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New jobs old roles: working for prevention in a whole-system model of health and social care for older people
- Authors:
- SMITH Naomi, BARNES Marian
- Journal article citation:
- Health and Social Care in the Community, 21(1), 2013, pp.79-87.
- Publisher:
- Wiley
The ‘Partnerships for Older People Projects’ programme provided government funding for local and health authorities to pilot prevention and intervention services in partnership with the voluntary sector and older people between 2006 and 2009. This evaluation of a pilot in southern England used a Theory of Change approach to gather and reflect on data with different groups involved in the delivery of this model of prevention. This whole-system model, although complex and challenging to implement, was considered overall to have been a success and provided significant learning for partners and stakeholders on the challenges and benefits of working across professional and sectoral boundaries. New posts were created as part of the model – two of these, recruited to and managed by voluntary sector partners, were identified as ‘new jobs’, but echoed ‘old roles’ within community and voluntary sector based health and social care. The authors reflect on the parallels of these roles with previously existing roles and ways of working and reflect on how the whole-system approach of this particular pilot enabled these new jobs to develop in appropriate and successful ways.
Making integrated care happen at scale and pace: lessons from experience
- Authors:
- HAM Chris, WALSH Nicola
- Publisher:
- Kings Fund
- Publication year:
- 2013
- Pagination:
- 8
- Place of publication:
- London
The current fragmented services in health and social care fail to meet the needs of the population. A shift to an approach that develops integrated models of care for patients, especially older people and those with long-term conditions, can improve the patient experience and the outcomes and efficiency of care. Making integrated care happen at scale and pace: Lessons from experience is intended to support the process of converting policy intentions into meaningful and widespread change on the ground. The authors summarise 16 steps that need to be taken to make integrated care a reality and draw on work by The King’s Fund and others to provide examples of good practice. There are no universal solutions or approaches to integrated care that will work everywhere and there is also no ‘best way’ of integrating care, and the authors emphasise the importance of discovery rather than design and of sharing examples of good practice when developing policy and practice. Finally, the paper acknowledges that changes are needed to national policy and to the regulatory and financial frameworks for local leaders to fully realise a vision of integration. (Publisher abstract)
Providing an alternative pathway: the value of integrating housing, care and support
- Authors:
- BERRINGTON James, NATIONAL HOUSING FEDERATION
- Publisher:
- National Housing Federation
- Publication year:
- 2013
- Pagination:
- 20p.
- Place of publication:
- London
This report by the National Housing Federation highlights the value of integrating housing with care and support in five case studies where integrated working between housing providers, health and social care have improved outcomes for individuals and reduced costs. These case studies, which provide practical examples of bringing together housing, health and care, deliver savings of between £2,946 and £17,992 a year compared to less integrated pathways. One service saved a total of £241,670 to local health and social care budgets. The report concludes that, at a time when local authorities have to cut spending while continuing to meet the needs created by changing demographics, it is imperative that we integrate as a way of improving outcomes while achieving efficiencies.
GP services for older people: a guide for care home managers
- Author:
- SOCIAL CARE INSTITUTE FOR EXCELLENCE
- Publisher:
- Social Care Institute for Excellence
- Publication year:
- 2013
- Place of publication:
- London
The health and wellbeing of older people in care homes depends on them accessing GP services in a timely way. Effective joint working between GP and care home management, the involvement of residents and their relatives and the engagement of care staff are factors that can affect the outcome and lead to quality improvements. This guide sets out steps the care home manager should take, in areas such as record-keeping, medications management and monitoring resident feedback on their experience of medical care, to complement the work of GPs and nurses. The main sections cover: residents entitlements and requirements; managers' responsibilities; GPs' role in relation to the resident; workforce development, standards and regulation. Clear recommendations are made for each section. The guide is written primarily for managers and senior staff of care homes but will also be useful for GPs and members of clinical commissioning groups and joint health and wellbeing boards. (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)
Together: a vision of whole person care for a 21st century health and care service
- Editor:
- BURNHAM Andy
- Publisher:
- Fabian Society
- Publication year:
- 2013
- Pagination:
- 98
- Place of publication:
- London
Whole person care – integrating physical, social and mental health care in a preventative and person-centred system – is potentially Labour’s big idea going into the 2015 election. The concept has already gained wide support among health professionals, policy experts, campaigners, practitioners and political advocates, who have united to welcome the approach. However, big questions remain around how to turn it from an interesting idea into a credible programme for government. To inform the development of the whole person care agenda, Andy Burnham MP, the shadow health secretary, brings together a range of independent experts to explore the policy implications of integrated health and social care. Their essays do not represent Labour party policy, but outline the key areas that will need to be answered, in order to develop a coherent and effective ‘whole person’ approach to health and social care. The publication has been supported by Age UK. (Edited publisher abstract)
The effectiveness of inter-professional working for older people living in the community: a systematic review
- Authors:
- TRIVEDI Daksha, et al
- Journal article citation:
- Health and Social Care in the Community, 21(2), 2013, pp.113-128.
- Publisher:
- Wiley
Types of Inter-professional working (IPW) vary according to context and it is not clear how differences in systems, professional mix, agencies, roles, and services influence outcomes for older people living in the community. This review aimed to identify the models of IPW that provide the strongest evidence base for practice. The literature was searched from 1990 to 2008 and updated with later systematic reviews. Papers were included if they described interventions that involved IPW for community dwelling older people or were randomised controlled trials (RCT) reporting user-relevant outcomes. These studies were classified by IPW models (Case Management, Collaboration and Integrated Team) and assessed for bias. The evidence was drawn together by type of care (acute, chronic, palliative and preventive) within each model of IPW. A total of 3211 records were retrieved and 37 RCTs were mapped onto the IPW models; study quality varied considerably. There was weak evidence of effectiveness and cost-effectiveness for IPW, although well-integrated and shared care models improved processes of care and appeared to have the potential to reduce hospital or nursing/care home use. The authors conclude that more information is needed on the outcomes of the process of IPW and evaluations of the effectiveness of different configurations of health and social care professionals for the care of community dwelling older people.
Co-ordinated care for people with complex chronic conditions: key lessons and markers for success
- Authors:
- GOODWIN Nick, et al
- Publisher:
- King's Fund
- Publication year:
- 2013
- Pagination:
- 33
- Place of publication:
- London
The costs of caring for people with age-related chronic and complex medical conditions are high and will continue to rise with population ageing. Yet people with multiple health and social care needs often receive a very fragmented service, resulting in less than optimal care experiences, outcomes and costs. However, there is a general lack of knowledge about how best to apply (and combine) the various strategies and approaches to care co-ordination. This report presents the findings from a two-year research project funded by Aetna and the Aetna Foundation, which aimed to understand the key components of effective strategies employed by studying five UK-based programmes to deliver co-ordinated care for people with long-term and complex needs. The five case study programmes were: Midhurst Macmillan Community Specialist Palliative Care Service (West Sussex); Oxleas Advanced Dementia Service (Bexley, Bromley and Greenwich); the Sandwell Esteem Team (West Midlands); community virtual wards in South Devon and Torbay; and community resource teams in Pembrokeshire. The research also involved a non-systematic review of the literature on care co-ordination for people with complex needs. The evidence suggests that comprehensive, system-based solutions to care co-ordinaton have the potential to improve collaboration within and between various parts of health care. The research elicits some key lessons and markers for success to help identify how care co-ordination might be transferred from the UK to the US context. (Edited publisher abstract)