Results for 'long term conditions'
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
This report summarises discussions from a roundtable event attended by older people and carer representatives, practitioners, providers and commissioners to identify how the NICE guideline on supporting older people with multiple long-term conditions and their carers could best be used and implemented. It also sets out practical examples, actions and ideas to help improve local practice. Small groups discussed how the guideline can help achieve three priorities that the Guideline Committee identified as most important for potential impact and the likely significant challenges. These were: empowering older people and carers; empowering health and social care practitioners; and integration of different care and support options to enable person-centred care. Suggested actions and practice examples in each of the three priority areas.
BURD Hannah, HALLSWORTH Michael
This report explores the behavioural science theories that suggest new ways of enabling people and communities to take a more active role in managing their own health and provides an accessible introduction to the theories of change. The report is structured around the three areas of capability, opportunity and motivation which researchers have identified as needing to be present for behaviour to occur. It highlights that a multi-faceted approach is needed to enable effective self-care. It identifies five enabling factors that that can influence engagement and self-management behaviours: a growth mindset where people view capabilities as something that can be developed, removing ‘friction costs’, social networks, motivation and goal setting. It also suggests how these factors can be targeted in order to encourage these behaviours. Examples and case studies illustrate the application of the theories. The report is aimed at policymakers, commissioners, service designers and organisations working to promote more person- and community-centred approaches for health and wellbeing.
A brief review of the literature on social prescribing. Social prescribing is a way of linking primary care patients with psycho-social issues, with sources of appropriate, non-medical support in the community. Suitable referrals to social prescribing initiatives are vulnerable and at risk groups such as: people with mild to moderate depression and anxiety; low income single parents; recently bereaved older people; people with long term conditions and frequent attendees in primary and secondary care. The review highlights that prescribed activities have typically included arts and creative activities, physical activity, learning and volunteering opportunities and courses, self-care and support with practical issues such as benefits, housing, debt and employment. The evidence on the impact of social prescribing is currently limited and inconsistent. While some initiatives have shown improved outcomes for patients and potential for cost-savings (in the longer term), few have been subject to economic analysis or the kind of rigorous evaluation which would inform commissioners. The report recommends that any new, local social prescribing initiatives should aim to add to the current evidence base and conduct transparent and thorough.
COMMISSION ON IMPROVING URGENT CARE FOR OLDER PEOPLE
Final report from the Commission on Improving Urgent Care for Older People which provides guidance for those involved in designing care for older people and outlines eight key principles the health and care sector can adopt to improve urgent care for older people. The Commission was established out of a concern that the care system was not meeting the needs of older people, resulting in lower quality of care, a lack of out-of-hospital services as an alternative to A&E, not enough focus on prevention and early intervention, and delayed transfers of care. It brought together a range of experts, received over 60 evidence submissions; carried out visits to sites using innovative ways to deliver care; consulted with NHS Confederation members and patient and carer groups; and commissioned an evidence review. The report draws on the evidence to look at the case for change. It then outlines eight key principles that can be used when redesigning health and social care system: start with care driven by the person’s needs and personal goals; a greater focus on proactive care; acknowledge current strains on the system and allow time to think; the importance of care co-ordination and navigation; greater use of multi-disciplinary and multi-agency teams; ensure workforce, training and core skills reflect modern day requirements; leadership should encourage us to do things differently; and metrics must truly reflect the care experience for older people. Short case studies of innovative practice are included in the report, covering acute and primary care, voluntary sector and local government partners and commissioners.
COALITION FOR COLLABORATIVE CARE
This discussion paper explores how to plan, develop and support an integrated workforce that routinely works in a person-centred, community-centred way. The paper focuses in four areas, looking at: mind-set challenges for person and community-centred care; the specific knowledge and skills that are needed; the importance of supportive working environments; and capacity, roles and workforce planning. The paper is intended to stimulate discussion. It briefly sets out some ideas on: the context and what we mean by person-centred, community-centred care; the workforce challenge; what is needed to create change at the local and national levels; and what action the C4CC partnership might take.
This summary briefing explores the latest research and findings on the preventive aspects of both capital and revenue housing interventions in local care economies and the wider benefit realisation. In particular, it captures research that evidences the cost benefit of support for older and vulnerable adults with a long term condition in extra care housing as an alternative to residential care, preventing unnecessary hospital admissions and speeding up patient discharges. This evidence shows the care efficiencies that can be achieved and the potential for savings on the public purse. The paper concludes that that for prevention and early intervention to be effective a multi-dimensional approach is required, rewarding closer integration, offering incentives to encourage innovation and market development, and supporting investment in physical and social capital.
NHS Lewisham Clinical Commissioning Group
Lewisham CCG carried out a Proactive Primary Care (PPC) project in 2014, aiming to provide better support to people with long-term conditions (LTCs). A test group of people were called three times over three months by trained "telephoners" using motivational techniques. Calls explored with individuals their current health, their confidence in managing potential deterioration in their condition and health issues they wanted to address. Callers supported people by suggesting ways to tackle any issues and by putting them in touch with local third sector or statutory agencies.
The report addresses the future housing needs of older people and the role of housing associations in providing supported accommodation and care. It examines these challenges over the medium term investment horizon to the 2030's. In particular, it explores what the older population will be like at that time, what housing association boards should be thinking about now, and what the sector and government need to do to realise the opportunities and manage the risks associated with older people's housing. The report also considers how the links between housing, health and social care can be improved, and asks if housing providers understand the expectations and aspirations of their tenants as they grow older. The report is based on published official statistics, a survey of social landlords, a round table discussion with social landlord executives and a literature review. The findings suggest that housing associations need to understand their older customers better, be clear about the implications of population ageing for their existing stock and new build housing, and to develop services which emphasise the promotion of personal, social and economic wellbeing.
One of three handbooks to support commissioners, GP practices and community health and care professionals in planning and providing personalised care for people living with long term conditions. The handbook brings together information about multi-disciplinary and integrated teams and looks at the types of teams that need to be in place to deliver integrated healthcare. It provides definitions of multi-disciplinary and multi-agency teams and also sets out a tool, the MDT Continuum, that describes different types of care team functioning. Four models or stages of multidisciplinary teams are presented, ranging from from unidisciplinary to transdisciplinary team working. Good practice examples representing each of the stages or models. The final section provide information to help integrated commissioning. Other handbooks published separately cover risk stratification and case finding and personalised care and support planning.
This report focusses on meeting the needs of working-age disabled adults as health and social care services are increasing integrated. It provides an empirical evidence base to demonstrate how whole person care (which is about making the connections between physical health, mental health and social care services) can be used to effectively meet these needs. The report also draws on the findings of a focus group with 12 disabled adults and carers on desired outcomes from the integration of health and social care services. Interviews with social care and voluntary sector professionals, commissioners and local authority policy to see if they are willing to include working-age disabled adults' needs in plans for future integration. The report looks at how working-age disabled adults have different needs and outcomes from older people and identifies the health inequalities they face in day-to-day life. Ten dimensions of health inequality are identified including housing, employment, financial security and quality of life. The report makes seven recommendations to inform the service response, including: taking a long term view of managing long-term conditions, viewing whole person care as a 10-year journey with matched by stable funding; debates on funding gap in social care should give consideration to the needs of working-age disabled adults; shifting resources from case management to community coordinated care to support prevention and providing a single point of contact for health and social care needs; service integration should take place across a much wider range of services to meet the needs of disabled people.