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What happens to quality in integrated homecare? A 15-year follow-up study
- Authors:
- PALJARVI Soili, et al
- Journal article citation:
- International Journal of Integrated Care, 11(2), 2011, Online only
- Publisher:
- International Foundation for Integrated Care
A case study of a joint homecare unit in Finland, created following the merger of home healthcare and home help services in 1994 - 1995, is used to explore the impact of structural integration on home care quality. The case study included a before–after comparison with baseline and four follow-up measurements during 1994–2009, using interviews with clients (n=66–84) and postal inquiries to relatives (n=73–78) and staff (n=68–136). Home care quality was analysed in three domains: sufficiency of care; responsiveness of care; and guiding, counselling and informing clients. Despite the organisational reform involving extensive mergers of health and social care organisations and cuts in staff and service provision, homecare quality remained at almost the same level throughout the 15-year follow-up. According to the clients, it even slightly improved in some homecare areas. The results show that despite the structural integration and cuts in staff and service provision, the quality of homecare remained at a good level. The results suggest that structural integration had a positive impact on homecare quality. To provide firmer evidence, the authors call for additional research with a randomised comparison design. (Edited publisher abstract)
Approaches to integrated housing, health and social care services: case studies from North Tyneside Council and Northumbria Healthcare
- Authors:
- COOK Glenda, et al
- Publisher:
- Housing Learning and Improvement Network
- Publication year:
- 2016
- Pagination:
- 17
- Place of publication:
- London
Three case studies from the North East of England highlighting innovative approaches to integrated working across housing, health and adult social care. The case studies show the relevance of understanding access processes within different services, the role of workforce development in aligning referral and access pathways, targeted and more cost-effective health intervention delivery via housing services, and the potential for achieving health outcomes through housing improvement. Understanding of these issues informed the approach that was developed for the co-ordination of services and departments to work together across organisation and sector boundaries. The case studies cover: direct referral from North Tyneside Living sheltered housing officers to Northumbria Healthcare Emergency Care Practitioners and Admission Avoidance Resource Teams - which has helped to avoid unnecessary hospital admissions; North Tyneside sheltered housing ‘Healthy Living’ pilot programme - which addressed issues such as falls prevention; and Safe and Healthy Homes in North Tyneside - which works with residents to identify hazards in the home and housing conditions which could affect health. (Edited publisher abstract)
Because it’s there …: voluntary councils reflect on contributing to strategic planning for integrated services for older people in Cwm Taf
- Authors:
- RICHARDS Sharon, MORRIS Anne, GREENWELL Stewart
- Journal article citation:
- Journal of Integrated Care, 23(4), 2015, pp.219-231.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to understand the strategic role of third-sector agencies, with a history that often left them 'sidelined' by the public sector, showing how all agencies involved can be respected and trusted, with conflicts of interest around commissioning services well managed. It highlights how power differentials between agencies/sectors influence behaviour and how a voluntary council can promote the voice of users and carers. Design/methodology/approach: A case study considering the nature of voluntary sector activity in Cwm Taf, referring to learning from elsewhere, confirming and challenging the experience. It draws on the experiences of two key third-sector workers and draws on local survey data, as well as the experiences of community co-ordinators. Findings: The importance of 'being there' in policy development, implementing change and taking action; 'being at the top table' was critical in developing a stronger third sector and user voice, supporting the ambitions of Social Services and Well-being (Wales) Act 2014. Third-sector agencies have been good and mature partners, honest brokers/commissioners, completer/finishers and critical friends. Originality/value: Power and influence are significant in changing the way that older people receive a different offer – not, 'what can we do for you?', but, 'help us to understand what will make a difference to your life. Third-sector agencies are crucial change agents, better at representing users and carers than public sector agencies doing it alone. It explores the concept of interdependence, as more energising for older people and agencies. (Edited publisher abstract)
Developing community resource teams in Pembrokeshire, Wales: integration of health and social care in progress
- Authors:
- THIEL Veronika, et al
- Publisher:
- King's Fund
- Publication year:
- 2013
- Pagination:
- 31
- Place of publication:
- London
For older people who need both health and social care support, the divisions in the organisation, funding and delivery of care in the United Kingdom (UK) can result in poor user experiences and outcomes. There is also a lack of knowledge about how best to apply care co-ordination tools in practice. This case study looks at integrated teams of health and social care professionals, known as community resource teams (CRTs), who work to co-ordinate care for people living at home in the largely rural county of Pembrokeshire. This model of care is one aspect of a wider strategic programme of integrated care, called Care Closer to Home. This case study is one ofi five successful UK-based models of care co-ordination, and is part of a research project undertaken by The King’s Fund and funded by Aetna and the Aetna Foundation in the United States, The report briefly explains the health and social care system in Wales. It examines barriers and facilitators in care co-ordination; and how care co-ordination can best be supported in terms of planning, organisation and leadership. Case studies about individual recipients of care illustrate the effectiveness of solutions offered by the CRTs. (Edited publisher abstract)
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.
Integrating health and social care in Torbay: improving care for Mrs Smith
- Author:
- THISTLETHWAITE Peter
- Publisher:
- King's Fund
- Publication year:
- 2011
- Pagination:
- 28p., bibliog.
- Place of publication:
- London
Integration of health and social care is a key policy of the new coalition government in England. It is said to have benefits for patients, particularly older people and those with long-term conditions, but how does integration work in practice? This paper describes how one area, Torbay, created an integrated care system that aimed to improve care for ‘Mrs Smith’, a fictitious user of health and social care services. This case study sets out the background to the development of integrated care, the setting up of a pilot team, the implementation of an integrated management structure, and the establishment of Torbay Care Trust (which is a fully integrated NHS organisation responsible for commissioning and providing community health and social care services). It assesses the impact of the integrated system on the performance of the Torbay health and social care economy. While local contexts will determine the detailed process of integration, some generic lessons were learned: it is important to have a clear vision based on making a positive difference for service users and to monitor progress; work from the bottom up, bringing together frontline teams and align these with general practices and their registered populations; establish joint governance early and be aware that it is possible to overcome cultural, political and organisational differences; and ensure managers and clinical leaders are engaged from the start.
Lanarkshire's managed care network: an integrated improvement collaborative
- Author:
- HENDRY Anne
- Journal article citation:
- Journal of Integrated Care, 18(3), June 2010, pp.45-51.
- Publisher:
- Emerald
“Promoting the Development of Managed Clinical Networks” set a strategy in place for the development of MCNs in Scotland, where they operate on a local, regional or national basis. This article describes how MCNs enable virtual integration of health, social care and housing service delivery, through collaborative working across care sectors within an agreed governance framework. When focused on outcomes and experience for service users and carers, they can provide integrated support for improvement in the pathways, processes and experience of care and support for older people. The article provides a case study of the development of a managed care network of health and social care partners in Lanarkshire in the context of current policy drivers in Scotland. It outlines the process of transforming the policy into practice, asks what should we integrate, and then considers the integration of resources. The author suggests that by ensuring that the resources available follow the patient to where they add most value, the integration framework development programme hopes to evidence a sustainable shift in the balance of care, improved experience, and better outcomes for both service users and carers.