Community Care services can be divided into services which meet ‘health care’
needs, and services which meet ‘social care’ needs.
Health Care Needs
Health care needs might effectively includes any care, treatment and therapy
that has to be provided by a registered nurse, doctor, or any indeed member of
an NHS multi-disciplinary team. There is no definition of what is and what is
not a health care need.
It is the responsibility of the National Health Service to provide a range of
services, which meet a person’s health care needs, where they require continuing
physical or mental health care, where appropriate.
These services can be provided either at home, in a nursing home or a
residential home and include:
- Primary health care;
- Assessment involving doctors and registered nurses;
- Rehabilitation and recovery (where this forms part of an overall package of
NHS care as distinct from intermediate care);
- Respite health care;
- Community health services;
- Specialist health care support
- Healthcare equipment;
- Palliative care;
- Specialist transport services.
Social Care Needs
Social care needs are those that can be met by non trained medical staff,
i.e:
- Basic help with mobility,
- Help with dressing,
- Feeding where it does not need to be intrusive / carried out by trained
medical staff
- Help at home
- Help with social and educational needs
A Social Care Need or a Health Care Need?
There is no defined list of what is a social or a health care need. Guidance
often is misleading and vague. With regard to health care needs, if the test is
whether the needs are already being met by trained NHS staff, then people whose
needs are not being met are in a difficult situation.
A problem can arise with some needs that appear to fall within the two, for
example poorly supervised continence needs can lead to infections and become
serious. Equally, although feeding may appear to be a social need, a person may
have additional psychological needs that might mean a trained person needs to
persuade and encourage them to eat at all.
The line becomes more blurred where a carer becomes so experienced in
providing care services that they take on duties that would ordinarily be the
responsibility of trained medical staff. Simply because a person never has
received care from health services staff does not mean that they do not have a
variety of complicated health care needs, as these might be met by their carer.
Social Services retain the responsibility for meeting social care or personal
care needs, where appropriate.