patterns of service provision unit 7.3

central government: the national, as opposed to the local level of government

devolved system: a system based on the devolution of power - where central government grants power to government at regional or local level

informal care: care that is provided by relatives and friends on an unpaid basis, outside of the professional care system

inter-professional working: team working arrangements where care practitioners with different disciplinary backgrounds work collaboratively to meet and manage the care needs of a service user or client

local government: the local as opposed to the national level of government

mixed economy of care: a care system that is financed through public private and voluntary sources of funding

multi-agency working: a situation where care practitioners employed by different care organisations (agencies) collavorate to provide care for a particular individual or group of people.

health and social care services are organised differently in England, Wales, Scotland and Northern Ireland. Variations in organisation occur because the care systems in each country are controlled by different political institutions and because each country has its own population health needs and its own particular social and welfare history. However, even though there are national differences in care organisation, clear similarities can be seen throughout the UK in the way that care services are provided for example:

• there is a mixed economy of care in each country
• the statutory sector is the largest of the professional care sector in each country. because of this central and local government play a major role in the planning, funding and to a lesser extent provision of care
• private and voluntary sector care organisation have become increasingly important suppliers of direct care services in each country pver the past decade.
• informal carers play a vital part in care provision throughout the UK. the informal care sector is, in fact the largest of all the care sectors

• health care provision in each country is still mainly dominated by one large statutory organisation, the NHS which has a clear national, regional and local structure. By comparison, private and voluntary organisation, play a relatively minor role in health care provision.
• social care is the statutory responsibility of local government authorities snd is delivered by a mixed economy of care providers. voluntary and private practitioners now play a significant role in actually providing statutory and non-statutory social care and support services.
• the organisational structure of public or statutory sector care in each country is based around a tiered system of national, regional and local care orgainisations.

until recently, health and social care services have tended to be provided separately by distinct health or social care organisations. Each of these types of organisation had their own management and funding arrangements. as a result health care organisations in an area tends to operate in parallel with social care organisations. one consequence of this approach was that it sometimes led to overlaps of service provision of complex care packages for clients with multiple needs quite difficult.

as we have seen, central government has the primary responsibility for developing health and social care services in the UK. the role of central government is to:

• develop national health and social care policies
• plan national health and social care services
• Monitor and have ultimate accountability for national care service provision
• allocate funding or care services to provider organisations

the department of health or its national equivalent in Scotland, Wales and Northern Island, is the key central government department that works on and coordinates these activities in each country. This department is staffed by civil servants and is led by a politician who has been appointed as secretary of state for health. The civil servants are the people who do the day-to-day work of the department.

each of the countries of the UK also has a system of regional bodies that are responsible for coordinating central government health care policy in a defined region of the country. These are called 'Regional Government Offices' in England and Wales, 'Health Boards' in scotland and 'Health and Social Care Partnerships' in Northern Ireland. Overall, central government is responsible for major policy development and makes any fundamental decisions relating to health and social care services and the funding of care services.