision for older people, commissioned by the King's Fund and chaired by
Sir Derek Wanless. The Wanless Review's final report, Securing Good Care for Older People; Taking a long-term view, King's Fund, 2006, provided a comprehensive analysis of the demand for social care. Estimates were provided for spending
requirements over the next 20 years based on a detailed examination of the factors affecting demand and how improvements in outcomes can be achieved cost-effectively. Importantly, the review also considered whether there is a fairer and more
cost-effective way of funding social care than the current means-tested system.
See also Care Homes, Care Home with Nursing, Carers, Care Services Efficiency Delivery (CSED) Programme, Change, Commissioning, Comprehensive Spending Review (CSR), Gershon Review, Government, Home Care, Local Government, Single Assessment Process, White Paper on Community Health and Social Care Services.
See Health Forecasting.
The state of being healthy, happy and prospering. An individual’s health and well-being is affected by a number of different
factors that contribute positively to health and well-being such as:
See also Diagnosis, Health, Heating in the Home,Mental Health,Self-Care/Self-Management, Treatment
- a balanced diet
- regular exercise
- supportive relationships
- adequate financial resources
- stimulating work, education and leisure activity
- use of health monitoring and illness prevention services (such as screening and vaccination)
- use of risk management to protect individuals and promote personal safety
Disclosure by an employee of genuine concerns about crimes, illegality, negligence, miscarriages of justice, or danger to
health and safety or the environment, when these have been ignored or covered up by the employer or by a fellow-employee.
White Paper on Community Health and Social Care Services
White Paper 'Our Health, our care, our say: a new direction for community
services' - the Government's White Paper on improving community health and care services.
The White Paper aims to provide people more choice and say over the care they receive in the community, and much closer working and coordination between health and social care. This will include improved access to GPs by increasing the choice of
practices for everyone and extending opening hours; a new generation of community hospitals and health centres that provide health and care services in the heart of the community; Direct Payments will be extended and Individualised Budgets will be introduced; and local partnerships between Local Authorities and Primary Care Trusts will be encouraged to produce joint teams
More support for people with long term needs will be offered.
Work will take place to build on the Single Assessment Process and over time develop a Common Assessment Framework to ensure less duplication across different agencies and allow people to self assess where possible.
An integrated health and social care information system for shared care is planned as part of the NHS Connecting for Health strategy. It is an essential requirement for effective care coordination.
An integrated health and social care information system will enable a shared health and social care plan to follow an individual as they move through the care system. Ultimately, everyone who requires one has a personal health
and social care plan as part of an integrated health and social care record. Initially the focus will be on offering integrated care plans to those individuals who have complex health and social care needs. By 2008 it is expected that
everyone with both long-term health and social care needs to have an integrated care plan if they want one. By 2010 it is expected that everyone with a long-term condition will be offered a care plan. Good practice guidance will be issued
early in 2007.
See also Common Assessment Framework for Adults, Common Assessment Framework for Children.
Note: A White Paper is a document issued by a Government department, which contains detailed proposals for legislation. It is the final stage before the Government introduces its proposals to Parliament in the form of a Bill. A
White Paper is sometimes produced following the consultation process, which is undertaken when the Government issues a Green Paper.
See also Act of Parliament, Bill, Government.
Whole System Long Term Conditions (LTC) Demonstrator Programme
Following on from the White Paper 'Our Health, our care, our
say: a new direction for community services' this programme is targeted at people with complex long term health and social care needs. It aims to bring together knowledge of what works internationally, with a powerful commitment to new,
electronic assistive technologies to demonstrate major improvements in care and support.
Pilot sites will run for a minimum of two years and will be subject to a rigorous ‘real time’ evaluation process. The technology employed by the pilots will need to be a mix of telecare, telehealth and
information integration. Pilots will need to demonstrate that installations are in areas and populations where they can make a significant difference to health and social care outcomes. The pilots will be on a scale significantly greater than
anything undertaken in England to date; in the region of several thousand telehealth and telecare installations over the two year period across all of the sites.
See also: Assistive Technology, Common Assessment Framework for Adults, Community Equipment Service, Long Term Conditions, National e-SAP
Project, Single Assessment Process.
Whole Systems Approach
Term for a strategic, integrated approach to planning and delivering services. A local whole system of care covers all
local health and social care provision and any other service that impacts upon health and social care. Multi-agency systems of care can be best improved if the process of change
involves staff from all levels of all organisations and, crucially, also the individuals and carers involved.
A will sets out who is to benefit from an individual’s property and possessions (estate) after their death. It also helps make sure that
the estate, after any taxes and debts have been paid, is passed as intended.
See also Legal Services.
Winter Fuel Payments
Winter Fuel Payment is an annual payment to help people aged 60 and over with the costs of keeping warm in winter.
Anyone aged 60 to 79 who is entitled to receive a Winter Fuel Payment, will get either £100 or £200, depending on their circumstances in the qualifying week.
Anyone aged 80 or over who is entitled to a Winter Fuel Payment, will get an extra £50 or £100 depending on their circumstances in the qualifying week.
Tax is not payable on Winter Fuel Payments.
See also Heating in the home.
World Health Organisation (WHO)
The United Nations specialised agency for health. It was established on 7 April 1948. WHO's objective, as set
out in its Constitution, is the attainment by all peoples of the highest possible level of health. Health is defined in WHO's Constitution as a state of complete physical, mental and social well-being and not merely the absence of disease or
See also Health
'Year of care' approach
Describes the ongoing care a person with a long-term condition should expect to receive in a
year, including support for self-management, which can then be costed and commissioned. It involves individuals through the care planning process, enabling them to exercise choice in
the design of a package to meet their needs.
A person who is neither an adult nor a child, but somewhere in between, sometimes referred to as an adolescent or as a teen or
teenager. Commonly, a young person is defined as being between age 13 and age 19, with different organisations and even government agencies having different definitions which could limit a young person’s access to certain services. Therefore
clinicians/practitioners should always check an organisation's definition to see if the young person falls inside the scope of that organisation.
See also Common Assessment Framework for Children.