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Developing multidisciplinary assessment - exploring the evidence from a social care perspective
- Authors:
- SUTCLIFFE Caroline, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 23(12), December 2008, pp.1297-1305.
- Publisher:
- Wiley
This paper provides an initial evaluation of the impact of the Single Assessment Process (SAP) in England upon practice regarding multidisciplinary assessment. The objectives were to investigate changes in recorded health needs of older people and in the number of multidisciplinary assessments undertaken using social care agencies' case files. Also to examine differences in approaches to the use of multidisciplinary assessment for older people with different health needs. An audit of case files of older people living in the community in receipt of social care in three areas carried out at two time periods before and after implementation of the SAP in 2004. Information extracted from files covered a number of domains including evidence of multidisciplinary assessments, and presence of mental and physical health problems. Data from 144 files at Time 1 were compared with 145 files from Time 2. Little evidence emerged that older people at Time 2 were more dependent. However, significantly more multidisciplinary assessments were undertaken following the introduction of the SAP, in particular by occupational therapists and secondary health care teams. Cognitive impairment was a significant predictor of multidisciplinary assessment at both time periods. The impact of the introduction of the SAP has been mediated by the influence of other policies in England: intermediate care and integrated health and social care provision. Nevertheless, the data suggest that consideration be given to more effective targeting of multidisciplinary assessments on the grounds of both cost and more accurate identification of those who will benefit from the process.
Listening to older care-givers: research into aspirations for support
- Authors:
- SKELTON Judd, et al
- Publisher:
- Manchester Metropolitan University. Interpersonal and Organisational Development Research Group
- Publication year:
- 1997
- Pagination:
- 69p., bibliog.
- Place of publication:
- Manchester
There is a need to address the problems identified by the study through multi-sectoral policies and programmes to sustain the health of older care-givers and to maintain their ability to provide adequate care. The fact that older care givers on “24-hour call” are particularly prone to failing health comes as no surprise. Often, there is a combination of factors such as vulnerability, heavy physical demands of care and a sense of losing the quality of life. Other contributory factors are the lack of sleep and rest, the curtailment or suppression of periods of sickness and the inability of maintaining hobbies. The main indicators of negative health effects are depression, fear and a low assessment of one’s own health.
Valuing older people: the Mayor of London's older people strategy
- Author:
- GREATER LONDON AUTHORITY
- Publisher:
- Greater London Authority
- Publication year:
- 2006
- Pagination:
- 92p.
- Place of publication:
- London
London is often seen as a city of young people, but almost 16 per cent of the city's population – nearly 1.2 million people – are aged 60 or over, and almost a quarter of a million people are aged over 80. Valuing Older People, the Mayor's Older People's Strategy, aims to challenge stereotyping of older people and provide a framework to develop a city in which older Londoners have the support they need to lead active, healthy and independent lives.
Valuing older people: highlights of the Mayor of London's older people strategy
- Author:
- GREATER LONDON AUTHORITY
- Publisher:
- Greater London Authority
- Publication year:
- 2006
- Pagination:
- 17p.
- Place of publication:
- London
London is often seen as a city of young people, but almost 16 per cent of the city's population – nearly 1.2 million people – are aged 60 or over, and almost a quarter of a million people are aged over 80. Valuing Older People, the Mayor's Older People's Strategy, aims to challenge stereotyping of older people and provide a framework to develop a city in which older Londoners have the support they need to lead active, healthy and independent lives.
Left out in the cold
- Author:
- KELLING K.
- Journal article citation:
- Nursing Times, 27.11.91, 1991, p.32.
- Publisher:
- Nursing Times
Summarises a report published by Age Concern Greater London on Older homeless people and their problem in getting access to health services.
Caring as a social determinant of health: findings from a rapid review of reviews and analysis of the GP Patient Survey: report and key findings
- Authors:
- SPIERS Gemma, et al
- Publisher:
- Public Health England
- Publication year:
- 2021
- Pagination:
- 49
- Place of publication:
- London
This report explores the consequences of being an unpaid carer of older people, and identifies evidence about how best to support this group of carers. To address these aims, a rapid review of existing evidence reviews (an ‘umbrella review’) was conducted, alongside analysis of data on carers (for any population) from the NHS England GP Patient Survey. The main findings are: there is mounting evidence that unpaid caring should be considered a social determinant of health; carers experience poor physical and mental health but also have unmet care needs themselves; different groups of carers may have different support needs; a lack of clear and robust evidence about how best to support people caring for older populations, and gaps in evidence on key outcomes. This report proposes a logic model as a tool for evaluating the impact of carer interventions. It also includes ‘access enablers’ as important in ensuring that carers are connected with relevant services and interventions on offer. Social prescribing is one of these enablers. (Edited publisher abstract)
Future health trends in the North East and how they might be supported or disrupted by policy changes: future of ageing: think piece
- Author:
- JAGGER Carol
- Publisher:
- Great Britain. Government Office for Science
- Publication year:
- 2014
- Pagination:
- 15
- Place of publication:
- London
This paper discusses the expected future trends in health in the North East, looking in particular to 2025 and 2040, and how policy changes might impact positively or negatively. Although life and health expectancies in the North East have risen in the last decade, values are still well below the average for England. The paper argues that inequalities in disability free life expectancy across England are wider than those in life expectancy and therefore the continued inclusion of life expectancy (SMR) in the NHS resources allocation formula disadvantages areas such as the North East. Extending the state pension age will be challenging in the North East since most areas have DFLE at birth below 65. Employers will therefore have to accommodate substantial numbers of workers who are already limited before 65. Net decreases in the numbers of people pre-retirement (55-64 years) compared to England, but similar doubling of the next generation of the very old who will be reliant upon them for care, may also impact on employers. Trends in diabetes, overweight and excess alcohol consumption are increasing in the North East and the region currently ranks amongst the highest on diabetes, CVD, IHD, stroke, excess alcohol consumption, and obesity as well as mental ill health in women. All of these are likely to impact on DFLE, potentially to a greater extent than life expectancy. (Edited publisher abstract)
The practice of GPs charging retainers to care homes
- Author:
- BALBES James
- Publisher:
- Care England
- Publication year:
- 2013
- Pagination:
- 3
- Place of publication:
- London
This briefing follows up two previous reports by Maria Patterson of the English Community Care Association (ECCA): ‘Can we afford the doctor?' (2008); and ‘Postcode tariff: PCTs and GP retainers in care homes’ (2010). These reports investigated the practice of general practitioners charging retainers to work with care homes. The research confirmed this to be a widespread practice, and that the concept of free health care at the point of need was not necessarily true for residents of care homes. This summary report published by ECCA’s successor body, Care England outlines findings of ECCA’s repeat of its survey, and indicates that GPs continue to charge retainer fees for basic services. Of the 34 care homes responding, 30 pay a retainer to secure the services of a GP practice. Of these 30, only two defined the service that they receive from their local practice as being enhanced. (Original abstract)
Living in the 21st century: older people in England: the 2006 English longitudinal study of ageing (wave 3)
- Authors:
- BANKS James, et al
- Publisher:
- Institute for Fiscal Studies
- Publication year:
- 2008
- Pagination:
- 303p.
- Place of publication:
- London
The third wave of the English Longitudinal Study of Ageing (ELSA) means that we now have a four-year follow-up period on a sample of the English population aged 50 and over at the first wave. In addition, there are earlier data coming from the original Health Survey for England (HSE) from which the ELSA sample of participants was drawn. The report from the first wave of ELSA showed how marked is the variability in older people's social and economic circumstances, physical and mental functioning, and health. The myth of older age as uniformly characterised by decline and dependency is contradicted by the evidence of vigorous and active nonagenarians. The report after the second wave of ELSA showed, in considerable detail, how most of the salient domains of people's lives varied according to their wealth. The authors used wealth as a socio-economic measure. The analyses in that report made use of a key feature of ELSA - its accurate assessment of wealth including pension wealth. Mortality, ill health, social isolation and loneliness all differed, in a graded way, with people's wealth: less wealth was associated with being sicker, less functional and more isolated. This third wave now allows two interrelated activities making use of ELSA's special strengths - exploring how the various areas of people's lives interact and using longitudinal data to sort out the order in which things happen.
Commissioning services for older people and mental health problems: is there a shared vision?
- Authors:
- TUCKER Sue, et al
- Journal article citation:
- Journal of Integrated Care, 15(2), April 2007, pp.3-12.
- Publisher:
- Emerald
UK policy seeks to shift commissioning of services 'closer to people' with a view to establishing shared visions of local care services grounded in the opinions and priorities of the public. But the participation of older people with mental health problems and their carers in the strategic planning process has been patchy. This article compares practitioner and public perspectives of the services that should be provided for older people with mental health problems in an area of North West England. Significant differences were found in the services the various stakeholder groups prioritised for development, and in their views on how they should be organised. The implications for commissioning are discussed.