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Book Full text available online for free

Who knows best? Top tips for managing the crisis: older people's emergency admissions to hospital

Authors:
GLASBY Jon, et al
Publisher:
University of Birmingham. School of Social Policy
Publication year:
2016
Pagination:
12
Place of publication:
Birmingham

This resource identifies ten key themes, or ‘top tips’, which could help health and social care services to reduce inappropriate hospital admissions. It has been developed from a national research project which involved interviews and focus groups with older people and their families, and front-line health and social care professionals. It is argued that these ‘perceptions’ from older people and front-line staff are important as they can have a significant impact on how people live their life and access services. The themes cover: not making older people feel they are a burden; making community alternatives to hospital easier to access; to distinguish between ‘inappropriate’ and ‘preventable’ admissions; the need for early action; the importance role of adult social care; and the importance of engaging with older people to understand and respond to the increasing number of emergency admissions. Quotations from older people, their families and professionals are included throughout to illustrate key points. (Edited publisher abstract)

Journal article

Part of the problem or part of the solution? The role of care homes in tackling delayed hospital discharges

Authors:
GLASBY Jon, HENWOOD Melanie
Journal article citation:
British Journal of Social Work, 37(2), February 2007, pp.299-312.
Publisher:
Oxford University Press

As part of current UK policies to reduce the number of delayed hospital discharges, a number of commentators have identified an alleged crisis in the care home market as one of key contributing factors. With local authorities under pressure to cut costs, it is argued, the number of care homes is reducing, and delays in hospital can often result. Behind this diagnosis is a series of assumptions about the role and nature of care home provision, the appropriateness of this form of service for many older people, and the need for more care homes to reduce the number of hospital delays. In order to explore and critique these assumptions, this paper reviews the role of care homes in tackling delayed discharges, and argues the need for fewer and different care home placements rather than more of this type of provision.

Journal article Full text available online for free

The £30bn question

Author:
GLASBY Jon
Journal article citation:
Community Care, 13.04.06, 2006, pp.36-37.
Publisher:
Reed Business Information

This article explores how the Wanless review's findings are social care's best hope for future funding and why policy makers need to make it work.

Book Full text available online for free

Who knows best? Older people's contribution to understanding and preventing avoidable hospital admissions

Authors:
GLASBY Jon, et al
Publisher:
University of Birmingham. School of Social Policy
Publication year:
2016
Pagination:
64
Place of publication:
Birmingham

This study sets out to understand the appropriateness of hospital admission for older people, looking at the issue from different perspectives. It estimates the rate of so-called ‘inappropriate admissions’ whilst also engaging older people in a meaningful way to gather their longer-term perspective on their health and what underlay their hospital admission, together with their views about what might have been done to prevent it. Working with 104 older people and some 40 local professionals, the research looked in detail at how the older people were admitted to hospital, whether they felt this was the best place for them and what alternatives might have been explored. Similar questions were also asked of a GP and / or hospital doctor representing as many of these older people as possible. Overall, the study found that most older people were admitted to hospital appropriately. Only nine of 104 older people (almost 9%) felt that hospital was not the right place for them – and even these nine people sounded very unwell at the time of admission. None of the GPs or hospital doctors who took part felt that these (or any other) admissions in the study were ‘inappropriate’ (making a rate of ‘inappropriate’ admissions of 0% from a medical perspective). Despite the majority of older people feeling their emergency admission was appropriate, about a quarter of the older people interviewed could identify earlier action which might have prevented their admission, mainly to do with earlier intervention following previous health assessments or earlier access to their GP. The report however cautions that reducing the number of emergency admission to hospital requires complex and multi-faceted interventions, with no evidence of simple solutions. It argues that potential solutions to reducing the number of emergency admissions to hospital of older people can only be addressed by health and social care services working together in collaboration, and that further exploration of the potential role of appropriately funded adult social care services is needed. (Edited publisher abstract)

Journal article

Making evidence fit for purpose in decision making: a case study of the hospital discharge of older people

Authors:
GLASBY Jon, WALSHE Kieran, HARVEY Gill
Journal article citation:
Evidence and Policy, 3(3), August 2007, pp.425-437.
Publisher:
Policy Press

This article focusing on a case study topic (hospital discharge), participants were provided with six sources of evidence chosen to illustrate six very different approaches to generating valid knowledge. Participants then explored a series of questions about each (including reliability/validity, key limitations and contributions to new knowledge). Overall, none of the sources was felt to offer a definitive insight into the issue at stake. A key challenge, therefore, is to design deliberative processes to synthesise and integrate evidence of different types and from multiple sources.

Journal article

‘The Billion Dollar Question’: embedding prevention in older people's services—Ten ‘High-Impact’ changes

Authors:
ALLEN Kerry, GLASBY Jon
Journal article citation:
British Journal of Social Work, 43(5), 2013, pp.904-924.
Publisher:
Oxford University Press

With ageing populations, social changes and rising public expectations, many countries are exploring ways of developing a more preventative approach within their health and social care services. In England, this has become a growing priority over time—made even more significant by recent economic change and by the urgent need to reduce public sector spending. However, a key dilemma for policy makers and managers is the patchy nature of the evidence base—with a lack of certainty over how to reform services or prioritise spending in order to develop a more genuinely preventative approach. Against this background, this commentary reviews national and international evidence around ten policy measures and interventions, highlighting some of the most promising approaches as well as the fragmented and contested nature of the evidence base. (Publisher abstract)

Book Full text available online for free

Achieving closure: good practice in supporting older people during residential care closures

Authors:
GLASBY Jon, ROBINSON Suzanne, ALLEN Kerry
Publishers:
Association of Directors of Adult Social Services, University of Birmingham. Health Services Management Centre
Publication year:
2011
Pagination:
30p., bibliog.
Place of publication:
London

Commissioned by the Association of Directors of Adult Social Services, this guide summarises emerging evidence about best practice when care homes for older people close and when residents need to be re-assessed and resettled. Its context is the mixed economy of care in the adult care home sector, the risk of increased ownership transfers and the impact this might have on older people. It is aimed at policy makers, managers and practitioners with responsibility for older people's services, and is intended to be read alongside the Social Care Association guidance Managing Care Home Closure. It draws on an overview of the literature, in-depth interviews with Directors of Adult Social Services with experience of overseeing care home closures, and emerging data from a detailed study of the outcomes of the modernisation of older people's services in Birmingham. Six key themes arose from the interviews: the importance of established policies and procedures, the importance of time, the role of assessment, the impact of closures, communication and information, and barriers and success factors. The report discusses the findings, with examples from the interviews. It notes the importance of following good practice for planned home closures or emergency closures.

Book

Acute concerns: responding to delayed discharges and 'blocked beds'

Editor:
GLASBY Jon
Publisher:
University of Birmingham. Health Services Management Centre
Publication year:
2003
Pagination:
24p.
Place of publication:
Birmingham

Often, accounts of hospital discharge refer to the problem of ‘bed blocking’ as a short-hand term for people (often older people) who it is believed are occupying a hospital bed when they no longer need the services provided in an acute setting. While such phrases are in widespread usage, this terminology is felt by many to carry a highly pejorative meaning, implying that the older people concerned are themselves to blame for the situation. As is increasingly clear, however, this is often totally inaccurate, as it is the system itself which causes many such ‘blockages’, not the individual patient (who often wishes to return home as soon as possible).

Journal article

Social services and the single assessment process: early warning signs?

Author:
GLASBY Jon
Journal article citation:
Journal of Interprofessional Care, 18(2), May 2004, pp.129-139.
Publisher:
Informa Healthcare

Following the publication of policy documents such as the NHS Plan and the National Service Framework for Older People, health and social care agencies in the UK have been charged with devising and implementing a Single Assessment Process by April 2004. Although service users and carers are often frustrated at having to give the same information to many different professionals, this article cites research which raises significant doubts about the present capacity of social services departments to deliver on this government initiative. Based on telephone interviews with 25 local authorities, this paper describes the findings of research into the use of dependency measures in residential and nursing care. Although this research was conducted prior to the introduction of the Single Assessment Process, the study suggests that some local agencies may lack the expertise and skills to develop effective assessment tools/scales and that considerable Developmental work may be required to prepare

Journal article Full text available online for free

Independence at a price

Author:
GLASBY Jon
Journal article citation:
Community Care, 29.08.02, 2002, pp.30-31.
Publisher:
Reed Business Information

Older people will soon have the right to receive payments to buy their own care services. But although this puts users in control, these new responsibilities may prove overwhelming without adequate support.

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