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Reasons for redesigning care for older people
- Author:
- PHILP Ian
- Journal article citation:
- Health Service Journal, 29.11.12, 2012, pp.30-32.
- Publisher:
- Emap Healthcare
South Warwickshire Foundation Trust has transformed its acute and community services to meet the needs of older people. A review of evidence about interventions to improve productivity and outcomes in older people's health and care led the Trust to focus on four main principles: get in early; invest in alternatives to acute hospital care; provide acute care by old age specialists; and discharge to assess. The principles have been put into practice in a number of linked projects. These include: using a single assessment instrument. EASY-Care, to be used by the health, social care and the third sector; close partnership working with adult social care and primary care services to provide alternatives to hospital care; and expansion of old-age specialist care teams.
The NSF for Older People: a vehicle for reform
- Author:
- PHILP Ian
- Journal article citation:
- Generations Review, 18(3), July 2008, Online only
- Publisher:
- British Society of Gerontology
The background to the development of the National Service Framework (NSF) for Older People in England, and its implementation in the seven years since its publication in 2001 are described. The author also provides views on what remains to be done in the three years in the life of the Standard a ten year programme for reforming the culture and system of health and social care for older people. The priorities of empowerment through the use of personalised budgets and direct payments, and improved dementia care are highlighted.
Dignity in care
- Author:
- PHILP Ian
- Journal article citation:
- Working with Older People, 11(2), June 2007, pp.11-14.
- Publisher:
- Emerald
The government's Dignity in Care agenda includes the establishment of a national network of older people's champions. The author, the National Director for Older People, explains what dignity in care means for health and social services, and the role of the Dignity in Care champions.
A recipe for care: not a single ingredient: clinical case for change
- Author:
- PHILP Ian
- Publisher:
- Great Britain. Department of Health
- Publication year:
- 2007
- Pagination:
- 8p.
- Place of publication:
- London
The reconfiguring specialist services to bring care closer to home will make a big difference to the lives of older people and their families, according to Professor Ian Philp, National Director for Older People.
Reducing hospital bed use by frail older people: results from a systematic review of the literature
- Authors:
- PHILP Ian, et al
- Journal article citation:
- International Journal of Integrated Care, 13(4), 2013, Online only
- Publisher:
- International Foundation for Integrated Care
Introduction: Numerous studies have been conducted in developed countries to evaluate the impact of interventions designed to reduce hospital admissions or length of stay (LOS) amongst frail older people. A systematic review of the recent international literature (2007-present) was carried out to help improve understanding about the impact of these interventions. Methods: The following databases were systematically searched: PubMed/Medline, PsycINFO, CINAHL, BioMed Central and Kings Fund library. Studies were limited to publications from the period 2007-present and a total of 514 studies were identified. Results: A total of 48 studies were included for full review consisting of 11 meta-analyses, 9 systematic reviews, 5 structured literature reviews, 8 randomised controlled trials and 15 other studies. Interventions were classified into those which aimed to prevent admission, interventions in hospital, and those which aimed to support early discharge. Conclusions: Reducing unnecessary use of acute hospital beds by older people requires an integrated approach across hospital and community settings. A stronger evidence base has emerged in recent years about a broad range of interventions which may be effective. Local agencies need to work together to implement these interventions to create a sustainable health care system for older people. (Edited publisher abstract)
Reducing antipsychotic prescriptions in primary care: a healthcare perspective
- Authors:
- MAVRODARIS Angelique, PHILP Ian
- Journal article citation:
- Journal of Public Mental Health, 12(1), 2013, pp.32-42.
- Publisher:
- Emerald
One in 14 people over 65 years suffer from dementia in the UK. Over 25 per cent are receiving antipsychotics, which cause increases in mortality and cerebrovascular events. The need for a reduction and the use of alternative supportive strategies has been advocated. The purpose of this paper is to investigate antipsychotic prescribing practices and patient review in primary care and in care homes. In total, two surveys comprising questions addressing prescribing practices were developed and distributed electronically to all GP practices and care homes in Coventry and Warwickshire, West Midlands, England. The majority of GPs (75 per cent) reported only “occasional” discontinuation of antipsychotics due to concerns at reducing drugs on their own, expectations of regulation from secondary care and resistance from care home staff. Poor reduction levels were reported in care homes, attributing low numbers to reluctance among GPs. History of cardiovascular risk factors did not appear to influence withdrawal. Only 40 per cent of GP practices maintained sole use of risperidone. At least six-monthly reviews were reported by 63 per cent of GPs and 64 per cent of care homes, with very few conducting reviews at least three-monthly. The importance of non-pharmacological alternatives was emphasized, yet access was limited and highly resource-dependent. This study reveals the perspectives of staff delivering healthcare for people with dementia and behavioural and psychological symptoms of dementia (BPSD). Potentially inappropriate antipsychotic principles were reported. A lack of communication and uncertainty of roles was evident. The development of understandable guidelines for healthcare workers and care home staff managing behavioural issues in patients with dementia is necessary. (Edited publisher abstract)
NHS End of Life Care Programme: progress report summary: March 2006
- Authors:
- RICHARDS Mike, PHILP Ian
- Publisher:
- Great Britain. Department of Health
- Publication year:
- 2006
- Pagination:
- 2p.
- Place of publication:
- London
This report charts the progress made in the NHS since the End of Life Care Programme was launched. It highlights examples of innovative work across the country to improve end of life care and ensure patients die with dignity. The End of life Care Programme (EoLC) was set up to improve care at the end of life for all wherever they live.
NHS End of Life Care Programme: progress report: March 2006
- Authors:
- RICHARDS Mike, PHILP Ian
- Publisher:
- Great Britain. Department of Health
- Publication year:
- 2006
- Pagination:
- 26p.
- Place of publication:
- London
This report charts the progress made in the NHS since the End of Life Care Programme was launched. It highlights examples of innovative work across the country to improve end of life care and ensure patients die with dignity. The End of life Care Programme (EoLC) was set up to improve care at the end of life for all wherever they live.
Securing better mental health for older adults
- Authors:
- PHILP Ian, APPLEBY Louis
- Publisher:
- Great Britain. Department of Health
- Publication year:
- 2005
- Pagination:
- 8p.
- Place of publication:
- London
This document marks the start of a new initiative and provides a vision for how all mainstream and specialist health and social care services should work together to secure better mental health services for older people.This is the first time that the mental health and older people's divisions have adopted such a strategic approach in order to influence change and improve services for older people with mental illness.
Care of older people: maintaining the dignity and autonomy of older people in health care setting
- Authors:
- LOTHIAN Kate, PHILP Ian
- Journal article citation:
- British Medical Journal, 17.3.01, 2001, pp.668-670.
- Publisher:
- British Medical Association
The first in a series of articles which explore key issues in the quality of health care for older people. The basis of these articles is the extensive literature reviews undertaken to inform the development of a national service framework for NHS care of older people in England. This first article examines issues relating to the dignity and autonomy of older people.