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Please look here for a list of Social Care Acronyms - its amazing how many there are!
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A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
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.
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
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.
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.
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 Acute Trust,
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.
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.
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 professional.
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.
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.
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).
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,
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.
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 Assessment Process.
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.
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.
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" 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.
See Coordination.
See Coordination.
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.
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’.
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 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.
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.
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.
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 needs.
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 Arrangements.
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.
A carer’s assessment, under the Carers and Disabled Children Act 2000, formally acknowledges the carer’s contribution as a partner in the caring process. It determines the carer’s own support needs, so that they can continue to contribute if possible, and sets out a contingency plan. This assessment has traditionally been carried out by social services.
New legislation, The Carers (Equal Opportunities) Act 2004, states that there is a need to ensure that all carers know that they are entitled to an assessment of their needs for services; place a duty on local authorities to consider a carer’s outside interests (work, study or leisure) when carrying out an assessment; and promote better joint working between social services and health, housing and education services to ensure support for carers is delivered in a coherent manner.
See also Care Plan, Care Planning, Care Management, Care Programme Approach (CPA), Case Management, Comprehensive Assessment, Continuity of Care, Coordination, Long Term Conditions, Overview Assessment, Participation, 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.
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.
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.
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 letter.
The capturing and recording of clinical information normally at the point of patient present such as consultation, assessment etc.
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 were created after consultation with Strategic Health Authorities (SHA's) on how best to deliver local Information Technology solutions as part of the NHS Care Records Service.
It was decided to split England 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 comprise of the: Eastern, North East, North West and West Midlands, London, and Southern clusters.
See also Local Service Providers.
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 2006.
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 Services,
"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, Transformational Government.
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 England.
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 individual.
See also Telecare.
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.
Annual plan produced by Social Services Departments stating how community care is implemented in their area over a three-year period.
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 Process
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 procedure.
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
See NHS Connecting for Health
Agreement articulated by an individual with the care professional to share information about them with other care professionals:
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 consent).
Implied consent refers to agreement signalled by the behaviour of an informed individual.
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.
See also Capacity, Confidentiality
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.
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).
Coordination
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.
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 planning stage.
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.
Assessment Coordination
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.
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.
Continuity of care and the best interests of the individual should be key criteria for deciding who should carry out this role.
Care Coordination
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.
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.
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.
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.
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.
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.
See also Anti-Discrimination Policy, Anti-Discriminatory Practice, Diversity Policy, Empowerment, Ethnicity, Ethnic Monitoring, Person Centred Approach, Racism.
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.
Data
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.
Day Case
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.
Day Hospital
Hospital where patients receive day care only, continuing to live at home.
See also Ambulatory Care, Day Case
Day Surgery
Surgical procedure that does not involve an overnight stay in hospital.
See also Day Case.
Decision Support
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.
Dedicated Ward
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.
Dementia
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,
Demographic Trends
Changes in sex, size and other characteristics of a population over time
Dentistry
A branch of medicine that involves diagnosis, prevention, and treatment of any disease concern about teeth, oral cavity, and associated structures.
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.
Diabetes
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.
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.
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.
See also Coronary Heart Disease, Obesity, Stroke.
Diagnosis
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.
Dignity
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.
Direct Gov
The main government online information access point.
See also NHS Direct Online.
Direct Payments
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.
Disability
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’:
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.
Discovery Interviews
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.
Discrimination
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.
Disease
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.
Disempowerment
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 management.
Disengagement
An individual’s loss of contact with care services.
Disinhibition
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.
Disorientation
A state in which individual loses his or her awareness of time and place.
Diversity
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.
Diversity Policy
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 by legislation.
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.
Domains/Sub Domains
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 ‘pain’.
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
See also Crime.
Domiciliary Care
Assistance provided to a person in their home, including home care, equipment and adaptation, and meals-on-wheels.
Drug Misuse
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
Eating disorders
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.
See also Diabetes, Health, Obesity, Well-being.
Eczema
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.
Elective Admission
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.
Eligibility Criteria
Set of standards or rules governing access to each particular non-NHS service.
See also Fair Access to Care Services.
Emergency Department
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.
Empathy
One person’s awareness of the emotional state of another person and their ability to share an experience with them.
Employment
An activity or service performed, usually for another, especially for payment or reward or as an occupation.
See also Education and learning.
Empowerment
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,
Enablement
Methods used by health and social care workers to support the people they work with and encourage them to be as independent as possible.
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.
Engagement
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.
Environment
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.
EPA
See Enduring Power of Attorney
Episode
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
Equality
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.
e-SAP
Electronic implementation of the Single Assessment Process
Ethics
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.
Ethics Committee
Oversees moral codes of practice in health geographical area.
Ethnic Group
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 groups.
Increasingly, there are many people of ‘Mixed’ origins - and their needs should be considered in view of the multiple heritages they can belong to.
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.
Ethnic Monitoring
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.
Ethnicity
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.
Evaluation
Judging the value of something by making a comparison.
Evidence
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.
Evidence base
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
Exclusion
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.
Explicit Consent
See Consent.
Express Consent
See Consent
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.
FACS
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.
Fairer Charging
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
Family History
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.
Flu (Influenza)
A disease of the lungs and upper airways caused by infection with a flu virus.
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
serious kidney disease
diabetes
lowered immunity due to disease or treatment such as steroid medication or cancer treatment
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.
See also Immunisation, Infectious disease.
Avian influenza (bird flu) is a highly infectious disease affecting many species of birds, including chickens, duck, turkeys and geese. It can affect commercial, wild and pet birds. There are 15 types of bird flu, but the type that is causing concern is the strain H5N1. Avian flu was thought only to infect birds until the first human cases were seen in Hong Kong in 1997. Investigation showed that close contact with live infected poultry was the source of the infection. Touching infected birds or having contact with their saliva, fluids from their nose or droppings can spread avian flu. Droppings can also contaminate dust, soil, water, feed, equipment, vehicles and clothing. It is important to note that, there is no firm evidence that H5N1 strain has the ability to pass from one person to another.
Foundation Trusts
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)
Frequent Flyers
See Very High Intensity Users (VHIU).
Gender
Classification of human sexuality
See also Sexism
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
Gershon Review
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.
GMC
See General Medical Council.
GMS Contract
NHS terms and conditions applicable to General Medical Services.
Government
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.
Green 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.
Hand-off
Term used when a person is passed from one health and social care worker to another.
See also Seamless Service.
Hay fever
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 fungal spores.
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 infirmity. 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:
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
See also Care Trust.
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
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 abou