Publication
Health promotion and community care: the perceptions of users, purchasers and providers of community care services
Glossary (III)
No shared understanding exists of many key terms used in this field. The same language may be used with different meanings across and within various agencies and professional groups, while professional jargon may be alienating for people whose expertise rests on their experience. A glossary is therefore provided to clarify the way terms have been used by the authors of this report. The varying uses of key terms such as ‘quality of life’ by respondents and the meanings they held are, of course, illustrated and reflected upon in the course of the text.
access
The availability of something (whether a building or information) in a form that is usable by those who need it.
assessment
A formal process by which the needs of someone who may require community care services are considered and a decision made about the kinds of support which may be provided to meet those needs. Assessments may be simple or complex depending on the level of needs. In theory assessments should be multidisciplinary and involve the user and any informal carers. Assessments are required to access community care services. A separate financial assessment may be undertaken to determine capacity to pay.
best value
The concept which has superseded ‘value for money’ to indicate the policy that services must demonstrate quality and effectiveness to justify the expenditure of public monies i.e. it is the quality of the service rather than the sector of the provider (public or private) which should determine spending choices.
care management
The process of identifying services to meet an individual’s needs, of managing the delivery of those services, whoever provides them, and of continuing to review the needs of the individual and the appropriatenes of the support provided. A care manager may or may not have control of funds and may or may not excusively exercise the care management function.
carer
A person who provides support to someone with a need.
commissioning
The contracting, purchasing, monitoring and if necessary, prior development of services to fulfil identified needs. Joint commissioning is collaboration between agencies (such as health, social work and housing) to commission services in response to agreed needs.
community
A group of people with common concerns who my live in the same area. Often used to indicate the general and collective, as distinct from the individual, interest.
community care
Policies and services developed to meet the needs of people who require support in order to live independently including older people, people with mental health problems and people with disabilities. The range of needs covered is not fixed, but in this report reference is made primarily to the ‘priority groups’ usually identified in community care plans (see below). Specifically community care is used to mean the policies introduced by the NHS and Community Care Act following the Griffiths Report, although concern to improve services for these population groups predates the Act, for example in the SHAPE and SHARPEN reports in Scotland. Community care policies embody the principles of normalisation (see below) and aim to develop the option of living as independently as possible in the community as an alternative to institutionalisation. While social work was designated the lead agency in community care, community care includes health, social and housing services, although the divisions of responsibility remain contested. Community care can include health as well as social care and may well work closely with health care delivered in the hospital setting.
community care plans
Public planning documents produced, after consultation, jointly by the local agencies invoved in community care, to indicate their policy priorities and service development and spending plans.
community participation
One of the key Health For All principles, the idea that people should be enabled to participate in decision-making about their lives and the policies and practices that affect them.
contract
A legal agreement specifying the services to be provided for a given price.
decentralisation
Administrative functions devolved to a more local or lower organisational level.
devolved budget
Some responsibility for spending or budgetary control exercised at a lower level than the centre of an agency, for example by an individual practitioner.
disability
Disadvantage, including social oppression, experienced by people with any kind of impairment.
empowerment
State of having the power to voice and determine one own’s destiny (and the process of enabling people to get there).
equity
Policies, services and expenditure to be proportionate to need i.e. those most in need may receive a greater share than those in lesser need.
exclusion
State of being marginalised or unable to participate fully in society. Also may refer to the legal, social or cultural processes that create the barriers to such participation.
formal care(r)
The work of someone who is employed to provide care.
See also informal care(r) below.
generic
Functions and skills which are general rather than specialist and may be shared by a range of practitioners, for example general nursing skills as distinct from specialist training in mental health.
good life
Term used in the focus groups for this study to indicate a desirable quality of life.
health
State of well-being, with physical, social, emotional and spiritual dimensions that represents optimal functioning and sense of ease, whatever the situation. Not the same as health care or medical care.
health care
Services provided by health care agencies to prevent or alleviate illness or to promote or maintain health.
health for all (HFA)
International movement that advocates a social model of health and sees co-operation between agencies as a vehicle for greater equity and improving quality of life. HFA is particularly associated with community development approaches and action by local authorities.
health promotion
Theory and practice to promote health. Includes work on the social and political barriers which may influence health as well as on ‘unhealthy’ behaviours. Sometimes used to refer to the profession or agency with this specific remit and sometimes denotes the broader set of ideas.
inclusion
A view of society in which barriers to participation are actively overcome by positive policies to include everyone.
independent living
The philosophy that the user should be in control and should employ the people s/he wants to give support. This way of thinking and organising services rejects a paternalistic philosophy of ‘care’.
informal care(r)
The work of a person who provides care because of their social relationship (family, neighbour) with the user, rather than as a job.
local government reorganisation
The replacement of 12 Scottish Regions by 32 unitary and island councils on 1 April 1996.
locality
A defined geographic area which may be meaningful to people who live there or may be a mere administrative division.
medical model
Reductionist approach that labels people’s needs according to their diagnosis and illness and may therefore result in narrow strategies that respond to an expert view of the situation.
mixed economy of care
Services provided to the public from a variety of sources i.e. statutory, voluntary and private sectors.
needs
Those things which have to be satisfied for a person to live a full life in society.
new public health
Public health ideas and practice that are holistic in their approach to the health problems of communities and identify the responsibility for health gain in a wide range of public services and policies.
normalisation
Theory that influenced the development of community care and was a reaction to the practices of institutionalisation. States that everyone has a right to to lead an ordinary life and that services should not stigmatise people by treating them differently.
positive mental health
A state of positive well-being as distinct from an emphasis on sicknes or its absence.
primary health care
The first line of health care in the community including general practitioners and community nurses with an emphasis on diagnosis and prevention.
provider
A practitioner or agency that provides a service directly to the consumer.
purchaser
A person or agency with responsibility for buying a service from a provider on behalf of the consumer, particularly in a market context where the functions of purchase and provision (or supply) have been separated.
quality of life
Social well-being i.e. well-being that includes all those elements that need to be present in society for the individual to enjoy well-being, such as political freedom.
rights
Entitlements, for example, as a citizen, to which a person has a legal or moral claim.
satisfaction
Subjective evaluation of extent to which a service meets personal needs.
service brokerage
Negotiating services on behalf of a user.
social care
Services provided to support social functioning.
social care market
The application of market theory to social care services.
social citizenship
The right to full social participation.
social inclusion
See inclusion
social justice
The policy goal of a framework of society based on a fair response to needs.
social model
The perspective that causes (of health) are multifactorial, that social and cultural factors may determine the barriers leading to disability and lay views (based on experience) are as legitimate as those of experts.
sustainability
Seeks development practices and solutions that can be viable over time.
user
The person who receives a service, the consumer.
user voice
Enabling the views of service users to be heard.
well-being
State of perceived ‘feeling good’, incorporating both subjective and objective elements.