Results for 'personalisation'
GOLLINS Tim, et al
This report discusses the need to for social workers in adult social care to change their workforce culture to one that is 'strengths-based' for promoting well-being, early intervention and prevention. It examines the value of this approach in creating better outcomes for people living more actively in their local communities, generating greater satisfaction for people using services and their carers; and creating a motived workforce. The report the sets out the key knowledge and skills the social care workforce needs to apply strengths-based approaches in improving people’s lives. It also considers the emerging business case for how a community-focused strengths-based approach can deliver efficiencies for the sector. Cases study examples from Shropshire, Essex County Council, Hertfordshire and Calderdale show how councils and their health partners are developing new ways of working to deliver an alternative health and social care operating model.
ERNST AND YOUNG
In this report, commissioned by the Local Government Association, a journey towards better health and care for individuals is set out; driven by local system leaders and supported by a more empowering and enabling system. The report has been developed through: a review of existing literature published by partners, charities and research organisations; four workshops with the LGA and partners to define the vision, understand the system barriers from a range of perspectives and describe the required changes; and further discussion with regional contacts and the Health Transformation Task Group to sense check that barriers and key considerations are locally relevant and reflect the experience in local areas. Section 1 sets out a vision for better care and support, arguing that a reformed system needs to deliver: better health and wellbeing more equally enjoyed; better choice and control for all; better quality care, tailored for each person; and better outcomes for each pound spent. Section 2 focuses on key barriers preventing the achievement of a reformed system. These include: creating dependency through the way treatment is provided; chronic underfunding of the system and a lack of capacity to transform; fragmented commissioning incentivising treatment over demand management; and national regulations that disempower local areas. Section 3 sets out four steps to better care, which are: put people in control; fund services adequately and in an aligned way; devolve power to join up care, support and wellbeing; and free the system from national constraints. The report concludes that collectively these steps will enable localities to address challenges, deliver a better system and ultimately drive better outcomes and greater sustainability for all.
This report explores four big ways that knowledge power and people power will affect the NHS in 2030 and the wider health system, through precision medicine, new forms of health data, people–powered health, and the use of behavioural insights. Section 1, in particular, concentrates on where new kinds of medical information about individuals will come from, as well as how it is interpreted in stratified care. Section 2 moves onto people managing their own health information and new digital platforms for supporting patient–led research and care. Section 3 looks at the possibility of a social movement for health: people being trusted to have a more active role in their own health and to look after others, supported by the NHS, as well as people supporting health services. Section 4 explores how insights into human behaviours can help redesign health services, products and treatments in a way that reflects better how people live their lives and make choices. This is followed by a summary of how these developments will change the function of the NHS. The final sections focus on the challenges involved in getting to the best version of this future and ideas for how these changes can be supported today. Concentrating on the widest gaps between these ideas and current policy, the conclusion includes four proposals that would support new functions in the health system. These are: developing digital platforms and widely agreed protocols for developing new kinds of health knowledge; creating prototypes for health data sharing that concentrate on understanding emerging attitudes to digital privacy; establishing an institution that supports and evaluates people powered health research; and creating a central institution to set standards and mandate processes that will maximise the clinical and research value of large genomic and other data sets as they become available.
NEEDHAM Catherine, et al
Outlines the findings of an evaluation of micro-enterprises in social care in England, which ran from 2013 to 2015. The report focuses on very small organisations, here defined as having five members of staff or fewer, which provide care and support to adults with an assessed social care need. The research design encompassed a local asset-based approach, working with co-researchers with experience of care in the three localities. Twenty seven organisations took part in the study overall, including 17 micro-providers, whose performance was compared to that of 4 small, 4 medium and 2 large providers. A total of 143 people were interviewed for the project. The study found that: micro-providers offer more personalised support than larger providers, particularly for home-based care; they deliver more valued outcomes than larger providers, in relation to helping people do more of the things they value and enjoy; they are better than larger providers at some kinds of innovation, being more flexible and able to provide support to marginalised communities; and they offer better value for money than larger providers. Factors that help micro-providers to emerge and become sustainable include: dedicated support for start-up and development, strong personal networks within a localities, and balancing good partnerships (including with local authorities) with maintaining an independent status. Inhibiting factors, on the other hand, include a reliance on self-funders and the financial fragility of the organisation. The report makes the following recommendations: commissioners should develop different approaches to enable micro-enterprises to join preferred provider lists; social care teams should promote flexible payment options for people wanting to use micro-enterprises, including direct payments; social workers and other care professionals need to be informed about micro-enterprises operating close-by so that they can refer people to them; regulators need to ensure that their processes are proportional and accessible for very small organisations; and micro-enterprises need access to dedicated start-up support, with care sector expertise, as well as ongoing support and peer networks.
ROUTLEDGE Martin, et al
Presents the latest information about personal budgets for older people, showing that older people experience positive benefits from having a personal budget, although these are not as marked as for other groups. The first section reflects briefly on recent changes to the policy context and then highlights new data about the performance of councils from the recent 2014 ADASS survey, and the third National Personal Budget survey from In Control. It then draws on research and recent TLAP events, which considered minimum processes and self-directed support, to review what does and doesn't work best for older people. The second section of this report presents some examples of what councils are doing to address the ongoing challenges both of the initial report and the current policy context. The case studies are summarised in Table. Section 3 examines personalisation and safeguarding, and specifically, whether personal budgets increase risks to older people whilst section 4 considers integration and the opportunities that government policy affords older people in relation to personalisation. In its conclusion, the report recommends that there needs to be further evidence of what is being done to support the use of personal budgets by older people.
MILLER Clive, WILTON Catherine
Sets out a strategy, which can be adapted locally, for how health and wellbeing boards can fulfil new wellbeing and prevention duties under the Care Act. The framework supports the development of strong and inclusive communities and indicates how people, communities and services can more effectively and efficiently work together to co-produce outcomes. The framework incorporates key areas of action for the health and wellbeing boards, which include: keep people at the centre and focus on their outcomes; focus on both assets and needs; focus on all levels of prevention; rethink integration; target people with two or more long term conditions; work through universal service providers; enable community and cross-sector systems leadership; develop a new approach to health and wellbeing strategies; and adopt a collaborative approach to priority setting and savings. The framework has been trialled with a number of trailblazer health and wellbeing boards each of whom refined and adapted it to reflect local circumstances.
OXFORD BROOKES UNIVERSITY. Institute of Public Care
The case study describes the process that Wiltshire Council has used to develop its new ‘Help to Live at Home Service’ for older people and others who require help to remain at home. The approach focused on the outcomes that the older people wish to gain from social care. It involved a complete overhaul of the social care system from the role of the social worker working alongside the customer to determine the required outcomes to the role of the providers of the service who must deliver these outcomes and receive payment based on that delivery. The report aims to promote discussion about how outcomes-based, personalised support can best work in social care in England in the future.
NHS CONFEDERATION. Community Health Services Forum
Explains outcomes-based commissioning and outlines how it might help enable service transformation. Outcomes-based commissioning incentivises high-value interventions, shifting resources to services in the community, a focus on keeping people healthy and in their own homes, delivering outcomes that matter to people using the services, and coordinated care. It discusses the opportunities that outcomes-based commissioning gives for providers of community services, including the main technical considerations that will need to be addressed. Health outcomes have become the standard for measuring successful care. More and more people are living with long-term, and often multiple, conditions. This briefing argues that successful care for this group of people is not about providing a cure or a certain number of procedures, but about enabling and supporting them to live as well as possible with their conditions over the long term. Achieving this will involve transforming the system so that all of its parts work in an integrated way towards the outcomes people want and need most. Unlocking the unmet potential in community settings is crucial in both transforming care and improving efficiency. The briefing includes practical examples showcasing how community providers are using innovative ways of supporting and enabling people with high levels of clinical need to be cared for at home or more locally, and are working in partnership with other health and care providers. It will be of interest to all commissioners and providers considering developing an outcomes-based commissioning approach that includes community health services. It is particularly relevant to providers of community services.
DOUGHTY Kevin, MULVIHILL Patrick
Purpose: The purpose of this paper is to consider the importance of digital healthcare through telecare and portable assistive devices in supporting the reengineering of healthcare to deal with the needs of an older and more vulnerable population wishing to remain in their own homes.
Design/methodology/approach: It supports the importance of the assessment process to identify hazards associated with independent living, and the possible consequences of accidents. By measuring and prioritising the risks, appropriate management strategies may be introduced to provide a safer home environment.
Findings: A process for assessing and managing these risks has been developed. This can be applied to a wide range of different cases and yields solutions that can support independence.
Research limitations/implications: The developed digital reablement process can be used to provide vulnerable people with a robust form of risk management.
Practical implications: If telecare services follow the process described in this paper then they will improve the outcomes for their users.
Originality/value: The process described in this paper is the first attempt to produce a robust assessment process for introducing telecare services in a reablement context.
ABENDSTERN Michele, et al
Prevention, comprising services that seek to delay deterioration of existing conditions and circumstances or prevent their occurrence by early access to support, is recognised as having an important role in adult social care. The gateway to social care services has traditionally been via needs-led assessments undertaken with professionals. In England, self-assessment, promoted as a means of accessing services more independently, has come to the fore in recent years. This article explores the relationship between prevention and self-assessment in practice. Data are derived from interviews with social services managers of five self-assessment projects situated within the adult social care sector that were described as providing a preventative approach, as well as project development documentation. A number of issues are highlighted including for whom self-assessment might be most optimal, the potential of self-assessment to widen access and the role it can play in promoting self-determination. It is argued that a natural relationship exists between self-assessment and prevention and that both concepts are at the core of the personalisation agenda. However, in order to achieve its potential in practice, self-assessment must be offered in conjunction with support and as an additional rather than alternative means of accessing preventative services.