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Horizontal or vertical: which way to integrate? Approaches to community services integration and consequences for emergency hospital activity
- Authors:
- WYATT Steven, MILLER Robin, SPILSBURY Peter
- Publisher:
- NHS Midlands and Lancashire Commissioning Support Unit. The Strategy Unit
- Publication year:
- 2018
- Pagination:
- 29
- Place of publication:
- West Bromwich
In 2010, Transforming Community Services policy required primary care trusts to decide how they organised the community health services they delivered; vertically integrate with an acute trust, horizontally integrate with a mental health trust, or set up a stand-alone community trust or Community Interest Company. This report explores the impact this choice had on the level and growth in emergency hospital use in older people and considers the wider implications for the NHS as it develops new models of care and integrated care systems. The report concludes that that decisions taken to structurally integrate community nursing services and the form of this integration (vertical or horizontal), did not systematically and differentially influence the rate of emergency hospital use of older people. The findings suggest that mergers and organisational changes should not be confidently promoted as a means of reducing hospital activity, and that local healthcare systems the freedom to develop their own approach of partnership working. (Edited publisher abstract)
The tartan road: the Scottish route to health and social care integration
- Author:
- PETCH Alison
- Journal article citation:
- Journal of Care Services Management, 6(1), 2012, pp.16-25.
- Publisher:
- Taylor and Francis
Plans for health and social care integration in Scotland were announced in December 2011. Under the proposals the existing community health partnerships are to be replaced by health and social care partnerships which will be the joint and equal responsibility of the NHS and the local authority in each area. The partnerships are intended to deliver integrated care and support in the community, with an initial focus on services for older people. This article explores the proposals in the context of earlier developments in Scotland, the evidence on effective models for integrated working, and the existing community health partnerships. It draws on the findings of an evidence review commissioned from the author by the Scottish Association of Directors of Social Work. It also looks at the Reshaping Care for Older People programme launched in 2011, and the work of the community health partnerships. The article notes the 7 proposed health and care integration outcomes set out in the formal consultation on the integration proposals, and identifies and discusses factors most likely to lead to successful implementation of the proposals.
What quality healthcare means to older people: exploring and meeting their needs
- Author:
- POTTER Charlotte
- Journal article citation:
- Nursing Times, 15.12.09, 2009, pp.14-18.
- Publisher:
- Nursing Times
Face to face interviews were conducted with 20 vulnerable older adults to find out what they valued in the NHS and whether their aspirations were being met. Nine aspirations were identified: face to face flexible appointments; to retain control in their own home; respect for property and belongings; company and the opportunity to be listened to; proactive healthcare and support; choice and control over daily routines; a connected relationship between staff and patients; maintenance of privacy in hospital; and joined-up care. The findings highlighted the importance older people attached to their needs being met rather than about how meets them.
Double jeopardy?: needs and services for older people who have learning disabilities
- Authors:
- BLAND Rachel, et al
- Journal article citation:
- Journal of Learning Disabilities, 7(4), December 2003, pp.317-338.
- Publisher:
- Sage
Increasing numbers of people with learning disabilities are living into older adulthood,creating important challenges for services. Greater local understanding of the specific health needs of this population is crucial to influence needs-led service planning. The study used a questionnaire survey to identify people aged over.. who have learning disabilities,covered by a community health trust in England. Specific types of health problems for this older population were identified,along with the sources and types of community supports received and care staff satisfaction with these supports. The most frequently occurring health problems related to psychological/behavioural,incontinence/excretory and circulatory/respiratory needs. Overall general practitioners,followed by community/district nurses,provided the majority of healthcare support. Generally care staff appeared satisfied with the access and quality of health support. There were alarming findings in relation to some areas of health screening. Cervical,breast and testicular examinations were rare. The implications of the study are discussed.
Community health services
- Author:
- ASSOCIATION OF COMMUNITY HEALTH COUNCILS FOR ENGLAND AND WALES
- Publisher:
- Association of Community Health Councils for England and Wales
- Publication year:
- 1994
- Pagination:
- 55p.,diags.
- Place of publication:
- London
Briefing paper reviewing the wide range of community services which are a crucial part of primary care in the NHS. Looks at their historical base and development, how they have been affected by the recent reforms, and the type of service patients expect to receive in the future.
The state of health care and adult social care in England in 2012/2013
- Author:
- CARE QUALITY COMMISSION
- Publisher:
- TSO
- Publication year:
- 2013
- Pagination:
- 86
- Place of publication:
- London
The Care Quality Commission's annual report on the state of health and social care services for the period 2013/13. The findings are based on the results of over 35,000 inspections to services. Part 1 of the report focuses on the increasing number of older people arriving in A&E with avoidable conditions. The thematic study looks at the increase in admissions, the impact on A&E departments, and regional differences. A case study of Queen's Hospital in Romford is included. Part 2 of the report sets out the quality of care in each sector. The remainder of Part 2 contains specific sections on: adult social care; NHS services; Independent health care; and primary dental care. The finding are summarised under the headings of safeguarding and safety; care and welfare; respect and dignity; suitability of staffing; and monitoring quality.Appendices include a listing of the numbers of registered adult social care providers across the different regions and sector performance tables by outcome. (Original abstract)
Waiting for change: how the NHS is responding to the needs of older people
- Authors:
- AGE CONCERN, HELP THE AGED
- Publisher:
- Age Concern; Help the Aged
- Publication year:
- 2009
- Pagination:
- 13p.
- Place of publication:
- London
This report by Age UK (formerly Age Concern) describes how the NHS, politicians and health professionals are failing to prioritise issues which older patients most value. The report focuses on the needs of the over 80s, and concluded that this group have a clear idea of what they want from health services, but all too often this is not delivered. Current NHS targets and performance indicators fail to adequately address the issues that matter most to older people. Findings indicate that face to face and flexible appointments with health professionals they know and trust and better coordination of care are among those things older people want from community-based healthcare. The study also highlighted the importance placed on social aspects of healthcare, particularly for those older people who are isolated in their own homes. The study also identified privacy, good relationships with staff and retaining choice and control over daily routines to be vital for positive patient experience, within hospital settings. The report stresses how these needs are not always met. Recent Government figures show that 47 percent of inpatients said that they were not, or only partially, involved as much as they wanted to be in decisions about their care and treatment in hospital.
Unit costs of health and social care 2008
- Authors:
- CURTIS Lesley, (comp.)
- Publisher:
- Personal Social Services Research Unit
- Publication year:
- 2008
- Pagination:
- 192p., bibliog.
- Place of publication:
- Canterbury
Aims to improve unit cost estimates for health and social services. Includes sections on services for: elderly people; people with mental health problems; people with learning difficulties; services for children and families; and substance misusers. Also provides a breakdown of costs of health care staff in the community and in hospitals.
Unit costs of health and social care 2007
- Authors:
- CURTIS Lesley, (comp.)
- Publisher:
- Personal Social Services Research Unit
- Publication year:
- 2007
- Pagination:
- 208, bibliog.
- Place of publication:
- Canterbury
Aims to improve unit cost estimates for health and social services. Includes sections on services for: elderly people; people with mental health problems; people with learning difficulties; services for children and families; and substance misusers. Also provides a breakdown of costs of health care staff in the community and in hospitals.
Unit costs of health and social care 2005
- Authors:
- CURTIS Lesley, NETTEN Ann, (comps.)
- Publisher:
- University of Kent. Personal Social Services Research Unit
- Publication year:
- 2006
- Pagination:
- 203p., bibliog.
- Place of publication:
- Canterbury
Aims to improve unit cost estimates for health and social services. Includes sections on services for: elderly people; people with mental health problems; people with learning difficulties; services for children and families; and substance misusers. Also provides a breakdown of costs of health care staff in the community and in hospitals.