title: The impact of changes in health and social care on enteral feeding in the community.
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&#8217;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 &#8220;Big Society&#8221;. 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.
authors.affiliation: Department of Acute and Continuing Care, School of Health and Social Care, University of Greenwich, Avery Hill Campus, London, SE9 2UG, UK. o.ojo@greenwich.ac.uk
authors.forename: Omorogieva
authors.initials: O
authors.lastname: Ojo
mesh_terms: D002318:Cardiovascular Diseases / Q000628:therapy; D003153:Community Health Services / Q000639:trends*; D004750:Enteral Nutrition / Q000191:economics / Q000639:trends*; D006258:Head and Neck Neoplasms / Q000628:therapy; D017048:Health Care Costs; D006285:Health Planning / Q000639:trends; D006295:Health Resources / Q000639:trends; D006301:Health Services Needs and Demand / Q000191:economics / Q000639:trends; D006742:Hospital Bed Capacity / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D011787:Quality of Health Care; D013222:State Medicine / Q000191:economics / Q000331:legislation & jurisprudence / Q000639:trends*; D006113:United Kingdom