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Challenges, benefits and weaknesses of intermediate care: results from five UK case study sites
- Authors:
- REGEN Emma, et al
- Journal article citation:
- Health and Social Care in the Community, 16(6), December 2008, pp.629-637.
- Publisher:
- Wiley
The authors explore the views of practitioners and managers on the implementation of intermediate care for elderly people across England, including their perceptions of the challenges involved in its implementation, and their assessment of the main benefits and weaknesses of provision. Qualitative data were collected in five case study sites (English primary care trusts) via semi structured interviews (n = 61) and focus group discussions (n = 21) during 2003 to 2004. Interviewees included senior managers, intermediate care service managers, clinicians and health and social care staff involved in the delivery of intermediate care. The data were analysed thematically using an approach based on the 'framework' method. Workforce and funding shortages, poor joint working between health and social care agencies and lack of support/involvement on the part of the medical profession were identified as the main challenges to developing intermediate care. The perceived benefits of intermediate care for service-users included flexibility, patient centeredness and the promotion of independence. The 'home-like' environment in which services were delivered was contrasted favourably with hospitals. Multidisciplinary team working and opportunities for role flexibility were identified as key benefits by staff. Insufficient capacity, problems of access and awareness at the interface between intermediate care and 'mainstream' services combined with poor co-ordination between intermediate care services emerged as the main weaknesses in current provision. Despite reported benefits for service-users and staff, the study indicates that intermediate care does not appear to be achieving its full potential for alleviating pressure within health and social care systems. The strengthening of capacity and workforce, improvements to whole systems working and the promotion of intermediate care among doctors and other referrers were identified as key future priorities.
'If I can't go home I'll die'
- Author:
- -
- Journal article citation:
- Community Care, 24.11.05, 2005, pp.42-43.
- Publisher:
- Reed Business Information
A consultant facing bed pressures wants to move an older woman from hospital to a nursing home, but she wants to go home. A panel provide their assessment of the case.
A multiple case study of patient journeys in Wales from A&E to a hospital ward or home
- Author:
- MANNING Sera Nia
- Journal article citation:
- British Journal of Community Nursing, 21(10), 2016, pp.509-517.
- Publisher:
- MA Healthcare
- Place of publication:
- London
The health service is having to plan for an increasingly older population putting extra demand on services, with a greater emphasis on providing care at home. A health board in Wales brought in an Early Response Service, which assessed whether patients attending accident and emergency needed to be admitted to hospital or could receive care at home. This qualitative study looked at the experiences of both patients and staff members in both settings. A multiple case study was undertaken using semi-structured interviews. The theoretical framework was derived from Kolcaba's comfort theory and the bio-psycho-social model. Staff were identifying the most suitable patients for care at home and all hospital admissions were necessary, as the patients required greater medical/surgical intervention than those cared for at home. (Publisher abstract)
The essential carer's guide
- Author:
- JORDAN Mary
- Publisher:
- Hammersmith Press
- Publication year:
- 2006
- Pagination:
- 232p.
- Place of publication:
- London
Illustrated with individual case stories, this book covers physical, social, and financial needs, across the stages of immediate, intermediate and advanced care. It is useful as a practical companion for those caring for, or responsible for the care of, an elderly friend or relative.
Don't cart me off
- Author:
- -
- Journal article citation:
- Community Care, 27.04.06, 2006, pp.40-41.
- Publisher:
- Reed Business Information
A practice panel give the assessment of a case where the death of an 88-year-old woman's husband has left her traumatised, isolated and unable to cope alone.
Intermediate care service in extra care sheltered housing
- Author:
- HOUSING LEARNING AND IMPROVEMENT NETWORK
- Journal article citation:
- Housing Care and Support, 8(4), December 2005, pp.13-16.
- Publisher:
- Emerald
This case study gives an example of an integrated intermediate care service providing short-term, intensive support and assistance combined with the facilities and services offered by extra care sheltered housing. The service aims to prevent hospital admissions and to facilitate quicker and more flexible hospital discharge for older people who need rehabilitation or who cannot return directly to their own home. The service located in the Royal Borough of Windsor and Maidenhead.
What we did on our holidays - a tale of health and social care
- Author:
- DAWSON Jill
- Journal article citation:
- Quality in Ageing, 9(4), December 2008, pp.4-8.
- Publisher:
- Pier Professional
- Place of publication:
- Brighton
The author discusses her experience of managing the complexities of inter-agency care when her mother-in-law became ill. She tells the story of how her mother-in-law was admitted into a nursing home and then discharged, after being assessed by the intermediate care team.
Careful thoughts: recognising and supporting older carers in intermediate care
- Authors:
- TOWNSEND Jean, MOORE Jeanette
- Journal article citation:
- Research Policy and Planning, 24(1), 2006, pp.39-52.
- Publisher:
- Social Services Research Group
Recognition and support for carers has become an increasingly important part of government policy over the past decade. This paper draws on data from a national evaluation of intermediate care. the study adopted a mixed-method, case-study approach across five English localities. It describes patterns of informal caring relationships among older people who were using intermediate care services and considers the issues which affect how the carers perceived their caring roles, the service interventions which they found helpful during intermediate care, and the negotiations and decision-making processes as people moved from intermediate care to mainstream services.
Changing models of health and social care
- Authors:
- AUDITOR GENERAL FOR SCOTLAND, ACCOUNTS COMMISSION FOR SCOTLAND
- Publisher:
- Audit Scotland
- Publication year:
- 2016
- Pagination:
- 42
- Place of publication:
- Edinburgh
This report identifies new local models of care in Scotland which are shifting the balance of care from hospitals to more homely and community-based settings. It aims to help to support new integrated authorities to implement new ways of working, address the challenges facing health and social care services and help increase the pace of change. The report draws on: analysis of national and local information to help hospitals, councils and community-based services to identify pressures in the system, including performance, activity and financial data; projection analysis to estimate the potential effect of increasing pressures in health and social care; desk research and interviews. Part 1 looks at the increasing pressures facing health and social care in Scotland. It highlights an increase in the numbers of older people complex health and social care needs, an increase in emergency hospital admissions, and how services need to adapt to cope with the effects of a changing population. Part 2 highlights examples of some of the new approaches to providing health and social care, which shifting the balance of care from hospitals to more homely and community-based settings. These include: community preventative approaches, enhanced community care models, intermediate care models, and initiatives designed to reduce delayed discharges. Part 3 looks at what still needs to be done to achieve the transformational change needed to deliver the Scottish Government’s 2020 Vision for health and social care and actions required to address them. It concludes that a lack of national leadership and clear planning is preventing the wider change urgently needed if Scotland’s health and social care services are to adapt to increasing pressures. Two supplements accompany the report, which provide details of the case studies referenced in the report and a model of East Lothian’s whole-system approach. (Edited publisher abstract)