Abstract
This paper examines the impact of the changes to health and social care on enteral feeding in the community, outlines implications for practice and offers recommendations to ameliorate the challenges. It is now clear that there have been significant changes especially in the last 10 years in health and social care provisions in the UK with an overarching effect on enteral nutrition in the community. Advances in technology, increasing demand and treatment costs, the need for improvement in quality, economic challenges, market forces, political influences and more choices for patients are some of the factors driving the change. Government’s vision of a modern system of health and social care is based on initiatives such as clinically led commissioning, establishment of Monitor, shifting care from acute hospitals to community settings, integrating health and social care provisions, Quality, Innovation, Productivity and Prevention (QIPP) program and the concept of “Big Society”. These strategies which are encapsulated in various guidelines, policies and legislation, including the health and social care Act, 2012 are clarified. The future challenges and opportunities brought on by these changes for healthcare professionals and patients who access enteral nutrition in the community are discussed and recommendations to improve practice are outlined.
Highlights
There have been changes in the UK National Health Service (NHS) since its inception in 1948 the changes have been profound in the last 10 years [1]
The individuals suffering from cardiovascular diseases, cancer and diabetes which are among the leading cause of death globally may require enteral feeding due to related complications such as stroke [3]
The drive towards primary care led NHS is one of the strategies being adopted by government which is aimed at addressing some of the health and social care challenges
Summary
There have been changes in the UK National Health Service (NHS) since its inception in 1948 the changes have been profound in the last 10 years [1]. The drive towards primary care led NHS is one of the strategies being adopted by government which is aimed at addressing some of the health and social care challenges This means that new ways of working have to be developed including the need for multidisciplinary collaboration and cooperation in the care of patients on enteral feeding in the community [9]. The target of government is to create greater flexibility in service provision, better accessibility and minimal disruption to daily lives [10] These changes have come with challenges and opportunities across the broad spectrum of health and social care provisions especially with respect to Home Enteral Nutrition (HEN) service in terms of professional roles and responsibilities, hierarchy, recruitment and retention. There are factors which hinder and facilitate collaboration in a multi-disciplinary team such as the HEN team, including organizational and individual factors [14,15]
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