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LO1: Explore the legal framework which health and social care practitioners operate.This assignment will provide an overview of the legal framework which health and social practitioners operate within giving an explanation of the ethical challenge’s which are faced and an evaluation of the impact of the Northern Ireland Assembly has on the provision of health and social care services. The planning and implementation of legislation and policy which applies to Health and Social Care The legislature consists of a purposeful assembly which has the authority to make laws for the country. The Northern Ireland assembly is made up of 108 members, each member is elected by a single transferable vote and has full power to make legislative changes on most economic and social matters. Members of the legislative assembly (MLAs) meet to dispute issues and present laws to support the individuals in Northern Ireland. The executive is organised to ensure power sharing, it is made up with the first minister and deputy first minister who are required to work supportively. The executive exercises executive authority on behalf of the Northern Ireland assembly. It takes decisions on important issues and also agrees proposals put forward by minsters for new legalisation in the form of executive bills for consideration by the assembly. (Gov, 2018)The judiciary is the most important feature of democracy, it is responsible for safeguarding the interests and fundamental rights of the people. It acts as a watchdog over the actions of the legislature and executive and curtails the same when it violates the rights of the individuals. Judiciary has to put in force the law and discipline those who are found to be breaching the same. Key features involved Legislation refers to the law that the parliament makes laws which reflect the statutory right of organisations, groups and individuals, legislation makes sure that everyone is clear about their rights and responsibilities within the environment. An example of legislation includes The Safeguarding Act (Northern Ireland) 2011, Legislation is very important as for health and social care workers and users as it can be used to help and protect them against poor practice. Statutory guidance sets out guidance to health care workers on what they must to do to comply with the law as it covers legislative requirements which are placed on individual services making it clear what organisations should do. It also supports professionalism which support and develop arrangements for best practice. An example of a statutory guidance is working together to safeguard children- a guide to interagency working to safeguard and promote welfare of children July 2018, this guide covers the legislation requirements placed on individual services who have a legal duty to safeguard children. (HM Government, 2018) Professional codes of practice are put in place in order to guide and inform practitioners of their rights and responsible. NMC is an example of code of practice which “Promotes Professional Standards” (NMC, 2018) which explain the way members of the profession must behave. The professional code of practice ensure that nurses and midwives keep their skills and knowledge up to date for example there are standards of education, training set ensure that there is constant high-quality care provide throughout their careers. A national policy is a course of action of statement by the government which responds to the calls for strengthening of health system, they serve to guide and steer the policy direction for ensuring the health of the population. Organisational policies are mechanisms by which legalisation is delivered and implemented. Organisational policies are used within organisations to promote equal opportunities and reinforce codes of practice of specific professional bodies. Ethical Challenges faced in Health and Social Care Ethics are a system of moral principles, which deals with right and wrong. It has been argued that health and social care is a value-based form of professional activity. In the field of a professional ethics, “values usually take the form of general ethical principles relating to ow professionals should treat people they work with and what sort of actions are right and wrong.” (Bernard, 2017). I will now examine two areas of ethical practice in health and social care which face with ethical challenges.Firstly area number one the Charlie Gard case. Within the case of Charlie Guard there has been a challenge with beneficence being applied. Beneficence was put in place in a legal way as it was very straight forward in putting the decision for experimented medical treatment in the best interest of Charlie. In this case law and ethics clashed as for the medical staff, under the English law when a patient is not competent to make decisions they must be made on his behalf in his best interest. As Charlie was too young, he did not have values or beliefs that contribute to an assessment of best interests which medical best interests are most important, the medical staff at GOSH held that treatment did not serve Charlies best interest therefore should be withdrawn. In this case professionals are following the NMC code of practice by “acting in the best interest of the patient” (NMC, 2018) they have done this by keeping all the laws ensuring that the rights and best interest of those who lack capacity are still receiving person centred care. Non maleficence in the case of Charlie guard was applied when faced with certain death without treatment Charlies parents searched for and found an experimental treatment that could possibly benefit him. However, The decision that was made by the doctors were only based on the reason that no therapy would save Charlies life as they wanted to protect Charlie and save him from any unnecessary pain. It came back very clear that “Hirani’s proposed treatment had never been used on patients like Charlie that he never even seen Charlies nots or read them when the treatment was offered and that he half financial interest in the treatment”. (Brassington, 2017) The medical team argued and were very confident in their findings as for them “allowing him to travel equates exacerbating his pain” (Bamijoko, 2018) meaning there avoiding harm. Area number two foetal alcohol spectrum disorder (FASD) is increasingly recognised as a growing public health issue worldwide. It is another area in health and social care where there are ethical challenges. The principle of autonomy implicates independence when making health care decisions. Adults are said to be capable to be able make such decisions but however there may be challenges in this as an individual’s alcohol addiction or dependence especially in minor adults may be considered to have limited capacity in this situation. For example health and social care workers have to consider using the NMC code “at all times with the requirement to respect a person’s right to accept or refuse treatment” (NMC, 2018) pregnant adults are free to make autonomous decisions about their body, they may have also tried all the tools of help to stop but their addiction is strong. Limiting the mother’s access to alcohol could begin to create conflict with the principle of autonomy being applied. The principle of justice can be applied to the ethical challenges towards FASD. Justice refers to the fair, equitable and appropriate treatment based on what is due to persons and this is compromised when unfair rules and restrictions are forced upon woman who are pregnant, a pregnant woman has the right to make her own choice and for it to be respect however this can be argued with the child having no rights. “True partnership working can be challenging as it involves enabling and respecting choice even though it may challenge a nurse’s own perspectives of what is best for the individual” (Scammell et al, 2012) Professionals are following the NMC code of practice ensuring that the ethical principle of justice is provide as the code states “by respect and uphold people’s human rights” (NMC, 2018)Own National System of Government: NI Assembly The Northern Ireland Government was established in 1998 which included the signing of a peace agreement after three decades of violence and conflict between two main communities in Northern Ireland. In January 2017 the Northern Ireland assembly and power sharing executive collapsed due financial, the ruling democratic unionist party was blamed for the failure of a renewable heating scheme. This corruption lead to implications within the health and social care sector, Marie-Louise Connolly states “Opportunities to transform the service were being lost and years of working to get Northern Ireland to this point were about to go down the drain” (Connolly, 2017) I will now examine two areas of which have been affected by this corruption with regards to health and social care. Firstly, In cancer care a 62 Day Ministerial Target is set “At least 95% of patients should begin their first treatment for cancer within 62 days following an urgent GP referral for suspect cancer” (Department of Health, 2018) Due to the collapse of NI assembly There is a concern for the delays in diagnosing patients is a concern as there is a failure to meet targets set for patients, “at the end of June, 109,571 patients were waiting a diagnostic test with 43.5% waiting longer than nine weeks, an increase from 36.5% at the end of march. Almost 12,700 patients were waiting more than 26 weeks for a diagnostic test” (Campbell, 2017). The increase in waiting list time has an impact on patients in many ways, the patient will begin to suffer from anxiety with the worry having an effect on mental health which ill progress onto the need for other services and more help. Stress will be added to the symptoms of the patients due to the uncertainty of the progress of the condition. Socially patients will begin to feel socially isolated with having so much pain and being embarrassed about condition. Financially the patient also will feel pressure to go private when they may not be able to afford it. The practitioners will be impacted by feeling the pressure and feel that they are in the blame when it is the government which are lacking in providing funding. Carers allowance is another area which the Northern Ireland assembly need to consister improvements towards. Carers are people who provide informal usually unpaid care to someone with a long lasting health or care need outside a professional or formal employment framework. “This informal care is often an ignored sector of the economy yet it is thought that a staggering 80% of all care across European Union is given by family and friends”. (Thompson, 2018). The carers allowance in Northern Ireland weekly rate is £64.50 for a carer who is caring at least 35 hours a week and they get certain benefits. (NI direct, 2018) Meanwhile on MLAs are getting paid an extremely extra amount of around £961.53 a week. This lack of income to carers will have a negative approach in many ways, the work they do is not half covered with the income which the NI assembly provide to them. Financially They may have to pay bills, essentials such as food may need to come out of the income they would have to attend a part time job which could have an negative impact on the service user not getting the best care that they should, and they will begin to see them self-stressed and find it difficult to juggle all their family responsibilities as well as a life outside caring. They could suffer mental health leading to depression with such low incomes. Reference ListBarnard. Adam (2017) Developing professional practice in health and social care., Routledge London Brassington. Iain (2017) Charlie Gard: An Ethical Analysis of a Legal Non Problem. Journal of Medical EthicsBamijoko. Abiola (2018) Does Charlie Gard deserve to be taken of life support. Postmodern Openings. volume 9 issue 1The Irish News (2017) collapse of Stormont power sharing, how services are being affected Department of health (2018) Northern Ireland waiting time statistics – available online: https://www.health-ni.gov.uk/sites/default/files/publications/health/hs-niwts- cancer-waiting-times-q1-18-19_0.pdf Scammell, J. Hemingway, A. Heaslip, V. (2012) Humanising Values at heart of nurse education. Nursing Times. Vol 108 No 41 NI Direct (2018) Carers Allowance – available online https://www.nidirect.gov.uk/articles/carers-allowance NMC code of practice (2018) available online https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf