Transformation of health care is an attempt to rearrange the delivery system to the patient as the receiver of the services from the services providers who are the health care officers. The program aims to have the services delivery change to assume a customer-centric focus, where they are more concerned about the services they provide to the patients. The transformation requires health care to acquire a leadership that can take the risk in change the system through, first changing from the traditional values by involving non-traditional partners. Secondly, directing the improvement of health care services to be high quality and affordable to the clients to enhance the delivery of the services. The creation of a strategic identity where all the efforts in the development strategies are directed towards achieving the goal of transformation achieved through good communication across the facilities. Also maintaining and building trust in the health care can be achieved through ensuring they change from facilities where data is placed for safekeeping to a centre where confidence in the system is built through the providers and the protocols among other commitments to changing the system.

The transformation of health care has led to the rethinking of the roles of most health care professionals as the market is shifting and change becomes inevitable. In response to change the development of the Affordable Care Act of 2010 provides the facilities with the entity, where the development of new roles is based in response to change. New roles and opportunities for the health care officials will be used in the attempt to increasing the quality of the services provided to the patient as the system is transformed into a patient-centred system. The transformation in health care is deeply dependent on the government policies in place to control the change as well as the leadership in place and their response to change. The transformation has so far led to the development and evaluation of the high quality and technologically developed hospitals, the care for chronically ill-being coordinated with that of the elderly in an attempt to improve the services to the customer among other achievements.

The transformation was driven by winterbourne's view of hospital cases where discrimination that the patient was experiencing was too high to be ignored. The closure of the hospital was to ensure that services are provided to the patient in an environment free from all forms of oppression by the health workers. In doing so the program was to change the existing culture where the value of the patient was degraded through the use of abusive words and phrases indicating the existing system required to be changed for the betterment of the services. The long period that the patients were staying at the hospital was the cause of the congestion that was reported in the hospital and was the cause for the call for changing the hospitals to have patients served at home to reduce those cases.

The quality of health services given at winterbourne view hospital was considered poor and thus unhealthy to the extent where the prescription was done without cases of diagnosis. The cases reported on a patient with the mental disorder being given anti-psychotic and antidepressant drugs without the following and administering the prescription ware numerous. Similarly, cases of restricted visitation of the patient by their family members created an environment where the degradation of the services provided to the patient as no observation was done on the quality of service they were offering. The degradation of the services was the failure of the management to meet its goal in the management of resources, but the failure of the hospital to have management was the cause of the failures as they lacked someone to monitor the progress of theirs resources, staffs, and health workers. The transformation aims to improve the quality of the health care services to the patients in an attempt to change it to patient-centred.

1.1         Literature review

The previous research on transformation forms a key aspect to the program on Winterbourne view hospital. According to, Taylor, et al. (2017).  On the effects of transformation of health care and consideration of the safety and effects the policies of transformation will have on [people with disabilities. The policy on the transformation lacks investment in the community where despite the lack of knowledge and clinical complexity that is associated with tackling and taking care of patients under the intellectual mental disorder (Taylor, et al. 2017). This patient usually displays offending and non-offending behaviours that usually have them restrained under the health act but the transformation is ensuring that most of the patients are discharged with reduced cases of readmission. The policy ensures the provision of the services to the patient by the community to reduce the lengthy stay in the hospitals as well as strengthen community service to individuals with intellectual disabilities (Newman, et al. 2018). The effect of the policy is the failure to strengthen the community service as most of these services require specialized personnel to tackle them. The discharge of this intellectually disabled character is exposing the community to the risk of damage of properties, sexual offenses, use of violence, and the property damage associated by the intellectually disabled people.

According to, Marshall-Tate, Chaplin, & McCarthy, (2017).  The cases of an individual with intellectual disability and autism are common as the cost of implication where the training of the health care workers was not meet. The issue was accelerated by poor staff training leading to the acquisition of little knowledge to tackle the patients challenging behaviours and the challenge of service commissioning where the health workers were separated from social workers. (Fylan, et al. 2019) The admission of the patient with mental health issues indicated that they have additional mental health needs that required special attention to reducing the case of mental breakdown. The development of autism policy and TS policy was aimed at the betterment of the services provided to this patient in the transformation program where all the facilities were to adapt to a new style of a hospital. The case of winterbourne on restraining and offensive practice were all working against the policies. Despite this, the TS policy aimed to reduce the bed for autism and intellectually challenged disabilities patients despite the challenges which advocate for increased bed (Alderwick, & Ham, 2017). The support from the UK government of twenty-five million dollars helped in pushing the process of disposing the patient into the community where the special services they required were not available.

According to Washington, Bull, & Woodrow, (2019). The transition of intellectual disability patients from the health institution to community-based care should be supported through adequate allocation of resources to support the program. The WHO, 2011 advocates for the support of the program through service infrastructure through the development of new services as the transformation calls for the development of new roles for the health care staff. Due to the development at Winterbourne view hospital, the England government and the department of health (DH) come up with guidance on supporting people who are discharged from the program with the local community care. In the development of the transformation program, the processes that used to take a long period like admission, assessment, and the procedural treatment measure were converted to the modern form. The reduction of the patient with autism being reduced to take thirty-three months in Scotland unlike the four years and three months taken in England.

According to Barnoux, (2019). The barriers to the transformation program are the aspect of poor staffing where the new programs lead to new roles, inadequate staffing of the hospitals, and ineffective teamwork affecting the effectiveness of the program. The barriers are the cause for the prolonged stay for the patients in the hospitals as the care unit needs more time to handle all the patients as the service users, considering the cases to prioritize on, provision of high-quality services to the users, and other difficulties. In the call for transformation and the health care can adopt a multi-agency approach where the teams in the health care unit should be locally accessible for the patient, effective in their service delivery thus high performance and should adopt a patient-centred approach in offering the services to the users. With the change in the health care unit the need for specialists, the community will need high quality and specialized services for the mentally challenged and autistic patients to be able to tackle them.