Contemporary themes in healthcare practice and policy

Patchwork task one

Concerning the case study, health inequalities are a part of the healthcare institutes. Addicott (2014) states that the health inequalities are causing  problems for the patients as well as for the entire healthcare department. According to the case study, the healthcare issue that Mrs. Kohli is facing requires proper care and assessment as per her medical condition. Patients who have dementia have to face social inequalities. This social inequality was also faced by Mrs Kohli as her husband could not provide her with care and became exceedingly anxious at the time of the separation. It reflects that Mrs Kohli is also facing access to healthcare for services users who may lack capacity. NHS is taking measures for controlling the issues in the mental health institutes. The Mental Capacity Act 2005 focuses on the best interests and the inability to make decisions.

Let us analyse the entire case by referring to the mental capacity act. This act has been a part of England since 2005 and has been in force since 2007. This act aims to deal with the primary purpose that are causing an increase in healthcare inequalities. This increase in healthcare inequalities challenges the entire legal framework. Here in the case, Mrs Kohli was not able to make decisions for herself. Both the healthcare service providers and her husband were making decisions for her. The primary purpose of this legal framework is to empower people for making decisions for themselves whenever possible. Also, this legal framework is to protect those people who lack capacity. Mrs Kohli had dementia, and the separation from her husband makes her suffer even more. The mental health care department must implement this acts legal framework to allow people to plan ahead of time. Principle one of this act is the presumption of the capacity, which provides the patients with the right to take every decision by themselves. No one has the right to make decisions for them due to their medical condition or eh disability. Supporting the individuals according to their own decision will increase these individuals capacity for making decisions. In the current situation, Mrs Kohli was not supported, and her decision was not taken into account during the entire situation. So, it goes against all the principle that MCA has set.  

Mr Kohli wants to take her wife to his home, and he wants to take care of her by himself, but the decision made by DoLS was not in support of this act. It means that the healthcare departments stakeholders were not supporting the decision made by her husband, which is against article 5 of the Human Rights Act 1998. Allen et al., (2014) states that this article of the act states that everyone has the right to liberty and personals security. The mental health care service providers were not giving them the right to liberty and security, which means that their health can even worsen. Human rights act 1998 also provides humans with the right to respect private and family life. The service providers on Mrs Kohlis discharge have decided to send the health care service providers for providing her with care. But Mr Kohli refused to do so as it was no less than a way to interfere in her personal life. So, article 8 of the Human Rights act is a qualified right and provides humans with the right that no one is supposed to interfere in the private and the family life of any individual. Barr, Kinderman, and Whitehead (2015) researched out and found out the trends of the mental health inequalities. Compared to the evidence with the current research, the primary two health care inequalities that Mrs Kohli faced include access to healthcare for service users who may lack capacity and the inability to provide Mrs Kohli with the rights to make decisions themselves (Bamford et al., 2020).

Moreover, the dementia 2020 challenge, review in 2018, also provides guidelines to provide support and care to those who have dementia. This dementia challenge involves 19 key commitments and the four key themes. These key themes are dementia awareness, health and care delivery, risk reduction and research and funding. The entire case studys analysis in correspondence to this case study indicates that the health care department was not using the right approach for treating dementia, especially in health and social care. Mrs Kohli must be provided with the proper care and treatment to identify the dementia risks. Giving her the rights of liberty and decision making will highly help her is no less than a risk reduction advice. She is supposed to assist the National Institute for Health and Care Excellence Guidance for meaningful care.  All the restrictions were bounding Mrs Kohli, and she was not enjoying the proper rights for life planning, and by the stakeholders, she was forced to become a part of the mental health institute.

The case analysis of Mrs Kohli’s case study also refers to the fact that the mental health care department was not practising the leadership. NHS provides a healthcare leadership model providing the nine dimensions to be appropriately addressed. These dimensions are highly essential for providing them proper care and treatment to those who suffer from mental health issues. Overall, the health inequalities and the policies and acts of mental health states that the health care service providers must make changes in their departments and provide the patients with the rights for the liberty of the decisions and security. These practices must be following the Mental Capacity Act, Human Rights Act 1998, and the Dementia 2020 challenge: 2018 Review (2019).

Patchwork task 2 – service user safety decision

            The decision will be made based on the theoretical perspectives of both decision making and problemsolving. This decision will be made to make improvements for ensuring the safety of the service user. The perspective that will be analysed is the impact on the services provided to the patients.

            The evidencebased practice that will be considered in the decisionmaking model is Gopee and Galloway, 2017. Firstly, all the facts that lead to the mental health inequalities will be considered appropriately. These facts will lead to the final decision. Berwick and Knapp (1987) states that the availability of the appropriate evidence, previous experience, and professional judgement will be considered. The main problem to be addressed here is to deal with the access to healthcare for service users who may lack capacity. The entire healthcare department needs to make quality improvements. This quality improvement will be based on the problemsolving approach. Quality improvement is defined as the systematic approach to deal with the issues faced in the health care departments (Bond et al., 2005).

            Bolton (2015) defines decisionmaking approach is defined as the perspective that involves diagnosing the problems and making a specific decision. The quality improvement in the health care department is based on the interventions that will improve mental health care. Decision making involves three stages, micro, mesco, and macro. Gopee and Galloway (2017) states that these stages of decision making are based on structural factors. In this situation, these structural factors are analysed by analysing the entire case study and the inequalities that Mrs Kohli has faced. The decision of the quality improvement was allocated after consulting with the stakeholders (Botsford, Clarke, and Gibb, 2017). Consultation with the stakeholders helps in knowing and analysing the critical factors involved. Hamm (1988) suggests that these decisions are supposed to be made by analysing the critical situation and implementing the intuitive approaches. The decisionmaking process is supposed to be highly structured and involves six structural stages in common. These structural stages includes the scientific decision, controlled trial, quasiexperiment, systemaided judgement, peer aided judgement and intuitive judgement. The above case study analysis demands to go for the cognitive continuum to make decisions. It allows a detailed diagnosis and the analysis of the clinical audits and the system aided judgements (NHS England, 2019). Overall, this entire decisionmaking process follows the clinical, theoretical model, which helps sort out the healthcare departments issues (Botma & Labuschagne, 2019).

            The decision made to solve the problem is the quality improvement of the mental health care department. Schmadl (1979) defines quality improvement in nursing perspective to provide the patients with treatment by the continuous measurement and evaluation. It will lead to all the activities required to deal with the health inequalities that Mrs Kohli is facing. The quality improvement in the mental health care department requires six elements to be considered as per Maxwell’s elements of quality theory. Charles, Whelan & Gafni (1999) introduces these elements as acceptability, accessibility, appropriateness, effectiveness, efficiency, and equity. Focusing on all these elements will increase the service users access with the increase in the capacity. Following this approach will also help in dealing with the health inequality issues. But the mental health care department needs to involve several resources as well (Wiig et al., 2014). According to the NHS, mental health institutes face an increase in the  According to Wakefield, 2008, the four drivers considered in the quality improvement of the mental health care institutes are cost, error/patient safety, effectiveness, and consumerism. These drivers of the health care department will improve the services provided to those who suffer from mental health issues (Plsek, 1999) . This quality improvement is supposed to be made at the national level and the international level. Collins (2019) defines these four levels of quality improvement includes international (WHO), national (CQC), organisational improvement (NHS improvement) and local improvements. Friedli & WHO (2009) states that stakeholders also needs to get involved in the current situation. These stakeholders will provide the appropriate guidelines according to the suitable leadership style. Outcomes of this decision will help increase the healthcare service providers capacity, time savings, timeliness of the service provision, cost reduction, and the errors of mistakes that come with treating Mrs Kohli. Overall, implementing this decision and plan will help the mental health care department deal with the areas in which it lacks. It will also support the ongoing improvements that are supposed to be made (Grey et al., 2013).

            The second alternative decision that will be considered to deal with the inequalities that Mrs Kohli is facing is balancing the health care measures Involving the legal policies and the Human Rights Act 1998 will help in dealing with the neglect of the rights that Mrs Kohli is facing due to the enforcement and the decreased efficiency of the healthcare department. The theoretical perspective which will be applied to this decision is the Donabedian’s theory. This theory involves three components that will improve the efficiency of the healthcare department. These three components are the structures, processes, and outcomes. Implementation of this structure will help increase the positive outcomes of the health care department (Kobayashi et al., 2011) .

Moreover, it will follow the national healthcare services guidelines for the improvements in the quality of care. As per the first component of the Donabedian theory, the improvements will be based on the structural changes of the health care institute. It includes both the physical and the organisational characteristics in which Mrs Kohli is seeking with healthcare. The next component is the process focusing on the care that has been delivered to the patient. If this stage is compared to the given case study, then it can be analysed that the mental health care institute was not involving the policies and legal regulations set by the NHS and the England government. Both article 5 and article 8 of the Human Rights Act 1988 was not considered. Lynn et al., (2007) states that this lack of policies increase challenges for the patients as well as for the department. The mental health care department must introduce all these policies to improve the services provided and balance the efficiency measures. This alternative decision will be highly beneficial for the patients with mental disabilities because the improvements will be made in the entire mental health institute. According to Mclean et al., (2003) this decision will improve the healthcare service providers and will keep a balance in the efficiency and the countermeasures that are being provided. It is a versatile decision that will be implemented to improve all the three domains like clinical effectiveness, patient safety, and the patient experience. Also, these responsive services will keep the entire health department organised with perfection in the leadership and the management style (McCradden et al., 2020).

Patchwork task three – reflection

            Adeani et al., (2005) Gibbs cycle is defined as the reflection cycle, reflecting the learning experience and drawing better performance according to the condition. This reflection refers to ones learning and helps in the improvement of the self in future. It is one of the highly used theoretical models for selfanalysis, especially the health professionals. Other than this, the model provides clear and precise information for description, analysis, and evaluation of the entire experience. The Gibbs reflective cycle will include evaluating the above strategies, which were being described as referring to five different stages. These stages include description, feelings, evaluation, conclusions, and the actions required for further improvement in the future.

i.Description:

The module research was based on the health inequalities and the strategies required to deal with the inequalities and the violence faced by the nursing department. Although the module was very challenging for me due to the covid19 conditions, I still work hard and ponder upon the points I lacked. The module covered different perspectives regarding the contemporary health issues and the health inequalities faced by the mental health care departments and the patients. This module provides a piece of detailed information regarding the policies and the legal framework that is required to address the health issues. Despite the challenges that I faced in this module, I still find it very motivating and encouraging. I stay consistent by working hard throughout the module and work along with my fellows. The resulting situation enhances my knowledge and provides me with an encouragement that I might face in the future. My module professor made every concept regarding leaderships, theoretical perspectives, and models required for the mental health care improvements.

ii.Feelings:

During the modules start, I felt a bit confused and stressed full due to the covid19, and I was not sure how I would deal with this situation. But when the module started, I get to know that it is not much I had to deal with, and I can cater to every point by doing hard work and staying consistent throughout. The credit goes to my module leader due to the efforts, and after the entire situation, I feel much relaxed and less stressed. This is all due to the satisfaction level that I achieved after getting every concept cleared. So, this module is a mixture of all these feelings.

iii.Evaluation:

The modules positive thing is that it lets me learn many concepts and provides me with detailed information on every aspect of the contemporary issues faced by the healthcare departments. Initially, I was not good at dealing with the case studies and case scenarios, but due to the module leaders efforts, I get to know the practical implementation of the skills required to solve these case studies. Also, the module provides me with a theoretical perspective of a concept that has been covered. But the negative thing of the module is the covid19 situation. This pandemic attack was very challenging for me due to the stress and anxiety it caused. It does not promote effective learning and the practical learning that needs to be considered in this module. This is why the situation does not go that much well.

iv.Conclusion:

The entire experience was very positive for me, and it lets me learn a lot of new concepts that I was never aware of before this module. This module enhances my interpersonal skills and transferable skills, which will make me a better leader and a problem solver in the future during practical life. The skills that I need to develop are stress management and time management, which I lack. Stress management skill is highly required to deal with the stressful situations in the health care department.

v.Action:

I will be taking in feature the possible actions to increase the practical learning that I lack due to the coronavirus. This practical learning will let me deal with the areas where I lack, and it will provide me a detailed knowledge regarding every concept. These future actions will let me understand the practical situation and the inequality faced by both the nurses and the patients suffering from mental health disabilities.

Overall, Gibb’s reflective cycle provides me with an opportunity to selfanalyse myself and to look upon the areas where I lack. It also enhances the awareness regarding the positive skills that I do have in my personality. So, this patchwork provides me with an opportunity to self analyse myself.

References:

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