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A journey through the years: ageing and social care
- Author:
- JONES Ray
- Journal article citation:
- Ageing Horizons, 6, 2007, Online only
- Publisher:
- Oxford Institute of Ageing
- Place of publication:
- Oxford
The paper analyses the history of English social care philosophy, policy, and institutions since the late seventies, and the challenges of today which they have helped to shape. Guiding principles changed in fundamental ways requiring and causing profound cultural and structural changes, not always with the intended mix of consequences. Changes in practice philosophy complemented changes in the philosophical bases of policy. They moved along a continuum of doing ‘to’ people (containing and controlling as well as caring), to doing for’ (paternalistic but often also patronisingly assuming ‘cosiness’ in looking after people), to doing ‘with’ (partnership and participation), to offering more independence choice and control and doing ‘by’ themselves but with ‘assistance’ when needed. Since 1989, policy and institutions have been adapted to reduce the dependence on institutions, better match responses to individual circumstances and increase control and choice by shifting the balance of roles of authorities from direct provision to planning and purchasing more diverse services and supporting the development of a succession of new models for securing their fit to user wishes and circumstances. From 1998, policy was designed to accelerate and secure greater consistency in development based on the national policy principles through performance management including rewards and incentives. From 2005, the challenge was defined more in terms of improving the broad wellbeing of older people and finding new ways of contributing to it, particularly in ways which would reduce the subsequent need for services. Pressures on public budgets have throughout been and continue to be a major concern of field agencies.
Bringing health and social care together for older people: Wiltshire's journey from independence to interdependence to integration
- Author:
- JONES Ray
- Journal article citation:
- Journal of Integrated Care, 12(1), February 2004, pp.27-32.
- Publisher:
- Emerald
Charts ten years of movement in Wiltshire towards greater integration for health and social care, and highlights messages for others at different stages of the process. Messages include that while an early strategic vision can create the right conditions, there can be no short cuts to effective integration. The second is that independent evaluation is necessary to produce the evidence to sustain initiatives and promote organisational and professional learning - which are the key ingredients of the change process. The article is based on the results of a longitudinal study commissioned and undertaken by the University of Bath/Wiltshire Social Services Research Partnership, and funded from the regional NHS Research and Development budget and by the Centre for Evidence-Based Social Services. The study looked at the experience and outcomes of 393 people aged 65 and over who were referred for a community care assessment between July 1999 and 2000, 195 receiving their assessment from the 'integrating service' and 198 receiving their service from 'traditional' area social services teams.