Healthcare Case Study Reflection

Introduction

The patient admitted to the hospital is a seventy-two-year man who was delivered to the facility via A & E. Initially, the man was admitted to the hospital with a facial laceration and elbow injury, but he was also diagnosed with an ankle and wrist fracture. It had been established during the investigation that the man’s injuries were explicitly correlated with alcohol intoxication. During their admission to the ward, the man acknowledged that he was a habitual drinker. Having undergone AUDIT, the man was found to have a score of 24, indicating an alcohol addiction.

While the man agreed to get professional help, the Alcohol Nurse Specialist supervising his case was now to deal with a variety of health and social obstacles in the way of recovery, including fractures, age, mental health status, and the scope of alcohol dependency. For this reason, the primary purpose of the present paper is to reflect on the given case study through the lens of public health policies and legislation, the role of a professional team and health promotion, and health economics challenges deriving from untimely health concern management. A major hypothesis prior to the analysis is the fact that health legislation and policies have a tremendous impact on the patterns of the patient’s rehabilitation, reduced readmission risks, and lower healthcare costs.

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Policy and Legislation

Prior to discovering the peculiarities of healthcare policies prevailing in the national framework, it is of paramount importance to dwell on the definition of policy in the given context. Hence, fundamentally, the notion of a policy stands for a set of specific initiatives, rules, and guidelines to meet a certain healthcare goal with the help of collaborative effort (Policies and procedures, n.d.). The policy, in this case, serves as guidance for healthcare professionals willing to improve the overall patterns of medical services across the state. However, in order to ensure that policies are relevant in the local context, it is critical to pinpoint the initiatives with quality data from research (Boswell and Smith, 2017). For instance, when speaking of a patient in question and the nurse’s initiative to redirect the man to the supervision of the Alcohol Nurse Specialist, such an initiative should be proved to be beneficial for both the health care and the patient.

A prime example of a policy framework developed by front-line medical professionals is the National Health Service Long Term Plan. This nationwide policy stands for the state initiative to allocate additional healthcare funding to meet the needs of the health care future, paying specific attention to such relevant issues as maternal support, increasing rates of the aging population, access to health care across the state, as well as the quality of care provided in relation to the money allocated for the procedures (NHS, 2019). The initiation of the policy was primarily predetermined by the detrimental environment for the healthcare development across the UK, as many people at the time were deprived of any kind of health care due to lack of funding and nationwide staff shortage (Alderwick and Dixon, 2019). As a result, the government decided to allocate nearly £20 billion to health care development.

Fundamentally, the NHS Long Term Plan manifests itself through the integration of two major policies. They include the Sustainability and Transformation Partnerships (STPs) and the Integrated Care Systems (ICSs) models. As far as the STP is concerned, its primary goal is to improve the patterns of providing healthcare by dividing the national healthcare networks into local partnerships that have the autonomy to create five-years finance and other resource allocation plans based on the healthcare demands in the area.

The existing framework has, by all means, a significant impact on the patient from the case study. In fact, one of the primary STP provisions implies the shift from A&E strain to better patterns of collaboration between GPs and patients, emphasizing the importance of primary and preventive care in saving money and promoting preventive health among the population (Lewney, 2017). As a result, instead of having an extensive network of hospitals in the area, the financial aid could be aimed at promoting better communication with primary care specialists such as GPs and proper access to preventive resources such as support groups for maintaining mental health and educational events to promote healthy behavioral patterns among the population.

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Speaking of holistic care per se, another significant contributor to the development and implementation of the NHS Long Term Plan is ICSs. The notion of ICS fundamentally stands for the complex process of removing the barrier to health care access catalyzed by the distinct division between healthcare branches, physical and mental health, and NHS and local support public services (NHS, n.d.). The primary goal of ICSs in the context of health care evolvement is to make sure that primary and preventive health care works efficiently enough in collaboration with other different assistance sources to prevent disease prevalence rates, health complications, and readmission instances.

While encouraging more efficient resource allocation and utilization, the ICS framework also encourages the eradication of socio-economic disparities in terms of access to health care. According to NHS (n.d.), when healthcare and public sectors are encouraged to collaborate, the primary attention is drawn to the issues that serve as potential health issue precedents. For this reason, while emphasizing the importance of improving social determinants of health, public organizations are as well encouraged to reduce such inequalities as housing and access to education, as these factors explicitly relate to the idea of better patient outcomes.

As far as the case study is concerned, it becomes evident that the rapid and efficient cooperation present between healthcare units is a critical factor for the patient’s well-being and recovery. Indeed, when talking about the complexity of the patient’s case, it should be mentioned that he simultaneously struggled with physical injuries, psychological trauma catalyzed by his wife’s death and isolation during COVID-19, and alcohol dependence. Thus, once he was admitted to the hospital via A&E because of physical injuries, the other issues were addressed as well in order to secure holistic care and prevent readmission to the facility with other injuries or alcohol intoxication. For this reason, it may be concluded that the NHS Long Term Plan on redesigning health care, especially as far as STP and ICS are concerned, is a vital component of providing meaningful, accessible, and cost-efficient treatment.

Apart from policies, every healthcare network is driven by legal provisions that define the terms of meeting specific goals. Essentially, the phenomenon of legislation concerns the framework of laws and legal guidelines that serve as a basis for health care. A prime example of legislation that has an explicit effect on the development of such policies as the NHS Long Term Plan is the Social Value Act of 2012. According to this Act, ‘people who commission public services [are] to think about how they can also secure wider social, economic and environmental benefits (GOV.UK, 2021, line 2). Thus, the major provision of this initiative is to make sure that organizations presenting public services, in this case, governments and private entities funding the healthcare sector, is to make sure these services contribute to the overall improvement of the socio-economic environment of the state.

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The logic behind such an assumption is the fact that the better the socio-economic environment is, the less effort would be needed in the context of secondary health care. As a result, the focus will be shifted towards eradicating inequality in society and promoting long-term healthy behavior among the population through education and continuous access to primary care with the help of online services. In the context of the case study, one of the underlying issues of the patient is the lack of social integration and support systems since the death of his wife and the start of the pandemic. Social Value Act of 2012, for its part, encourages public bodies to allocate human and financial resources to the promotion of social determinants of health that address community and social context as one of their primary concerns (GOV.UK, 2021). For this reason, it may be concluded that while the legislation does not directly participate in the cooperation between the patient and the practitioner, it serves as a roadmap for developing intervention and health promotion policies across the state.

The Multidisciplinary Team

One of the assets of health care is the ability to secure a proactive approach in terms of treatment and care. In order to ensure a proper model of healthcare intervention, primary and secondary care professionals, including GPs, clinicians, nurses, social workers, and public organizations, cooperate for the sake of positive patient outcomes and the prevention of readmission. In the context of UK health care, such a phenomenon is known as a multidisciplinary team (MDT) (NHS, 2021). The underlying principle of any MDT is the process of sharing relevant information across different team members in order for them to react to the patient information that might potentially become their prerogative.

Considering all the current prerequisites to the promotion of integrated care, it becomes evident that the scopes of MDTs, including physicians, nurses, the public sector, and patients, require the presence of an intermediator that brings these teams together. In the context of today’s health care, such a role is performed by a community health nurse. In the situation of a patient struggling simultaneously with physical injuries, alcoholism, and depressive disorder, it is vital that the nurse accounts for each of these aspects when designing a medical intervention.

Thus, while dealing with alcohol dependence with the assistance of the Alcohol Nurse Specialist, the patient is also likely to require the help of a counselor and a physiotherapist. Given that the situation concerns three hospital divisions, is it necessary for the patient to feel comfortable with accessing all these services in a holistic and integrated way in order to facilitate rapid recovery and quality patient outcomes? Moreover, the collaborative work of a physiotherapist, an addiction specialist, and a counselor is likely to result in fall prevention in patients due to the elimination of fall risk catalyzed by depression and alcohol abuse as well as the promotion of increased mobility efficiency with the help of physiotherapy.

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Indeed, there exists data that proves that isolated patterns of treating injuries, alcohol addiction, and mental conditions, although frequent, are highly inefficient when it comes to long-term implications. The research claims that the correlation between alcohol addiction and depression occurs alarmingly often, with such an interdependence leading to increased risks of health issues, deterioration of alcohol abuse, and social isolation (Owens et al., 2017). As a result, in order to combat this issue, the MDT referral system for alcohol-dependent patients emerged.

In many cases, patients feel rather confused when they pursue separate treatment for their alcohol dependence and depression, as they often face contradictions in terms of recommendations and therapy patterns. However, once a united team of professionals works on the case, encompassing physiotherapist, alcohol team, and mental health team, the patient is more likely to undergo efficient and long-term health intervention. Moreover, in the given scenario, there is a reduced risk of emergency department visits from the patient in the future; according to Owens et al. (2017), patients who are unaware of the source of help they need in a certain situation, ‘were utilizing the ED as a fail-safe when they were troubled’ (p. 393). However, once the help is provided in a holistic manner, the risks of readmission and poor patient outcomes are significantly lower. As a result, there are benefits for both the patient and the healthcare system, as integrated care secures lower chances of additional hospital expenses during readmission.

Health Economics and Inequality

The financial constituent of health care is a critical factor when considering the potential development of this sector. The significance of economics in health is especially evident in the example of UK health care before and after 2019, as 2019 was marked with a governmental initiative of allocating more than £20 billion to the healthcare sector. Considering the existing issues in the context of health care, the primary focus of such healthcare providers as NHS is to define the areas that currently require the most financial investment and locate the ways of reducing these expenses for the sake of preventive measures. When tackling the case study in question, the potential cost risks include the age of the patient, falls, mental health, and alcohol addiction.

As far as aging is concerned, many people are preoccupied with the fact that a higher number of people aged 65+ is likely to significantly affect the pattern of health care expenditure in the near future. However, while an increasing rate of the aging demographic is not beneficial for the development of health economics, the potential outcomes are not as drastic (Cylus et al., 2019). According to the World Health Organization’s reports (Cylus et al., 2019), aging population development is an extremely gradual process that cannot result in a rapid health economics crisis. Still, there is a need to promote healthy behavior among the older population in order to make sure there is no disruption in the overall patterns of economic equity among the population, as increased socio-economic disparities would inevitably affect the allocation of healthcare resources and costs.

In the context of the given case scenario, the primary catalyst of health expenses is the patient’s mental condition. Indeed, the prevention of a severe depressive episode and isolation could have prevented such detrimental health complications as injuries and intoxication. According to Le et al. (2021), the presence of mental disorders in people has severe consequences for one’s health and socio-economic stability, which means that a person with mental conditions eventually faces considerable financial and social challenges. For this reason, it is reasonable to encourage the promotion of mental well-being from both health-related and financial perspectives. Once more initial investment is allocated to addressing mental health issues of the population, fewer financial losses are expected in other parts of the healthcare paradigm. In the given case study, such an initial investment could concern with creating community outreach services for older people experiencing losses of close family members. If the patient had initially been encouraged to visit offline or online support groups or have a community-based counselor, he would not have been admitted to A&E in the first place.

The next issue relevant to national health economics is the problem of alcohol abuse and addiction. According to the most recent calculations, nationwide consumption of alcohol results in nearly £3 billion of NHS expenses (NHS, 2020). For this reason, it becomes evident that the adoption of a proactive approach towards community education on the risks of addiction and alcohol abuse, along with the education on support services that may replace one’s urge to drink, is a beneficial tool for the reconsideration of local health economics. Finally, the notion of falls, which is a considerable aspect of national health economics, is as well preoccupied with the strategies of fall prevention, such as using assistive walking equipment.

Reflection

In order to provide a reasonable reflection on the content presented, it is necessary to dwell on the initial aims of the essay. Thus, the essay aimed to analyze the case study of a seventy-two-year-old patient struggling with several physical injuries as a result of alcohol abuse and serious mental issues. The nurse estimated that on a weekly basis, the patient tended to take up to 70 units of alcohol per week, so she had no option but to encourage the patient to seek professional help, as since his wife’s death three years ago, the man had been living on his own and had no supervision in terms of alcohol consumption. For this reason, I found it necessary to look at this situation through the lens of a complex healthcare system in the UK. This complex system encompassed the roles of existing policies and legislations, multidisciplinary teams, and economics.

The first aspect of health care, policy, and legislation defined the underlying direction of the existing healthcare initiatives, including the promotion of collaborative practice and county autonomy in terms of these collaborations. When applied to the case study context, these frameworks helped understand the professionals’ motivation behind conducting a psychologic and narcological assessment of the patient with several fractures. The second aspect or the prevalence of multidisciplinary teams as a means of securing efficient healthcare. It was established in the process of writing that such teams serve as a foundation for personalized and proactive care. In the case with the patient discussed, it was the collaboration within an interdisciplinary team that allowed for a timely intervention concerning the man’s potential heavy alcohol dependence. Finally, the paradigm of health economics was found to be a framework of a decision-making process in health care, as financial opportunities of a healthcare sector could be defined as a leading factor in the formation of policies and legislation.

In terms of research, I have discovered a strong correlation between the arguments in favor of primary preventions as an economic tool and the public well-being initiatives pursued by such policies as the NHS Long Term Plan. Such an intersection is, by all means, an indicator that the health care sector is currently moving in the right direction, as saving money on secondary medical interventions will potentially result in allocating finance to preventive care and addressing such aspects as social determinants of health. Consequently, the investment in primary and preventive care, especially as far as the mental health of the population is concerned, is an asset not only for preventing excessive healthcare expenditure but for the social welfare of a nation as well.

Having closely considered these phenomena with the help of primary sources such as NHS reports and documents, as well as the third-party scholarly evaluations of such initiatives, I have discovered the fascinating power of collaboration in the healthcare context. Indeed, I finally realized the extent to which preventive care is crucial for society. While many people understand the need to take care of their health in advance and avoid various health risks, few may acknowledge the actual scopes of significance such prevention has on national health and socio-economic patterns. The case study, as a foundation for the analysis, in fact, manifests how early health interventions serve as saviors in terms of potential complications.

When pondering a specific case scenario, it became evident to me that instead of being admitted to the hospital with a series of injuries and an evident alcohol abuse problem, the patient’s condition could have been easily prevented with the help of a timely mental health support intervention. For this reason, it should be noted that such policy initiatives as STP are of paramount significance to the development of the overall healthcare network, as providing local communities with autonomy to address relevant problems may become a beneficial patient-centered approach to holistic care.

The autonomy in question, however, walks side in side with the idea of cooperating and looping efforts to make a better healthcare environment. Indeed, I now understand that strategic partnership is about trusting local community leaders to have enough skills to bring their communities together in the pursuit of harmony and well-being. Bearing this in mind, the nurse from the case study, instead of focusing solely on her area of expertise, conducted a full-scale assessment of the patient, incusing his addiction problems and possible reasons behind its emergence. As a result, she was able to share this information with another professional and encourage the patient to proceed with his treatment regarding other issues he experienced. In such a way, health professionals minimized the risk of readmission, simultaneously providing the patient with the wholesome care and support he required at the time. Hence, it may be concluded that the presence of MDTs in terms of health care is a central aspect of securing timely and quality implementation of the policies described above.

For this reason, I have realized that the future of health care is never dependent solely on one party, whether it is government or the community. The interaction between these social layers is what truly matters in the context of developing a working care framework. Moreover, I reached a conclusion that in the future, it would be critical to raise people’s awareness on the matter of mental well-being. Compared to physical health, the paradigm of mental care has recently become overtly discussed in the community. However, while some people continue thinking that mental health is about one’s psychological stability, they fail to recognize the impact mental health support has on their physical condition.

It is imperative to encourage front-line health workers and researchers to present tangible healthcare solution models, as they are the ones aware of the first-hand complications of community health neglect and lack of interprofessional collaboration. Thus, considering all the points, it may be concluded that the concept of health care is a combination of policies, legal guidelines, social collaboration, and allocation of resources. Once at least one of these aspects is removed from the equation, the results will never be satisfactory for the community.

Reference List

Alderwick, H. and Dixon, J. (2019) The NHS long term plan. BMJ [online], 364.

Boswell, C., and Smith, K. (2017) Rethinking policy ‘impact’: four models of research-policy relations. Palgrave Communications [online], 3 (1), pp. 1-10.

Cylus, J., Figueras, J., and Normand, C. (2019) Will population ageing spell the end of the welfare state? A review of evidence and policy options [online].

GOV.UK (2021) Social value act: information and resources [online]. Web.

Le, L.K.D., Esturas, A.C., Mihalopoulos, C., Chiotelis, O., Bucholc, J., Chatterton, M.L. and Engel, L., (2021) Cost-effectiveness evidence of mental health prevention and promotion interventions: A systematic review of economic evaluations. PLoS medicine [online], 18 (5).

Lewney, J. (2017) Sustainability and transformation partnerships: what are they and how do they affect dentistry? British Dental Journal [online], 223 (8), pp.565-566.

NHS (2019) The NHS Long Term Plan [online]. Web.

NHS. Statistics on alcohol, England 2020 [online].

NHS (2021) Information sharing in multidisciplinary teams [online]. Web.

NHS (n.d.) What are integrated care systems? [online]. Web.

NHS Kernow (n.d.) Policies and procedures [online]. Web.

Owens, L., Patterson, K., King, G. and Richardson, P. (2017) A multidisciplinary team (MDT) approach to managing alcohol-dependent patients with comorbid depression in an acute hospital setting. European Psychiatry [online], 41 (1), pp. 393-393.

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