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- W4313388670 abstract "Abstract A change of government in 2010 brought fresh NHS reforms and a new Health and Social Care Act (HSCA, 2012). Both, along with the 2014, Five Year Forward View (NHSE) set the tone for this Chapter. We discuss how the continued emphasis on competition between providers, and the introduction of Clinical Commissioning Groups (CCGs) which replaced Primary Care Trusts (PCTs) as commissioners of community services, impacted on community nursing service management and delivery. Policy shifted in favour of a more co-operative approach to service provision and familiar agendas were set out for keeping people out of hospital with reform based around integration between health care sectors and between health and social care services. There was little change on the ground for district nurses in this era despite increasing emphasis on integrated care, collaborative, cross-sector working (i.e. with LA social care) and multi-disciplinary team management of complex patients. The HSCA 2012 began to unravel almost as soon as it was enacted, with the emphasis on competition undermined by the Five Year Forward View shift towards integration between sectors as a dominant organising principle. Community Health Services (CHS) were, to some extent, protected from the fragmentation associated with the Act, and in terms of district nursing practice, this era generated little change with patterns of service provision remaining very much as they were following the upheaval generated by the Transforming Community Services agenda." @default.
- W4313388670 created "2023-01-06" @default.
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- W4313388670 date "2023-01-01" @default.
- W4313388670 modified "2023-09-26" @default.
- W4313388670 title "2010–2015: The Health and Social Care Act, NHS Fragmentation" @default.
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- W4313388670 doi "https://doi.org/10.1007/978-3-031-17084-3_7" @default.
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