Reports on the findings of six workshops in total held across England between November 2012 and February 2013 to help social care providers, individual employers and support organisations to embed personalisation and develop a workforce that is capable and skilled to deliver personalised care and support. The workshops aimed to: raise awareness and use of the PA Framework and Making it Real;
(Edited publisher abstract)
Reports on the findings of six workshops in total held across England between November 2012 and February 2013 to help social care providers, individual employers and support organisations to embed personalisation and develop a workforce that is capable and skilled to deliver personalised care and support. The workshops aimed to: raise awareness and use of the PA Framework and Making it Real; identify challenges and gaps in approaches to working in a personalised way; raise awareness of the materials and resources available to individuals and providers; and offer networking opportunities with others in your local area.
(Edited publisher abstract)
Subject terms:
personalisation, staff development, evaluation, case studies;
This report is the result of a three-year independent evaluation of the impact of Together for Mental Wellbeing’s personalised, community-based mental health services. The project was funded by the Department of Health. This new approach is called Your Way and has five essential elements: meaningful personalisation; open-minded approach and high-quality service; peer support; healthy living
(Edited publisher abstract)
This report is the result of a three-year independent evaluation of the impact of Together for Mental Wellbeing’s personalised, community-based mental health services. The project was funded by the Department of Health. This new approach is called Your Way and has five essential elements: meaningful personalisation; open-minded approach and high-quality service; peer support; healthy living in the community; and service-user leadership. People can access support from the service via referrals from community mental health teams (or in some cases through Supporting People panels), their GP or through self-referral. Those with a personal budget can use this to purchase support from the service. This evaluation highlights the important findings in relation to improvements in wellbeing, health-promoting lifestyles and goal attainment. There were statistically significant increases in wellbeing in the first three months of service use for people who enrolled on the evaluation within a month of accessing support from Your Way. Significant improvements were also noticed in relation to social life and relationships, a sense of meaning, dealing with health professionals, and health-promoting lifestyle activity. Cost comparisons between Your Way and other services appear to suggest some cost benefits if Your Way works on a large-scale basis or is provided as part of a broader range of services rather than in isolation.
(Edited publisher abstract)
Subject terms:
evaluation, intervention, mental health care, personalisation, community care;
Housing Care and Support, 16(3/4), 2013, pp.136-144.
Publisher:
Emerald
Purpose: The purpose of this paper is to consider the role of housing and housing support services in working with systems of self-directed support (SDS). The paper draws upon findings from an evaluation and follow up study of three SDS Test Sites in Scotland and wider research.
Design/methodology/approach: The evaluation of the SDS Test Sites took place in 2009-2011 with a follow up study in 2011-2012. Methods included a literature review; an analysis of secondary data on the use of SDS in Scotland; interviews with key stakeholders; learning sets in the three areas; 30 depth individual case studies and a large-scale stakeholder event prior to finalising the report. These data are drawn upon to reflect on the implications for housing providers and practitioners.
Findings: The interviews revealed that some SDS users had housing and related support needs, such as to prevent or resolve homelessness, to facilitate resettlement, to prevent hospital admissions, to access supported accommodation or to move from shared to independent housing. For some people flexible housing support seemed to enhance community living, also well-informed independent advocacy could make a difference to outcomes. While there was policy support for the Test Sites, it was notable that linkages between agencies at strategic level were limited, with neither housing nor health services greatly involved in strategic planning. Training, alongside liaison and partnerships, may help to broaden SDS.
Research limitations/implications: While housing and related support needs and services were not specifically investigated in this evaluation, data suggest that the contribution of housing services may be both under-developed and under-researched in the context of SDS. There are indications that SDS may act as a catalyst for improving housing opportunities provided that collaboration between housing and care services is maximised.
Practical implications: This paper suggests approaches that may improve and consolidate the role of housing in achieving SDS objectives of maximising user control and choice, improving outcomes and sustaining ordinary living.
Originality/value: This paper considers the less charted territory of the implications of SDS for the role of housing services. While drawing primarily on recent research in Scotland the themes raised will have wider relevance to housing and care services generally.
(Publisher abstract)
Purpose: The purpose of this paper is to consider the role of housing and housing support services in working with systems of self-directed support (SDS). The paper draws upon findings from an evaluation and follow up study of three SDS Test Sites in Scotland and wider research.
Design/methodology/approach: The evaluation of the SDS Test Sites took place in 2009-2011 with a follow up study in 2011-2012. Methods included a literature review; an analysis of secondary data on the use of SDS in Scotland; interviews with key stakeholders; learning sets in the three areas; 30 depth individual case studies and a large-scale stakeholder event prior to finalising the report. These data are drawn upon to reflect on the implications for housing providers and practitioners.
Findings: The interviews revealed that some SDS users had housing and related support needs, such as to prevent or resolve homelessness, to facilitate resettlement, to prevent hospital admissions, to access supported accommodation or to move from shared to independent housing. For some people flexible housing support seemed to enhance community living, also well-informed independent advocacy could make a difference to outcomes. While there was policy support for the Test Sites, it was notable that linkages between agencies at strategic level were limited, with neither housing nor health services greatly involved in strategic planning. Training, alongside liaison and partnerships, may help to broaden SDS.
Research limitations/implications: While housing and related support needs and services were not specifically investigated in this evaluation, data suggest that the contribution of housing services may be both under-developed and under-researched in the context of SDS. There are indications that SDS may act as a catalyst for improving housing opportunities provided that collaboration between housing and care services is maximised.
Practical implications: This paper suggests approaches that may improve and consolidate the role of housing in achieving SDS objectives of maximising user control and choice, improving outcomes and sustaining ordinary living.
Originality/value: This paper considers the less charted territory of the implications of SDS for the role of housing services. While drawing primarily on recent research in Scotland the themes raised will have wider relevance to housing and care services generally.
(Publisher abstract)
This is the second Personal Health Budgets Evaluation (PHBE) interim report that focuses on the personal health budget implementation process. This second interim report focuses on the views of a number of organisational representatives around the implementation of personal health budgets. Over the period September to October 2010, 43 interviews were conducted among operational staff, health professionals, commissioning managers and third-party budget holders across the 20 in-depth sites. The interviews were semi-structured, allowing participants to discuss their implementation processes and other relevant issues. Each interview lasted approximately 1.5 hours. A number of themes were covered in the interviews which can broadly be separated into two areas: how the personal health budget process impacts on the budget holder and carer; and local challenges of implementing the personal health budget pilot programme. There was an overwhelming view that personal health budgets would have a positive impact on both budget holders and carers. This positive impact was attributed to: increase in choice and control over services; encouraging flexible and creative services; improvements in outcomes as self- confidence, self-esteem and sense of purpose is increased; and improved relations between the NHS and personal health budget holders as views are being listened to.
This is the second Personal Health Budgets Evaluation (PHBE) interim report that focuses on the personal health budget implementation process. This second interim report focuses on the views of a number of organisational representatives around the implementation of personal health budgets. Over the period September to October 2010, 43 interviews were conducted among operational staff, health professionals, commissioning managers and third-party budget holders across the 20 in-depth sites. The interviews were semi-structured, allowing participants to discuss their implementation processes and other relevant issues. Each interview lasted approximately 1.5 hours. A number of themes were covered in the interviews which can broadly be separated into two areas: how the personal health budget process impacts on the budget holder and carer; and local challenges of implementing the personal health budget pilot programme. There was an overwhelming view that personal health budgets would have a positive impact on both budget holders and carers. This positive impact was attributed to: increase in choice and control over services; encouraging flexible and creative services; improvements in outcomes as self- confidence, self-esteem and sense of purpose is increased; and improved relations between the NHS and personal health budget holders as views are being listened to.
Subject terms:
personal budgets, personalisation, choice, evaluation, personal health budgets;
Health and Social Care Delivery Research, 8(26), 2020, Online only
Publisher:
National Institute for Health Research
Place of publication:
London
Background: The number and proportion of older people in the UK are increasing, as are multimorbidity (potentially reducing quality of life) and polypharmacy (increasing the risk of adverse drug events). Together, these complex factors are challenging for older people, informal carers, and health and care practitioners. Objectives: MEMORABLE (MEdication Management in Older people: Realist Approaches Based on Literature and Evaluation) aimed to understand how medication management works and propose improvements. Design: A realist approach informed three work packages, combining a realist review of secondary data with a realist evaluation of primary interview data, in a theory-driven, causal analysis. Setting: The setting was in the community. Participants: Older people, informal carers, and health and care practitioners. Interventions: Studies relating to medication management and to reviewing and reconciling medications; and realist-informed interviews. Data sources: MEDLINE, CINAHL (Cumulative Index of Nursing and Allied Health Literature) and EMBASE were searched (all searched from January 2009 to July 2017; searched on 1 August 2017). Supplementary articles were identified by the Research Team. Data were also obtained through interviews. Review methods: Searches of electronic databases were supplemented by citation-tracking for explanatory contributions, as well as accessing topic-relevant grey literature. Following RAMESES (Realist And Meta-narrative Evidence Syntheses: Evolving Standards) guidelines, articles were screened and iteratively analysed with interview data, to generate theory-informed (normalisation process theory) explanations. Results: Developing a framework to explain medication management as a complex intervention across five stages: identifying problem (Stage 1), starting, changing or stopping medications (Stage 3) and continuing to take medications (Stage 4), where older people, sometimes with informal carers, make individual decisions and follow routines that fit medication management into their day-to-day lives, engendering a sense of control. In getting diagnosis and/or medications (Stage 2) and reviewing/reconciling medications (Stage 5), older people and practitioners share decision-making in time-limited contacts: involving four steps – sense-making, relationships, action and reflection/monitoring (normalisation process theory); and conceptualising burden – through a detailed analysis of Stage 5, generating a theoretical framework and identifying five burden types amendable to mitigation: ambiguity, concealment, unfamiliarity, fragmentation and exclusion. Proposing interventions: risk identification – a simple way of identifying older people and informal carers who are not coping, at risk and who need appropriate help and support; and individualised information – a short, personalised record and reference point, co-produced and shared by older people, informal carers and practitioners that addresses the experience of living with multimorbidities and polypharmacy. Limitations: Few studies directly address the complexity of medication management as a process and how it works. Limitations included, having identified the overall complexity, the need to focus the analysis on reviewing/reconciling medications (Stage 5), the exclusion of non-English-language literature, the focus on non-institutionalised populations and the broad definition of older people. Conclusions: MEMORABLE explored the complexity of medication management. It highlighted the way interpersonal stages in the medication management process, notably reviewing/reconciling medications, contribute to the mitigation of burdens that are often hidden. Future work: Co-produced studies to scope and trial the two proposed interventions; studies to extend the detailed understanding of medication management, linked to burden mitigation; and a study to clarify the medication management outcomes wanted by older people, informal carers and practitioners.
(Edited publisher abstract)
Background: The number and proportion of older people in the UK are increasing, as are multimorbidity (potentially reducing quality of life) and polypharmacy (increasing the risk of adverse drug events). Together, these complex factors are challenging for older people, informal carers, and health and care practitioners. Objectives: MEMORABLE (MEdication Management in Older people: Realist Approaches Based on Literature and Evaluation) aimed to understand how medication management works and propose improvements. Design: A realist approach informed three work packages, combining a realist review of secondary data with a realist evaluation of primary interview data, in a theory-driven, causal analysis. Setting: The setting was in the community. Participants: Older people, informal carers, and health and care practitioners. Interventions: Studies relating to medication management and to reviewing and reconciling medications; and realist-informed interviews. Data sources: MEDLINE, CINAHL (Cumulative Index of Nursing and Allied Health Literature) and EMBASE were searched (all searched from January 2009 to July 2017; searched on 1 August 2017). Supplementary articles were identified by the Research Team. Data were also obtained through interviews. Review methods: Searches of electronic databases were supplemented by citation-tracking for explanatory contributions, as well as accessing topic-relevant grey literature. Following RAMESES (Realist And Meta-narrative Evidence Syntheses: Evolving Standards) guidelines, articles were screened and iteratively analysed with interview data, to generate theory-informed (normalisation process theory) explanations. Results: Developing a framework to explain medication management as a complex intervention across five stages: identifying problem (Stage 1), starting, changing or stopping medications (Stage 3) and continuing to take medications (Stage 4), where older people, sometimes with informal carers, make individual decisions and follow routines that fit medication management into their day-to-day lives, engendering a sense of control. In getting diagnosis and/or medications (Stage 2) and reviewing/reconciling medications (Stage 5), older people and practitioners share decision-making in time-limited contacts: involving four steps – sense-making, relationships, action and reflection/monitoring (normalisation process theory); and conceptualising burden – through a detailed analysis of Stage 5, generating a theoretical framework and identifying five burden types amendable to mitigation: ambiguity, concealment, unfamiliarity, fragmentation and exclusion. Proposing interventions: risk identification – a simple way of identifying older people and informal carers who are not coping, at risk and who need appropriate help and support; and individualised information – a short, personalised record and reference point, co-produced and shared by older people, informal carers and practitioners that addresses the experience of living with multimorbidities and polypharmacy. Limitations: Few studies directly address the complexity of medication management as a process and how it works. Limitations included, having identified the overall complexity, the need to focus the analysis on reviewing/reconciling medications (Stage 5), the exclusion of non-English-language literature, the focus on non-institutionalised populations and the broad definition of older people. Conclusions: MEMORABLE explored the complexity of medication management. It highlighted the way interpersonal stages in the medication management process, notably reviewing/reconciling medications, contribute to the mitigation of burdens that are often hidden. Future work: Co-produced studies to scope and trial the two proposed interventions; studies to extend the detailed understanding of medication management, linked to burden mitigation; and a study to clarify the medication management outcomes wanted by older people, informal carers and practitioners.
(Edited publisher abstract)
This report provides a critical examination of how personal budgets have been used to deliver public services in the UK. It suggests where personal budgets show potential to deliver more effective, personalised public services, whilst also highlighting and suggesting solutions to the key challenges raised by their implementation so far. The report looks at how personal budgets could be expanded in different areas; the need to develop the evidence base - especially in the areas of achieving improved outcomes and value-for-money and financial or value-based assessments to secure buy-in of local authority commissioners; and the factors that need to be in place for personal budgets to work. These include the need to ensure a healthy provider market, for local authorities to ensure personal budget holders can make informed decisions about their service needs; providing the right information and working collaboratively with third-sector and peer-to-peer advocacy groups. Recommendations are included.
(Edited publisher abstract)
This report provides a critical examination of how personal budgets have been used to deliver public services in the UK. It suggests where personal budgets show potential to deliver more effective, personalised public services, whilst also highlighting and suggesting solutions to the key challenges raised by their implementation so far. The report looks at how personal budgets could be expanded in different areas; the need to develop the evidence base - especially in the areas of achieving improved outcomes and value-for-money and financial or value-based assessments to secure buy-in of local authority commissioners; and the factors that need to be in place for personal budgets to work. These include the need to ensure a healthy provider market, for local authorities to ensure personal budget holders can make informed decisions about their service needs; providing the right information and working collaboratively with third-sector and peer-to-peer advocacy groups. Recommendations are included.
(Edited publisher abstract)
Subject terms:
personal budgets, evidence, policy, evaluation, choice, personalisation;
Health and Social Care in the Community, 25(5), 2017, pp.1634-1643.
Publisher:
Wiley
Personal health budgets (PHBs) in England have been viewed as a vehicle for developing a personalised patient-based strategy within the substance misuse care pathway. In 2009, the Department of Health announced a 3-year pilot programme of PHBs to explore opportunities offered by this new initiative across a number of long-term health conditions, and commissioned an independent evaluation to run alongside as well as a separate study involving two pilot sites that were implementing PHBs within the substance misuse service. The study included a quantitative and qualitative strand. The qualitative strand involved 20 semi-structured interviews among organisational representatives at two time points (10 at each time point) between 2011 and 2012 which are the focus for this current paper. Overall, organisational representatives believed that PHBs had a positive impact on budget-holders with a drug and/or alcohol misuse problem, their families and the health and social care system. However, a number of concerns were discussed, many of which seemed to stem from the initial change management process during the early implementation stage of the pilot programme. This study provides guidance on how to implement and offer PHBs within the substance misuse care pathway: individuals potentially would benefit from receiving their PHB post-detox rather than at a crisis point; PHBs have the potential to improve the link to after-care services, and direct payments can provide greater choice and control, but sufficient protocols are required.
(Publisher abstract)
Personal health budgets (PHBs) in England have been viewed as a vehicle for developing a personalised patient-based strategy within the substance misuse care pathway. In 2009, the Department of Health announced a 3-year pilot programme of PHBs to explore opportunities offered by this new initiative across a number of long-term health conditions, and commissioned an independent evaluation to run alongside as well as a separate study involving two pilot sites that were implementing PHBs within the substance misuse service. The study included a quantitative and qualitative strand. The qualitative strand involved 20 semi-structured interviews among organisational representatives at two time points (10 at each time point) between 2011 and 2012 which are the focus for this current paper. Overall, organisational representatives believed that PHBs had a positive impact on budget-holders with a drug and/or alcohol misuse problem, their families and the health and social care system. However, a number of concerns were discussed, many of which seemed to stem from the initial change management process during the early implementation stage of the pilot programme. This study provides guidance on how to implement and offer PHBs within the substance misuse care pathway: individuals potentially would benefit from receiving their PHB post-detox rather than at a crisis point; PHBs have the potential to improve the link to after-care services, and direct payments can provide greater choice and control, but sufficient protocols are required.
(Publisher abstract)
Subject terms:
personal health budgets, policy implementation, evaluation, substance misuse, personalisation, policy;
An evaluation of has found that Choice Support's personalisation programme to support adults with learning disabilities has delivered better lives for adults with learning disabilities while saving £1.79 million. The evaluation found a number of initiatives had developed through the programme, including Individual Care Plans, Individual Service Funds (ISFs), personal support workers
(Edited publisher abstract)
An evaluation of has found that Choice Support's personalisation programme to support adults with learning disabilities has delivered better lives for adults with learning disabilities while saving £1.79 million. The evaluation found a number of initiatives had developed through the programme, including Individual Care Plans, Individual Service Funds (ISFs), personal support workers and an improved night support scheme. The evaluation also found positive views on the programme from support workers, parents and social service staff
(Edited publisher abstract)
In 2011 the Department of Health (DH) produced 'Working for personalised care: a framework for supporting personal assistants (PAs) working in adult social care (known as the PA framework). Skills for Care developed an implementation plan for the framework. This report evaluates the effectiveness of the PA framework and its implementation plan. It assesses the impact it has had on the overall challenges facing the PA workforce and employers. The evaluation involved a interviews with key stakeholder; an analysis of key literature and research; and an analysis of the National Minimum Dataset for Social Care (NMDS-SC). The reports main sections cover: the context, rationale and activities carried out as part of the PA framework; an assessment of the outcomes achieved by the PA framework and the effectiveness of delivery; main conclusions and seven recommendations.
(Original abstract)
In 2011 the Department of Health (DH) produced 'Working for personalised care: a framework for supporting personal assistants (PAs) working in adult social care (known as the PA framework). Skills for Care developed an implementation plan for the framework. This report evaluates the effectiveness of the PA framework and its implementation plan. It assesses the impact it has had on the overall challenges facing the PA workforce and employers. The evaluation involved a interviews with key stakeholder; an analysis of key literature and research; and an analysis of the National Minimum Dataset for Social Care (NMDS-SC). The reports main sections cover: the context, rationale and activities carried out as part of the PA framework; an assessment of the outcomes achieved by the PA framework and the effectiveness of delivery; main conclusions and seven recommendations.
(Original abstract)
Subject terms:
personal assistants, adult social care, evaluation, policy, personalisation, performance indicators, employment;
In 2011 the Department of Health (DH) produced 'Working for personalised care: a framework for supporting personal assistants (PAs) working in adult social care (known as the PA framework) and Skills for Care were charged with developing an implementation plan for the framework. This report evaluates the effectiveness of the PA framework and its implementation plan and assesses the impact it has had on the overall challenges facing the PA workforce and employers. The evaluation involved a interviews with key stakeholder; an analysis of key literature and research; and an analysis of the National Minimum Dataset for Social Care (NMDS-SC). This summary presents the three main areas covered by the report: context and rationale of the PA framework; the main inputs, activites and outpus of the PA framework; and outcomes achieved so far. The seven main recommendations for the future are also provided.
(Original abstract)
In 2011 the Department of Health (DH) produced 'Working for personalised care: a framework for supporting personal assistants (PAs) working in adult social care (known as the PA framework) and Skills for Care were charged with developing an implementation plan for the framework. This report evaluates the effectiveness of the PA framework and its implementation plan and assesses the impact it has had on the overall challenges facing the PA workforce and employers. The evaluation involved a interviews with key stakeholder; an analysis of key literature and research; and an analysis of the National Minimum Dataset for Social Care (NMDS-SC). This summary presents the three main areas covered by the report: context and rationale of the PA framework; the main inputs, activites and outpus of the PA framework; and outcomes achieved so far. The seven main recommendations for the future are also provided.
(Original abstract)
Subject terms:
evaluation, personalisation, adult social care, personal assistants, policy, performance indicators, employment;