Health and social

• Definitions of health and wellbeing -

  positive - the achievement and maintenance of physical fitness and mental stability.

  negative - the absence of physical illness , disease and mental distress.

  holistic- a state of complete physical , mental and social wellbeing and not merely the absence of disease or infirmity.
• Models of health , disability and wellbeing-

  Health is :

  “ a state of complete physical , mental and social wellbeing and not merely the absence of disease or infirmity “
• Biomedical model 


  Assumes the existence of illness or disease . It emphasises clinical diagnosis and scientific intervention in the treatment of disease or its symptoms .
• Biomedical Strengths -

  • respected for under-pinning health with science .
  • Focus on assessment, diagnosis and treatment can cure disease / broken bones etc .
  • medical interventions in pregnancy and birth reduced infant mortality rates
  • NHS
• Biomedical limitations

  • Does not always work
  • medicalised pregnancy and birth - took control away from women
  • concerns about safety / side effects / dependency on medication
• Social model 


  individuals are excluded by barriers constructed by society, which make life harder for them to be part of the

  community. The exclusion is not from their health, impairment or difference. The social model of disability proposes that what makes someone disabled is not their medical condition, but the attitudes and structures of society.
• Social strengths -

  • Recognises diverse factors that contribute to HWB

  • Emphasises that good outcomes rely on needs being met – support is key

  • Barriers can be removed to promote good health
• Social limitations - 


  • External determinants do not solely account for health – individuals have free will, choice and personal responsibility

  • Individual decisions impact health, regardless of their start in life

  • High economic status (affluence) does not guarantee good health – factors such as genetics and abuse also impact health.
• Biopsychosocial model 


  incorporates interactions between several factors to help determine why an individual might suffer from a disorder. The biopsychosocial model applies to us all. The biopsychosocial model is great for helping us understand how mental health conditions might develop. However, we shouldn’t only think of it as being useful for people who are not mentally well.
• Biopsychosocial strengths - 


  • Encourages a holistic and enquiring approach

  • Sees factors as interactive and interdependent

  • Acknowledges the complexity of causes of HWB

  • An assessment of need may focus on multiple methods of support to address different aspects concurrently

  • Supports co-production with an individual – work together to address factors to improve HWB
• Biopsychosocial limitations -

  • Can create uncertainty - which intervention has contributed to which outcome?

  • Hard to establish which interventions were needed and which were unnecessary if delivered concurrently (at same time)

  • E.g which simultaneous intervention can be attributed to making a difference? Or is it a combination?
• Holistic concepts of HWB & factors that contribute to them - 


  Holistic concepts of health and well-being:

  • consider the whole person and how they interact with their environment

  • emphasise the connection of mind, body and spirit

  • encourage people to accept responsibility for their own level of well-being

  • are based on the premise that optimal health is not based upon just the absence of disease, but upon the living balance of the ‘whole person’
• Interdependence 


  Physical , intellectual, emotional, social, spiritual-

  physical is supported by - “ I am active”

  intellectual is supported by- “I am happy and able to learn“

  emotional is supported by - “I do things that make me happy“

  social is supported by - “I engage and contribute to society“

  spiritual is supported by - “ I belong” / “ I worship”
• Equality Act 2010


  Aims to protect people from discrimination in the workplace and wider society
• Human Rights Act 1998


  Aims to ensure fundamental rights that everyone is entitled to are treated equally with fairness, dignity and respect
• Human Rights Act 1998


  • Principles: the right to equality, freedom from discrimination, the right to liberty and security, freedom from slavery, freedom from torture and degrading treatment
• Well-being of Future Generations (Wales) Act 2015


  Aims to improve the social, economic, environmental and cultural well-being of Wales
• Well-being of Future Generations (Wales) Act 2015


  • A prosperous Wales, a resilient Wales, a healthier Wales, a more equal Wales, a Wales of cohesive communities, a Wales of vibrant culture and thriving Welsh language, a globally responsible Wales
• Social Services and Well-being (Wales) Act 2014


  Aims to provide a framework for delivering more integrated care and support for older people with complex needs
• Social Services and Well-being (Wales) Act 2014


  • Principles: voice and control, prevention and early intervention, well-being, co-production
• A Healthier Wales: our Plan for Health and Social Care


  Aims to provide preventative health care to help people stay healthy for longer
• Regulation and Inspection of Social Care (Wales) Act 2016


  Aims to promote quality and improvement in the provision of social care
• Public Health (Wales) Act 2017


  Aims to improve and protect the health and well-being of the people of Wales
• Prudent Healthcare Wales

  Aims to ensure healthcare resources are used in a way that maximises value for patients and for the population as a whole
• Rights


  • The right to life, liberty and personal security
  • Freedom from slavery
  • Freedom from torture and degrading treatment
• The right to life, liberty and personal security, freedom from slavery, freedom from torture and degrading treatment are equal
• The Social Services and Well-being (Wales) Act 2014 aims to improve the well-being of people who need care and support and for carers that need support
• 4 main principles of the Social Services and Well-being (Wales) Act 2014


  • Voice, choice and control
  • Prevention and early intervention (minimising critical need)
  • Achieving well-being
  • Co-production (individuals involved in design of their own care)
• The Public Health Wales Act 2017 aims to address public health issues and create conditions conducive to good health
• Areas of public health covered by the Public Health Wales Act 2017


  • Health impact assessments
  • Food hygiene ratings
  • Pharmaceutical needs in local communities
  • Smoking
  • Tattoos and piercings
  • Public toilet facilities
• The Well-being of Future Generations (Wales) Act 2015 aims for long-term improvement of the social, economic, environmental, and cultural well-being of Wales
• Principles of the Well-being of Future Generations (Wales) Act 2015


  • A prosperous Wales
  • Resilient Wales
  • More equal Wales
  • Healthier Wales
  • A Wales of cohesive communities
  • A Wales of vibrant culture and thriving Welsh language
  • A globally responsible Wales
• The Regulation and Inspection of Social Care (Wales) Act 2016 provides a framework for regulating and inspecting social care in Wales to improve quality
• Principles of the Regulation and Inspection of Social Care (Wales) Act 2016


  • Reflects the changes brought about by the Social Services and Well-being (Wales) Act 2014
  • Puts people at the centre of their care and support
  • Developed a coherent & consistent Welsh approach
  • Tackles provider failure
  • Responds quickly & effectively to new models of service & concerns over the quality of care and support
• The Wales Health and Care Standards framework 2015 aims to ensure a consistent approach to providing safe, high quality care
• Prudent Healthcare (Wales) is focussed around allowing people to make more informed decisions about treatments/prescriptions and improving outpatient care to increase specialist access, partnership working and integration between services to provide the right care
• The Equality Act 2010 aims to protect people from discrimination in the workplace and wider society based on age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex and sexual orientation
• The Framework for delivering integrated health and social care for older people with complex needs in Wales aims to provide stronger community-based care, better and more consistent outcomes, and a more co-ordinated approach