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Integrating health and social care from an international perspective
- Authors:
- WATSON Jessica, INTERNATIONAL LONGEVITY CENTRE UK
- Publisher:
- International Longevity Centre Global Alliance
- Publication year:
- 2012
- Pagination:
- 10
- Place of publication:
- London
This report draws on the ideas, issues and challenges of integrating care raised at the Conference on Integrated Care for Frail Older People held on 29th September 2011. The conference was organised by ILC-Netherlands in cooperation with the Leyden Academy, the Dutch Medical Research Council, Vilans (a Centre of Expertise for Long-term Care) and the International Longevity Centre Global Alliance. This report links to previous research conducted by ILC-UK on integrating health and social care (Lloyd and Wait, 2006). It examines the potential benefit of integrating health and social care services for frail older people in a global context. It highlights that while financial, cultural and logistical barriers exist, countries should continue to work towards integrating health and social care services given its possibilities for cost efficiency, freeing up acute healthcare facilities and benefits for service users. It covers: the need for integrated care; the current global context of care for frail older people; the benefits and challenges of integrating health and social care services for this group; and priorities for action in advancing the issue of integrated care worldwide (Edited publisher abstract)
Integrated care for frail older people 2012: a clinical overview
- Author:
- MORRIS Jackie
- Journal article citation:
- Journal of Integrated Care, 20(4), 2012, pp.257-264.
- Publisher:
- Emerald
This article explores a clinician's perspective on the shared integrated care of older people with dementia or frailty, and describes the significance and value of dignity, kindness and compassion in care. It presents a general review of current policy, research and good practice, amplified from a clinical perspective. The key components of effective integrated care are shared knowledge, understanding, training and support. Equally important are shared objectives, leadership, and governance. This confirms that comprehensive geriatric assessment, as well as working with individuals and their families, must underpin all integrated, humane and effective care for older vulnerable people.
Assessing patterns of home and community care service use and client profiles in Australia: a cluster analysis approach using linked data
- Authors:
- KENDIG Hal, et al
- Journal article citation:
- Health and Social Care in the Community, 20(4), July 2012, pp.375-387.
- Publisher:
- Wiley
The delivery of care requires knowledge on the ways in which individuals access available services. This study identified groups of Home and Community Care (HACC) clients in New South Wales, Australia, based on patterns of actual service use, and explored the health and social needs and resources of client groups that accessed different services. Multiple data sets linked at the individual level provide a basis to investigate the complexity of access to service use. Analyses based on clients’ type and volume of community service use was conducted between 2006 and 2008 on the 4890 HACC clients in the linked dataset and nine distinct clusters of clients were identified. Three of these clusters were considered complex in terms of the range of community and hospital assistance received, while the others comprised mainly of one or two dominant service types. The findings provide a client-centred approach to evaluate access to local services that are being reformed to better integrate the delivery services currently funded and managed separately by national and state governments.
A story of hard won success
- Author:
- VIZE Richard
- Journal article citation:
- British Medical Journal, 9.6.12, 2012, pp.24-25.
- Publisher:
- British Medical Association
The North West London pilot of integrated services was launched in 2001 to meet the needs of people with diabetes and those aged over 75. It brings together primary care, community services, acute care, social care and mental health. It aims to cut hospital use and nursing home admissions while reducing costs of services for diabetic and older patients by 24% over five years. The pilot is showing early signs of success, but clinicians explain that this is often despite NHS processes and not because of them. The article highlights the importance of listening to and involving patients and overcoming professional hostility.
The whole is greater than the sum of the parts
- Author:
- WELLS Jane
- Journal article citation:
- Health Service Journal, 26.4.12, 2012, pp.30-31.
- Publisher:
- Emap Healthcare
The author highlights the role people management plays in successful integrated care by drawing on the experience of integration work at Greenwich Community Health Services - which covered integration in end of life care, long term conditions, intermediate care and reablement. The article discusses the factors that contributed to improved efficiency, and productivity and looks at the benefits of using joint health and social care performance measures and those focusing on patient related outcomes. The work at Greenwich won the engagement category at the 2011 HSJ Awards.
Avoiding unnecessary hospital admissions: the headlines
- Author:
- SOCIAL CARE INSTITUTE FOR EXCELLENCE
- Publisher:
- Social Care Institute for Excellence
- Publication year:
- 2012
- Place of publication:
- London
This film explores the challenge of reducing hospital admissions for older people through contributions from a range of health and social care experts. Their reflections highlight the complex health needs of older people in this country, the need for responsive and joined up health and social care services, and the role that home care staff can play in helping to identify deteriorating conditions that may result in a hospital admission. The film acknowledges that at a crisis point, hospital admission may be the only safe alternative but argues that integrated care, well-managed hospital stays, improved health provision in care homes, reablement, and self-management of health conditions can all play a part in reducing hospital admissions. The film will be of interest to health and social care commissioners and managers; social workers; GPs and community nurses; health and social care providers; health and social care policy leads.
Breaking the mould: re-visioning older people's housing: examples of innovative housing, care and support solutions for older people
- Author:
- NATIONAL HOUSING FEDERATION
- Publisher:
- National Housing Federation
- Publication year:
- 2012
- Pagination:
- 5p.
- Place of publication:
- London
The report describes a number of the business opportunities that an ageing population brings, particularly in the wider community. It also offers examples of how care, support and other practical services such as handyperson or ‘help at home’ services can be offered to older people in all types of tenure, including people who would pay for such a service from a trusted provider. It contains case studies and suggestions about how the increasing number of older people seeking effective housing solutions can provide business opportunities despite reduced public funds for housing and care. Published by the National Housing Federation it demonstrates how the growing numbers of older owner occupiers and people able to pay for care are keen to find alternatives to traditional care and housing options.
Case management for at-risk elderly patients in the English Integrated Care Pilots: observational study of staff and patient experience and secondary care utilisation
- Authors:
- ROLAND Martin, et al
- Journal article citation:
- International Journal of Integrated Care, 12(3), 2012, Online only
- Publisher:
- International Foundation for Integrated Care
In response to the perceived need to provide better integrated care, in 2009 the Department of Health appointed 16 Integrated Care Pilots which used a range of approaches to provide better integrated care. The aim of this article is to report on part of the multi-method national evaluation of the 16 Integrated Care Pilots. Specifically, it describes the quantitative analysis of 6 of the demonstration projects which used risk profiling tools to identify older people at risk of emergency hospital admission, combined with intensive case management for people identified as at risk. Questionnaires were completed by staff and patients to explore their views regarding the changes. In addition, changes in hospital utilisation and costs were analysed using data on 3,646 patients and 17,311 matched controls. The findings showed that most staff thought that care for their patients had improved. More patients reported having a care plan but they found it significantly harder to see a doctor or nurse of their choice and felt less involved in decisions about their care. Unexpectedly, case management interventions were associated with a 9% increase in emergency admissions. However, there were significant reductions of 21% and 22% in elective admissions and outpatient attendance in the 6 months following an intervention. Overall inpatient and outpatient costs were significantly reduced by 9% during this period.
“Happily Independent” – configuring the Gwent frailty support and wellbeing worker
- Authors:
- BARBER Kevin, WALLACE Carolyn
- Journal article citation:
- Journal of Integrated Care, 20(5), 2012, pp.308-321.
- Publisher:
- Emerald
This article discusses the integrated Support and Wellbeing Worker (SWB) role in an innovative Gwent Frailty programme from 2009 until 2011. The health and social care Gwent Frailty programme used a configuration approach by adopting ‘frailty’ as its unifying theme across the seven agencies involved. In order to configure this role, the Frailty Workforce Group (FWG) identified three tasks; staff engagement, identifying the SWB worker training needs, and scoping the employment options for the new role. For others facing the same challenges there are three key principles. The first is that having a unifying concept underpinned by the commissioned Happily Independent study legitimately enabled the FWG to deliver on its three tasks identified by the Frailty Board. The second was that time spent on early staff and trade union engagement gave positive messages about their value within the role configuration. Finally, that developing an integrated role meant that core training and development had to be consistent so that registered staff were confident they could delegate accordingly.
Service coordination for frail elderly individuals: an analysis of case management practices in Québec
- Author:
- CARRIER Sébastien
- Journal article citation:
- Journal of Gerontological Social Work, 55(5), July 2012, pp.392-408.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
In Québec, case management is responsible for the interprofessional and interorganisational coordination of integrated services networks for frail elderly individuals with both intense and multidimensional home care needs. Case management is designed to come into action early in the disability process to maintain home care as long as possible and avoid institutionalisation. The aim of this article is to understand coordination as it unfolds in case management practices in the context of integrated care networks devoted to frail elderly individuals. More specifically, the goal is to describe practical coordination processes. A qualitative exploratory study was conducted using an embedded case study design in 3 Health and Social Services Centres in Québec. In each institution, 3 data collection methods were used: documentary analysis of the prescribed coordination processes; interviews of case managers to determine actual coordination practices; and direct observation of professional practices. The findings showed that case management is more frequently justified by a situation in which home care is precarious rather than by the intensity and multidimensionality present in a situation. Therefore, it fails to address the fundamental goal of general coordination, which is proactive and continuous, instead acting in ‘standby mode’.