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Evaluating the impact of integrated health and social care teams on older people living in the community
- Authors:
- BROWN Louise, TUCKER Christine, DOMOKOS Teresa
- Journal article citation:
- Health and Social Care in the Community, 11(2), March 2003, pp.85-94.
- Publisher:
- Wiley
Although it is perceived wisdom that joint working must be beneficial there is little evidence to support this. Evaluates 2 integrated co-located health and social care teams established in a rural county to meet the needs of older people and their carers. Identifies that patients from 'integrated teams' may self-refer more and are assessed more quickly, maybe indicating the 'one-stop shop' approach is having an impact on service delivery. Findings also suggest that in integrated teams the initial stages of the process of seeking help and being assessed for a service may have improved through better communication, understanding and exchange of information among professional groups. However, the degree of 'integration' seen within these teams does not appear sufficiently well developed to have had an impact on clinical outcomes for patients/users. It appears unlikely from available evidence that measures such as co-location go far enough to produce changes in outcomes for older people. If the Department of Health wishes to see benefits in process progress to benefits to users more major structural changes will be required. The process of changing organisational structures can be enhanced where there is evidence that changes will produce better outcomes. At present this evidence does not exist, although this study suggests that benefits might be forthcoming if greater integration can be achieved. Nevertheless, until social services and NHS trusts develop more efficient and compatible information systems it will be impossible to evaluate what impact any further steps towards integration might have on older people without significant external resources.
Professional perceptions of joint working in primary care and social care services for older people in Scotland
- Authors:
- HUBBARD Gill, THEMESSL-HUBER Markus
- Journal article citation:
- Journal of Interprofessional Care, 19(4), August 2005, pp.371-385.
- Publisher:
- Taylor and Francis
The purpose of this paper is to report health and social care professionals' perceptions on joint working for the care of older people in Scotland. Semi-structured interviews were conducted with 34 primary care and social care professionals. These professionals emphasised that joint working requires a fundamental change in thinking and a scrutiny of professional roles and identities and is influenced by the given geographical and organisational infrastructure. In order to facilitate sustained joint working knowledge and models of care bespoke to joint working need to be developed. This requires health and social care organisations to focus on the co-creation and generation of new knowledge by health and social care professionals as well as the communication and exchange of existing knowledge between services. However, joint working also needs to be based on patient views to guarantee a whole systems perspective.
The changing role of the practice nurse
- Authors:
- JONES Dee, EDWARDS Judy, LESTER Carolyn
- Journal article citation:
- Health and Social Care in the Community, 5(2), March 1997, pp.77-83.
- Publisher:
- Wiley
Examines the results of a study looking at the changing role of practice nurses in the primary care of elderly people. The study took place in three district health authorities where random samples of people aged 65 years and over were interviewed in 1990 and again in 1992 and questioned on their utilization and opinions of primary care services. More older people in 1992 than in 1990 were aware that their practice employed a nurse and annual consultation rates increased. Their principal reasons for consulting a practice nurse included blood pressure checks, blood tests, 'flu injections and ear syringing. There was an increase in the number of patients aged over 75 years who reported having a health assessment 'health check' and an increase in the proportion of assessments carried out by the practice nurse. Concludes that the role of practice nurses appears to be expanding and there is therefore an on-going need for evaluation and training to enable nurses better to fulfil their enhanced role in the primary care team.
Identifying patient-level health and social care costs for older adults discharged from acute medical units in England
- Authors:
- FRANKLIN Matthew, et al
- Journal article citation:
- Age and Ageing, 43(5), 2014, pp.703-707.
- Publisher:
- Oxford University Press
Background: acute medical units allow for those who need admission to be correctly identified, and for those who could be managed in ambulatory settings to be discharged. However, re-admission rates for older people following discharge from acute medical units are high and may be associated with substantial health and social care costs. Objective: identifying patient-level health and social care costs for older people discharged from acute medical units in England. Design: a prospective cohort study of health and social care resource use. Setting: an acute medical unit in Nottingham, England. Participants: four hundred and fifty-six people aged over 70 who were discharged from an acute medical unit within 72 h of admission. Methods: hospitalisation and social care data were collected for 3 months post-recruitment. In Nottingham, further approvals were gained to obtain data from general practices, ambulance services, intermediate care and mental healthcare. Resource use was combined with national unit costs. Results: costs from all sectors were available for 250 participants. The mean (95% CI, median, range) total cost was £1926 (1579–2383, 659, 0–23,612). Contribution was: secondary care (76.1%), primary care (10.9%), ambulance service (0.7%), intermediate care (0.2%), mental healthcare (2.1%) and social care (10.0%). The costliest 10% of participants accounted for 50% of the cost. Conclusions: this study highlights the costs accrued by older people discharged from acute medical units (AMUs): they are mainly (76%) in secondary care and half of all costs were incurred by a minority of participants (10%). (Publisher abstract)
Adult community statistics: 1st April 2008-31st March 2009
- Author:
- NORTHERN IRELAND. Department of Health, Social Services and Public Safety
- Publisher:
- Northern Ireland. Department of Health, Social Services and Public Safety
- Publication year:
- 2009
- Pagination:
- 80p., tables
- Place of publication:
- Belfast
This statistical report presents information on activity for all Programmes of Care for adults, gathered from HSC Trusts via the annual and quarterly statistical returns. Statistical tables are presented in 6 sections. All Programmes of Care, Elderly Care, Mental Health, Learning Disability, Physical and Sensory Disability, and Primary Health and Adult Community.
Adult community statistics: 1st April 2009-31st March 2010
- Author:
- NORTHERN IRELAND. Department of Health, Social Services and Public Safety
- Publisher:
- Northern Ireland. Department of Health, Social Services and Public Safety
- Publication year:
- 2010
- Pagination:
- 77p., tables
- Place of publication:
- Belfast
This statistical report presents information on activity for all Programmes of Care for adults, gathered from HSC Trusts via the annual and quarterly statistical returns. Statistical tables are presented in 6 sections. All Programmes of Care, Elderly Care, Mental Health, Learning Disability, Physical and Sensory Disability, and Primary Health and Adult Community.
Adult community statistics: 1st April 2007-31st March 2008
- Author:
- NORTHERN IRELAND. Department of Health, Social Services and Public Safety
- Publisher:
- Northern Ireland. Department of Health, Social Services and Public Safety
- Publication year:
- 2008
- Pagination:
- 78p., tables
- Place of publication:
- Belfast
This statistical report presents information on activity for all Programmes of Care for adults, gathered from HSC Trusts via the annual and quarterly statistical returns. Statistical tables are presented in 6 sections. All Programmes of Care, Elderly Care, Mental Health, Learning Disability, Physical and Sensory Disability, and Primary Health and Adult Community.
Treatment of anxiety, depression, and alcohol disorders in the elderly: social work collaboration in primary care
- Author:
- RINFRETTE Elaine S.
- Journal article citation:
- Journal of Evidence-Based Social Work, 6(1), January 2009, pp.79-91.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The author reviews the literature on the prevalence, assessment and treatment of anxiety, depression and alcohol disorders in the elderly. She comments that it is vital that social workers consider the impact of anxiety and depressive disorders and symptoms along with alcohol and physical disorders in their older clients, as these can have a devastating impact on the elders’ quality of life. Additionally, medical conditions that are manifested as psychological symptoms, or medications that cause symptoms, must be considered and addressed in order to maintain an older adult’s optimal health and level of functioning. Engagement of the older adult in mental health/substance abuse treatment has been found to be more successful if it occurs in collaboration with primary care treatment. Collaboration between social workers and physicians appears to be an obvious solution to meeting the needs of elderly persons with mental health and/or substance abuse problems who present for medical concerns in their physician’s office.
Take your partners
- Author:
- DAVIS Rowenna
- Journal article citation:
- Community Care, 10.04.08, 2008, pp.14-16.
- Publisher:
- Reed Business Information
The Excellence Network is Community Care's new honours programme which recognises innovative practice. This article profiles six teams that judges felt demonstrated excellence in partnership working. The teams are: The Bridge Substance Misuse Service in Birmingham; Gateway in Poole, which aims to bridge the gap between social and mental health services; East Cambridgeshire Children's Team; Aberdeenshire Autism Service; the Reprovisioning Project Team in Melrose, Scotland which developed a new community based service to meet the needs of former nursing home residents with physical and complex disabilities; and the Meadows Centre for Excellence which joins social care rehabilitation, primary care trust intermediate care and voluntary sector services to provide seamless support for people over 50 in Stoke on Trent.
Advancing the field of elder mistreatment: a new model for integration of social and medical services
- Authors:
- MOSQUEDA Laura, et al
- Journal article citation:
- Gerontologist, 44(5), October 2004, pp.703-708.
- Publisher:
- Oxford University Press
The purpose of this work is to describe the development and operation of a new model for integration of medical and social services in the US. The Vulnerable Adult Specialist Team (VAST) provides Adult Protective Services (APS) and criminal justice agencies with access to medical experts who examine medical and psychological injuries of victims of elder abuse. This retrospective, descriptive analysis included community-dwelling elders and adults with disabilities who were reported for mistreatment and referred to VAST (n = 269). Most cases came from APS for mental status and physical examination for evidence of abuse. Cases referred to a medical response team (n = 269) were significantly different from cases that were not referred (n = 9,505). Ninety-seven percent of those who referred cases to VAST indicated that the team was helpful in confirming abuse, documenting impaired capacity, reviewing medications and medical conditions, facilitating the conservatorship process, persuading the client or family to take action, and supporting the need for law enforcement involvement. As a result, VAST has become institutionalized in our county. Amenable to replication, medical response teams for elder abuse may be useful in other counties across the nation.