A2: The Healthcare Sector

• A2.1 The diversity of employers and organisations within the healthcare sector:

  Employer and organisational settings:

  • NHS 
  • Private healthcare 
  • Private/non-profit organisations 
  • Social care services: 
  • adult social care, children and young people’s social care 
  • housing services 
  • youth and community services 
  • Diverse working environments: hospital, GP surgery, community setting, residential setting, service user’s home, judicial care, schools, local authority departments
• Primary care services

  • General practice (GP)
  • Dental services
  • Walk-in centres
  • A&E
  • 111 telephone service
  • Health visitors
  • School nurses
• Primary care


  • Often the first point of contact
  • Accessed directly
  • General care
  • Public participation
  • Deals with acute medical problems and refers to specialist
• Secondary care services

  • Hospital services: inpatients
  • Hospital services: outpatients
  • Social care services
• Secondary care

  • Services which individuals are referred to
  • Planned care
  • Specialised care
• Tertiary care services

  • Residential care home
  • Hospices
  • Mental health services
  • Individuals' own home
• Tertiary care


  • Often long-term care
  • Highly specialised care (for example specialist burns unit)
  • Can be used as respite for families
  • End of life care
• Range of personal factors

  • Pre-existing health condition (for example diabetes management)
  • Physical disabilities (for example multiple sclerosis - ongoing support with managing specific symptoms as well as self-management of symptoms)
  • Mental health conditions (for example cognitive behaviour therapies)
  • Learning disabilities (for example annual health checks)
  • Different ages (for example infancy, childhood, adulthood, senior years)
  • Social care needs (for example support with activities of daily living, maintaining independence)
• Barriers to accessing healthcare services

  • Socioeconomic (e.g. Can't afford to take time off work/ Can't afford some services/ Cost off transport to the service)
  • Psychological (e.g. Fear of diagnosis/ Embarrsed about probolem/ Scared/ May feel there is a stigma)
  • Physical (e.g. Lack of access/ Health services not avaible at covientent time/ Sensory imparmerment)
  • Cultural and language (e.g. Staff only speak english/ No female staff/ Some treatments not acceptable to certain cultures)
  • Geographical (e.g. No local services/ Lack of transport to get there/ \ Waiting list)
• Health applications

  • Promotes healthier choices by offering advice and support
  • Supports independent management of conditions
  • Supports health professionals with ongoing monitoring of conditions
  • Supports health teams to manage appointments
• Assistive computer technology

  • Supports the health team to treat or manage conditions more efficiently
  • Provides solutions that may not have been previously available in order to support conditions
• Artificial intelligence technologies

  • Supports health teams to gain access to more expansive data across a wider geographical area
  • Supports health professionals to stay informed in relation to trends in condition and response from a wider pool of individuals
  • Supports diagnosis through use of patient data/images and complex algorithms
• Artificial intelligence technologies

  • Machine learning radiology
• National Health Service (NHS)

  The first completely free healthcare service founded on 5 July 1948 as a result of many years of debate and discussion from the early 1900s, created by the NHS Act 1946 when Aneurin Bevan became health minister
• How the healthcare sector has developed since 1945

  1. NHS has undergone many changes, updates and re-organisations

  2. Due to expenditure exceeding demand and the resulting pressure on funding some services incurred charges (for example prescription charges)

  3. Private sector healthcare has developed in parallel with NHS, funded through private medical insurance or individual payments, this sector continues to expand

  4. Many charities have also developed services to support health and wellbeing and provide healthcare (for example Marie Curie hospices)

  5. Increase in multi-agency working to support individuals

  6. Increase in community care
• Potential impacts of future developments in the healthcare sector in relation to care provision

  • Artificial intelligence (AI) for improved diagnostics process and triaging systems
  • Technological infrastructure for remote access and collaboration across services
  • Regenerative medicine to restore function to damaged organs or tissues
  • Biomarkers to assist in identifying early onset of cardiovascular disease, increase success rate of drug development programmes, and accelerate availability of new therapeutics
  • Remote care through online clinics/virtual consultations and mobile clinics/screening
  • Patient self-management through personal digital health monitors
  • Stretched funding as more people access the services
  • More private healthcare provision services available and more users
  • Changes in patient/service user demographics with changes in life expectancy and increase in complex care needs and obesity rates
• Importance of adhering to national, organisational and departmental policies in the healthcare sector

  • Provide quality standardised care for all patients and service users
  • Ensure safety of all service users
  • Prevent errors
  • Provide consistency
  • Promote health and wellbeing
  • Ensure safety and wellbeing for practitioners
• Possible consequences of not following policy:
• Ways in which the sectors are funded

  • Public sector: Tax funded, National Insurance, Current government health sector policy
  • Private sector: Premiums, One off payments, Current government health sector policy
  • Voluntary/charity sector: Donations, Fund raising, Grant funding, Current government health sector policy
• Evidence-based practice

  An approach of making decisions and providing the best standards of care by considering all the available facts, knowledge, data, statistics, etc. and using them as a basis for making a decision
• Application of evidence-based practice

  1. Combine research findings with clinical expertise and professional judgement

  2. Assess all the findings from research including validity of information and data

  3. Draw conclusions and apply findings to improve practice or introduce innovations

  4. Review the impact of improvements or innovations made
• How evidence-based practice benefits and improves the healthcare sector

  • For the population: Facilitates improvements in person-centred care, Improves outcomes for individuals, Improves safety, Promotes equity in provision, Informs health promotion requirements
  • For the sector: Encourages quality provision, Improves cost effectiveness, Improves capability and competency of the workforce
  • For the healthcare practitioner: Job satisfaction, Empowerment, Continuous professional development
• Flat organisational structure

  • Involves few or no levels of middle management, with employees reporting directly to executives
  • Resulting job roles: management roles, caring roles, ancillary roles
  • Pros: Gives employees more responsibility, Fosters more open communication, Improves co-ordination and speed of implementing new ideas
  • Cons: Can create confusion if employees do not have a clear supervisor to report to, Can produce employees with more generalised skills and knowledge, Can be difficult to maintain once the organisation grows
• Tiered hierarchical organisational structure

  • There is a chain of command and responsibility goes from the top downwards to entry-level employees
  • Advantages: Better defines levels of authority and responsibility, Shows who each person reports to or who to talk to about specific projects, Motivates employees with clear career paths and chances for promotion, Gives each employee a specialty
  • Disadvantages: Can slow down innovative or important changes due to increased bureaucracy, Can cause employees to act in the interests of the department instead of the organisation as a whole, Can make lower level employees feel as though they have less ownership and can't express their ideas for the organisation
• External Agencies

  • Functions within the sector, Complementing or supporting NHS care services or providing continuing care, Contractors/contracting roles, Services purchased for a set period of time to do a specific task, Integrated/non-integrated service
• Multidisciplinary and multi-agency teams

  • Multidisciplinary teams with individuals who have different roles (for example caring roles working alongside those with management roles)
  • Multi-agency teams that work in partnership with colleagues (for example practitioners from the social care sector to provide support for individuals in discharge planning)
  • Provide respect for colleagues, Build rapport and positive relationships, Take ownership of own job role and responsibilities, Take on board feedback and provide constructive, effective feedback to others, Share best practice and contribute to discussions to support problem solving, Actively listening to colleagues' contributions, Share relevant information with each other and collaborate to support the continuity of care including with social care provision
• Job description

  Scope of role, Purpose of role, Responsibilities and reporting lines, Accountabilities
• Person specification

  Experience required, Essential and desirable skills, Attributes required, Qualifications required, Mandatory training and continuing professional development required including reflective practice, Registration requirements where appropriate
• Career pathway opportunities for employment and progression within the healthcare sector as defined by the Institute for Apprenticeships and Technical Education occupational maps
• Potential impact of external factors on the activities of the healthcare sector

  • Epidemic/pandemic/endemic outbreak, Extreme weather, Infrastructure (for example building and maintenance), Geographical events (for example disasters that happen in specific geographical locations), Government policy
  • Service overload (for example too many people requiring treatment), Insufficient staff resources, Inaccessible services, Damage to facilities, Additional resource requirements (for example equipment and materials), Effect on supply chain (for example costs, delivery capacity), Contingency plan implementation requirements (for example a disaster recovery plan)
• Role of public health approaches

  • To determine health issues through collecting information regarding the extent of the issue, who it impacts and the effects
  • To determine why a particular health issue might occur and factors that may contribute or increase the risk of the issue occurring
  • To determine what could help to decrease the risk and providing interventions to a wide range of people, in a number of different health related environments and locations
  • To determine the impact of social issues for health and wellbeing
• Benefit of public health approaches to regional and national health

  • Raises awareness amongst the public regarding risk
  • Provides education on how to live healthier lifestyles and self-care
  • Improves generational prospects
  • Reduction in required social care services
  • Reduction in number of people impacted by health issues and preventable illnesses
  • Reduction in pressure on NHS