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Citizenship in further education: next steps in personalised transition: a discussion paper in association with ibk iniatives and Maddocks Associates
- Authors:
- MURRAY Pippa, SHEPHERD Jane
- Publisher:
- Centre for Welfare Reform
- Publication year:
- 2011
- Pagination:
- 12p.
- Place of publication:
- Sheffield
This discussion paper outlines the need for, and the possibility of, significant progress in personalising support in further education for young disabled people. Currently, many young people with profound and multiple learning disabilities are not provided opportunities to extend their learning, but instead are offered day centre provision or out of area residential placements. Residential colleges and care homes cost a great deal, seldom have a positive impact on people’s lives, and rarely lead to improved outcomes. This proposal supports the development of local further education in order that young people with profound and multiple learning disabilities going to Further Education colleges are helped to create meaningful and fulfilling lives. It argues that a personalised response creates a greater chance of disabled adults remaining within their communities as opposed to going into residential care homes. In addition, a personalised package is likely to offer significant cost savings over residential care.
Psychological treatments in intellectual disability: the challenges of building a good evidence base
- Authors:
- BHAUMIK Sabyasachi, et al
- Journal article citation:
- British Journal of Psychiatry, 198(6), June 2011, pp.428-430.
- Publisher:
- Cambridge University Press
While psychological treatments are common interventions in the treatment of people with learning disabilities, the evidence base for their clinical efficacy, and cost-effectiveness, is limited. This editorial describes the strengths and limitations of the evidence base for a range of psychological treatments available. It focuses on behavioural interventions, cognitive-behavioural therapy and psychodynamic therapies. The editorial also highlights current problems in conducting randomised controlled trials in this area and suggests a way forward. The author concludes that developing a research-based evidence base is critical to the establishment of new services and interventions, and is necessary in supporting the value of existing services.
Applied behaviour analysis and standard treatment in intellectual disability: 2-year outcomes
- Authors:
- HASSIOTIS Angela, et al
- Journal article citation:
- British Journal of Psychiatry, 198(6), June 2011, pp.490-491.
- Publisher:
- Cambridge University Press
The development of multidisciplinary teams to provide specialist care for problem behaviours in people with intellectual disabilities was a key recommendation of the Mansell report in the UK. However, research into its effectiveness is limited. In this study, 63 participants with behavioural problems were recruited form community intellectual disabilities services in England; 31 were administered standard treatments, and 32 were administered standard treatment augmented by a specialist behaviour service. The costs of both groups were estimated from a health and personal services system perspective. Costs were compared between the standard and intervention group. The augmented treatment was reported to be clinically and cost-effective after 6 months. In a 2-year follow-up of the same trial cohort (n=58), participants receiving the specialist intervention had significantly lower total and subdomain Aberrant Behavior Checklist scores than those receiving usual care alone. After adjustment for baseline covariates there was no significant difference in costs between the trial arms. The authors concluded that trained professionals may improve clinical outcomes of individuals with severe and complex needs at no extra cost.
Managing behaviour and sleep problems in disabled children: an investigation into the effectiveness and costs of parent-training interventions
- Authors:
- BERESFORD Bryony, et al
- Publisher:
- Great Britain. Department for Education
- Publication year:
- 2011
- Pagination:
- 302p.
- Place of publication:
- London
Sleep problems are common among all children but more common among disabled children, especially those with learning disabilities. For these children sleep problems appear to be very persistent, and are not likely to disappear without intervention. Behaviour problems are also more common among disabled children than among their nondisabled peers, with studies finding rates of behaviour problems to be three to four times higher compared to non-disabled peers. Such behaviours can be difficult to manage, anti-social, distressing, and/or interfere with family routines and activities. Current evidence suggests that access to early/preventive interventions which help parents better manage the behaviours they find difficult or problematic may be an important factor in improving outcomes for disabled children and their families. This report: evaluated the effectiveness of four different parent-training interventions for parents of disabled children with sleep problems; identified the costs of these interventions and explored their cost effectiveness; explored the factors which hindered or support the effectiveness of these interventions; described parents' experiences of receiving these interventions; and described professionals' experiences of delivering these interventions.
Commissioning care in the 21st century: improving outcomes for people with learning disabilities
- Author:
- KUZNETSOVA Daria
- Publisher:
- New Local Government Network
- Publication year:
- 2011
- Place of publication:
- London
In this report it is argued that the only way to ensure that personalised services in social care in England are affordable is to accelerate moves towards a new form of outcome-based commissioning. The report presents an analysis of council cost data. It finds increases in expenditure with additional direct payments issued to people with a learning disability, but notes that this may reflect the fact that personal budgets are identifying new and previously unmet needs and that it is possible that the new system will save money for other sectors such as the NHS. It proposes embedding new measures (such as Social Care Related Quality of Life) that assess the quality and impact of social care services, arguing that with a robust outcomes measurement system in place commissioning tools such as payment by results and social impact bonds could be developed within social care. It also suggests that commissioners will need to play a greater role in developing the market, and that this will ensure that people with learning disabilities have a real choice between a wide range of services. The author says that there is a need for a decisive shift away from managing outputs to developing new metrics and commissioning approaches based on outcomes, to drive a focus on value for money and to help commissioners identify effective forms of intervention that help people with learning disabilities in their lives.
Fit to negotiate
- Author:
- MOONEY Helen
- Journal article citation:
- Health Service Journal, 29.9.11 Supplement, 2011, pp.20-21.
- Publisher:
- Emap Healthcare
The NHS have been using the expertise of consultants to help commissioners get a better deal with providers of complex mental health and learning disability placements. This article looks at the issues facing commissioners and the savings resulting from the use of expertise in Liverpool PCT.
'A home of my own': developing cost effective housing options for people with learning disabilities across the East Midlands
- Author:
- EAST MIDLANDS IMPROVEMENT AND EFFICIENCY PARTNERSHIP
- Publisher:
- East Midlands Improvement and Efficiency Partnership
- Publication year:
- 2011
- Pagination:
- 8p.
- Place of publication:
- Melton Mowbray
This Good Practice Case Study describes a housing solutions programme to reduce reliance on residential care for people with learning disabilities. The programme was stimulated by the initiative taken by Nottinghamshire County Council to engage the Care Services Efficiency Delivery programme (CSED) to undertake a local strategic housing analysis. Nottinghamshire’s findings were shared at a regional housing event in July 2009 and resulted in the other 8 local authorities in the East Midlands signing up to undertake a similar programme of support. The programme set out to achieve a target of a 5% reduction in the number of people with learning disabilities who live in residential care, whilst increasing other local housing options. Phase one of this project will support over 200 people with learning disabilities moving back into the community, with a further 110 identified. The potential to save over £10.8 million has been identified across the 8 local authorities through the development of a range of new housing and support options.
Illustrative cost models in learning disabilities social care provision
- Author:
- ROE David
- Publisher:
- Laing and Buisson
- Publication year:
- 2011
- Pagination:
- 62p.
- Place of publication:
- London
There has been considerable innovation in the housing options and support available for those with learning disabilities, including individual and shared supported living, residential care, extra care, shared lives and shared ownership. A better understanding of the relative unit costs of different types of service and approach should be beneficial in aiding better choices by individuals with learning disabilities, and their advisors, existing local authority commissioners and providers. This report addresses some of the questions relating to relative costs and unit costs, and comments on specific cost-effectiveness considerations. It compiles and describes a range of illustrative cost models, depicting relative unit costs of different approaches, based on input from providers. It focuses on the description of different types of provision, with additional comments on economies of scale, efficiencies and other cost considerations and issues, in the main body of the report. Accompanying illustrative cost models, with further explanation, are set out in the appendices. These illustrative cost models relate to: residential care; supported living; housing benefits; social housing provision through a registered social landlord; examples of the use of assistive technology; a case study of deregistration; shared lives; and extra care.