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Integrating mental health services for older people in England - from rhetoric to reality
- Authors:
- TUCKER Sue, et al
- Journal article citation:
- Journal of Interprofessional Care, 23(4), July 2009, pp.341-354.
- Publisher:
- Taylor and Francis
The provision of integrated, person-centred care is particularly important for older people with mental health problems. Nevertheless, a series of reports at the end of the last century highlighted unacceptable differences in collaborative working practices in England, variations that a national service framework specifically aimed to address. This study utilised a cross-sectional survey of old age psychiatrists to explore the extent to which, some three years after the publication of this guidance, structures to deliver integrated care across the interfaces between specialist old age mental health and primary, acute and social care services were in place. Three hundred and eighteen (72%) consultants responded. Measures to facilitate integrated practice were generally poorly developed: many areas missed targets to agree protocols for the management of older people with mental health problems with primary care; more than 45% of respondents reported the presence of fewer than two of four indicators of integration with the acute sector; and approaching 30% of respondents reported the presence of fewer than four of 13 markers of integration with social care. The implications of these findings and the challenges inherent in providing integrated care for this client group are discussed.
Improving public services for older people: twenty-ninth report of session 2003-04; report, together with formal minutes
- Author:
- GREAT BRITAIN. Parliament. House of Commons. Committee of Public Accounts
- Publisher:
- Stationery Office
- Publication year:
- 2004
- Pagination:
- 22p.
- Place of publication:
- London
The UK population is becoming older, with currently more than 10.5 million over the state pension age, whilst this figure is forecast to reach 16 million (or 25 per cent of the population) by the year 2040. This demographic trend has significant implications for the delivery of, and demand for, public services, particularly in terms of social services, health, housing, public transport and leisure services. This overview report draws on a number of the Committee's previous reports on pensioner poverty discharge of older patient from NHS acute hospitals , the inherited SERPS problem, and fuel poverty amongst vulnerable groups. Conclusions reached include: stronger co-ordination of activities and initiatives by public bodies is required to ensure better service delivery to older people and avoid duplication; service delivery to older people needs to be based on research and consultation to ensure effective access arrangements; and the specific needs of older people from ethnic minorities needs particular attention.
Acute hospitals and older people in Australia
- Author:
- McCORMACK John
- Journal article citation:
- Ageing and Society, 22(5), September 2002, pp.637-646.
- Publisher:
- Cambridge University Press
The Australian health care system is frequently portrayed as being in crisis, with reference to either large financial burdens in the form of hospital deficits, or declining service levels. Older people, characterised as a homogeneous category, are repeatedly identified as a major contributor to the crisis, by unnecessarily occupying acute beds while they await a vacancy in a residential facility. Several enquiries and hospital taskforce management groups have been set up to tackle the problem. This article reviews their findings and strategic recommendations, particularly as they relate to older people. Short-term policy responses are being developed which specifically target older people for early discharge and alternative levels of care, and which, while claiming positive intentions, may introduce new forms of age discrimination into the health system.
Partnerships performance and primary care: developing integrated services for older people in England
- Authors:
- GLENDINNING Caroline, COLEMAN Anna, RUMMERY Kirstein
- Journal article citation:
- Ageing and Society, 22(2), March 2002, pp.185-208.
- Publisher:
- Cambridge University Press
Critically examines recent policy developments in England aimed at improving health and social services for older people. Summarises the current funding and organisation of services for older people, and highlights some key problem areas. Highlights three main policy themes that are shaping services: an emphasis on partnership; active demonstration of improved performance; and increasing involvement of frontline health professional in decisions of services development. Considers the implications and impact of these factors on the development of services for older people, and discusses whether health service developments are likely to address some of the most pressing needs of older people.
The responsibility to care for single homeless people
- Authors:
- CRANE Maureen, WARNES Anthony M.
- Journal article citation:
- Health and Social Care in the Community, 9(6), November 2001, pp.436-444.
- Publisher:
- Wiley
Examines the reasons why in contemporary Britain many single homeless people with severe physical and mental health problems and welfare needs do not receive the treatment, care and financial support that they manifestly need, and in particular considers the interaction between their personal characteristics and the organisation and the obligations of services. The greatest weaknesses of the service system are that no single agency has a statutory responsibility to ensure that vulnerable homeless people are served. The article appraises the approaches to single homeless peoples problems that have recently been introduced by the Rough Sleepers Unit (RSU), and discusses the ways in which current reforms of the welfare services may impact on the situation of homeless people. With the possibility that the RSUs prime responsibility for commissioning single homeless peoples services will transfer to local authorities in 2002, the article concludes by specifying the implications for voluntary and statutory providers and makes recommendations about the attribution of the responsibility to care for this vulnerable group.
New beginnings: towards patient and public involvement in primary health care
- Editors:
- GILLAM Stephen, BROOKS Fiona
- Publisher:
- Kings Fund
- Publication year:
- 2001
- Pagination:
- 168p.,bibliogs.
- Place of publication:
- London
Explores the issues related to public and patient involvement in primary care. Begins by describing the theoretical and policy contexts that are shaping user involvement currently; why user involvement is regarded as important; and its role in primary care at organisation level and in the individual consultation. Moves on to consider a range of case studies of involvement of different types of user, including women, members of ethnic minorities, older people and people with mental health problems. Concludes with an overview of the challenges remaining and suggestions for future development.
Working on the fault line
- Editors:
- BRADLEY Greta, MANTHORPE Jill
- Publisher:
- Venture Press/British Association of Social Workers
- Publication year:
- 2000
- Pagination:
- 160p.,bibliog.
- Place of publication:
- Birmingham
Provides five research studies focusing on health-related social work and its engagement with hospital, primary and community care, with particular reference to services to older people. The studies comprise: social workers in primary care settings; day-to-day activities of social workers in both hospital and community based settings; hospital social work in the context of care management; relevant issues in accident and emergency departments; and a policy study of continuing care.
The rough road and the smooth road: comparing access to social care for older people via area teams and GP surgeries
- Authors:
- LE MESURIER Nick, CUMELLA Stuart
- Journal article citation:
- Managing Community Care, 9(1), February 2001, pp.7-13.
- Publisher:
- Pavilion
This article discusses the results of a comparative evaluation of a social worker in primary care with her equivalents in an area team. Direct referral was found to be more efficient than referral to the area team, enabling the attached social worker to manage a higher workload and improved levels of contact with service users and the primary care team. The options available for service users are thus enhanced, with consequent cost advantages for the social services department.
Mental health and primary care: an alternative policy agenda
- Authors:
- BUTLER Tom, et al
- Journal article citation:
- Journal of Mental Health, 6(4), August 1997, pp.331-334.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Critically reviews the Green paper on mental health published by the last Conservative government in 1997, and puts forward an alternative policy agenda.
Professional power and managerial control: the case of GP assessments of the over-75s
- Authors:
- GLENDINNING Caroline, CHEW Carolyn, WILKIN David
- Journal article citation:
- Social Policy and Administration, 28(4), December 1994, pp.317-332.
- Publisher:
- Wiley
The Family Health Services Authorities (FHSAs) administer a new Contract for General Practitioners which includes a requirement for GPs to make, each year, a written offer of a health check, at home to all patients over 75. Examines the strategies adopted by FHSAs in tackling the administration of this particularly controversial requirement. Concludes that although apparently effective in the short term these strategies may have considerable long term shortcomings.