Context of care and service delivery

This chapter explores some of the current political, economic and social policies that are shaping the context of nursing practice and service delivery for children and young people with long‐term illnesses. Examples of service models and nursing roles are used, demonstrating their influence upon the shifting boundaries of clinical practice and service delivery. The chapter also explores the complexities surrounding shifting health and social care workforce role boundaries, associated competencies and their impact upon service users, professionals and managers. There have been changes to the mechanisms for funding and commissioning health care services to encourage more integrated local needs‐based commissioning and increasing accountability and governance of health care expenditure. The chapter considers some of the implications of the political, social and economic drivers upon service from a practice context. It highlights the impact on the roles of parents and nurses, and service challenges that need to be addressed to support these changes