1. HUBERT KAIRUKI MEMORIAL UNIVERSITY Topic: PROVISION OF SERVICES Facilitator: Mr. Isaac Lema

2. Presenters: 1. Erimina Damas 7. Wende Albert Scope, Introduction, Objective Probation and After 2. Irene Kimario Care Services National Health Services 8. Jerina Amon 3. Philomena Lyamuya Voluntary Agencies General Practitioner Services 9. Nicodemus Zemba 4. Jesse Ngalesoni Summary, Conclusion Community Health Council 10. Juvenalius Kirango 5. Elisha Kiranga Recommendation, Social Services References 6. Joshua Tadayo Local Authority Social Services Department

3. INTRODUCTION OBJECTIVE MAIN PRESENTATION SUMMARY RECOMMENDATION CONCLUSION REFERENCES SCOPE

4. Models of care, and the level to which provision is made, vary widely in different countries. In Britain,1946 National Health Service Act proposed a three party structure. Responsibility was to be shared between three statutory authorities: i. Local authorities. ii. The regional hospital boards. iii. Local executive council INTRODUCTION

5. To understand the details of:  National Health Services  General practitioner services  Community health councils.  Social services OBJECTIVES

6. Was born on 5 th july,1948. The head of the hierarchical structure of organization is the minister and his ministry: The department of Health and Social Security. England is then divided into fourteen Regional Health Authorities(RHAs). Most of the members of a RHA are not professionally involved in health service. This committee is augmented by five full-time managers who constitute the regional team of officers. NATIONAL HEALTH SERVICES

7. The next level of organization is the District Health Authority,(DHA). A part time paid chair person is appointed by the secretary of the state. The DHA has four full time chief officers who together with one consultant and general practitioner. The general practitioner are self employed contractors to the NHS paid on nationally agreed scale of capitation fees NATIONAL HEALTH SERVICES

8. Local authorities are in control of social work, non-medical residential care and other community services. In order to facilitate the integration of services joint consultative committees exist to plan collaboration between the hospital based and local authority community-based services. NATIONAL HEALTH SERVICES

9. About 50% of doctors who qualify enter general practice. In order to encourage a more equitable distribution of general practitioners the secretary of state established a national medical practices committee, the task of which is to asses the number of doctors practicing in an area relative to population. These are assigned to one of four categories:  Designated area  Open area  Intermediate area  Restricted area GENERAL PRACTITIONER SERVICES

10. Where the number of patients per doctor exceed 2500, special encouragement to move into that area by means of a financial inducement is given (designated area). On the other hand, in an restricted area, where the average number of patients per doctor drops below 1800, entry is only allowed when a vacancy becomes available through death or retirement. GENERAL PRACTITIONER SERVICES

11. Were established in 1974, with the task of representing the views of local users of the health services to the health services. The council range in size from eighteen to thirty six members, these members are nominated by the Local Authorities, the Voluntary Organizations and by the Regional Health Authorities. The Community Health Councils must: Examine the health care needs of the local population. Examine existing services to see how they meet them; publicize the services offered. Give advice about how complaints may be made. COMMUNITY HEALTH COUNCILS

12. At its inception the number of cases has continued to increase and the cost of both treatment and maintaining people, particularly the elderly has increased enormously. General hospital and maternity patients absorb the greatest proportion of money. COST

13. Complimenting the health service are a number of Social Services. These may be seen to fall into three broad sectors:  Local authority social services departments.  Probation and after care services  Voluntary agencies SOCIAL SERVICES

14. Their work may be divided into four parts: Residential Services Field Work Services Support Services Hospital Services 1. LOCAL AUTHORITY SOCIAL SERVICES DEPARTMENT

15. A. Residential Services Old people’s accommodation Homes for the physically and mentally handicapped, and Children: homes, reception centers, residential nurseries 1. LOCAL AUTHORITY SOCIAL SERVICES DEPARTMENT

16. B. Field work services: Child care: social work support and counseling to parents and children. Oversight of children at risk, particularly for non –accidental injury. Provision of services such as day nurseries and child minding, Adoption, fostering, etc. and Counseling, aids and advice to elderly, disabled and mentally ill. 1. LOCAL AUTHORITY SOCIAL SERVICES DEPARTMENT

17. C. Support services: Day centers for elderly, physically and mentally disabled, etc. Home helps Meals on wheels, and Visiting warden services: particularly for the elderly 1. LOCAL AUTHORITY SOCIAL SERVICES DEPARTMENT

18. D. Hospital services Counseling patients and relatives Environmental assistance, particularly with regard to discharge, and adjusting to the return home, Financial and practical help, and Liaison with other agencies to facilitate continuity of care 1. LOCAL AUTHORITY SOCIAL SERVICES DEPARTMENT

19. This service is responsible to the Home Office, and is involved with a variety of largely court-based work. This includes: supervision of probation orders, preparing social enquiry reports for the court, prison after-care, parole orders, etc. 2. PROBATION AND AFTER CARE SERVICES

20. In spite of the development of statutory services many voluntary agencies continue to flourish, often serving particular interest groups. In many cases they enable non-professionals to make a contribution to the care and will-being of others, and to provide a personalized service. 3. VOLUNTARY AGENCIES

21. National Health Services was made to offer quality health services together with the cost sharing, has its own structure and organization as discussed. SUMMARY

22. There are a lot of challenges facing provision of services, including accountability and cost to run National Health Services. CONCLUSION

23. We Heath providers should understand the community we are going to treat, we should not become money oriented so as to provide health service. RECOMMENDATIONS

24. M A.C.P Sims & W.I.Hume, Lecture notes on behavior sciences REFERENCES