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A-Z of Services | Alphabetical directory of health and social care resources. y
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A and E / A and E Department | See Emergency Department y
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Abuse | 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. y
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Access | 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. y
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Accident and Emergency | See Emergency Department. y
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Accident Prevention | 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 Home y
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Accountability | 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 Department. y
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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. y
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Active Support | 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. y
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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. y
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Acute Care | Hospital-based or emergency health services- sometimes referred to as secondary care. 'Acute' relates to the care being short-term. y
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Acute Services | Medical and surgical treatment provided in hospitals. Acute services are managed by an acute trust. See also Secondary Care. y
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Acute Trust | A legal entity formed to provide health services in a secondary care setting. y
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Admission | 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. y
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Adult Protection | 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. y
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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. y
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Advice | A proposal for an appropriate course of action. See also Benefits, Information, Legal Services. y
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Advocacy | 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. y
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Age Discrimination | Action that adversely affects an individual because of their age. See also Ageism, Anti-discrimination Policy, Anti-discriminatory Practice. y
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Ageism | Discrimination against or unfair treatment of individuals on the basis of their age. See also Age Discrimination y
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Agency | Name for any organisation responsible for delivering services and for which workers may work or act as volunteers. y
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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. y
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AIDS | See HIV / AIDS. Y
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Alcohol misuse | 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:
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. y
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Alert | A warning call, alarm or message which addresses concerns where urgent action may be needed to be provided by a health and social care professional. y
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Allergy | 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. y
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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. y
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Allocated Case | 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. y
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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 Y
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Ambulance Trusts | 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 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 (PCTs). y
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Ambulatory Care | 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. y
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Anti-Discrimination Policy | 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. y
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Anti-Discriminatory Practice | 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. y
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Appraisal | The process by which an employee’s performance is reviewed periodically against the requirements of the job. See also Personal Development Plan. y
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Arthritis | 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. Y
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Assertive Outreach | 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. y
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Assertiveness | Communicating clearly, honestly and directly, without avoiding the issue or resorting to manipulative or aggressive behaviour. y
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Assessment | 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. y
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Assessment Notification to Social Services (Section 2) | See Notification Arrangements. y
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Assessment Tools | 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. y
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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). y
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Assumption | 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. y
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Asthma | 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. y
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Asylum Seekers | 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. y
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Attitude | 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. y
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Audit | 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. y
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Audit Commission | 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. y
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Autonomy | 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 Assessment Process. y
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Avoidable Admission | Entry to a hospital bed that would be unnecessary if alternative services were available y
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Background History | 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. Y
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Baseline | An imaginary line or standard by which things are measured or compared, e.g. the established baseline for a budget. y
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Basic Personal Information | See Contact Assessment. y
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Beacon Services | 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. y
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Benchmarking | 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. y
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Benefits | 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 y
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Bereavement | Loss or separation from a loved one. Bereavement affects individuals in different ways as they grieve. See also Depression, Loneliness, Mental Health, Well-being. y
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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. y
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Best Value | 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. y
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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. y
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Bill | 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. y
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Block Contract | 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 y
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Caldicott Guardians | 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. y
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Cancer | 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. y
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Capacity | 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. . y
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Care Co-ordination | See Coordination. y
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Care Co-ordinator | See Coordination. y
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Care Event | A discrete activity carried out by a health or social care profession for an individual e.g. a GP consultation, or an outpatient appointment. See also Episode. y
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Care Event Report | Correspondence from one professional to another to highlight the key outcomes of a care event. y
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Care Home | 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’. y
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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. y
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Care Management | 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. y
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Care Package | 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. y
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Care Pathway | 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). y
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Care Plan | 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 team. 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. y
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Care Planning | 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. y
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Care Professional | Anybody involved "professionally" in the provision of health/social care and who is an employee of the agents providing care services. y
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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. y
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Care Record Service (CRS) | See NHS Care Record Service. y
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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 Heal |