Results for 'social care'
NHS CONFEDERATION, et al
Joint publication from the Association of Directors of Adult Social Services, Local Government Association, NHS Clinical Commissioners and NHS Confederation which describes what a fully integrated, transformed system of health and social care should look like. Sections look at what can be achieved through integration for individuals, communities, local health wellbeing systems, and Government and national bodies; what is needed to make integration happen; what has been learnt about successful integration so far; and the issues that local and national leaders need to tackle. Drawing on a selection of evidence, reports, case studies and local experience, the document highlights three key components for effective integration. These are: shared commitments – to improving local people’s health and wellbeing, providing services around the individual, and a preventative approach; shared leadership and accountability; and shared systems – such as information and technology, payment and commissioning models, and integrated workforce planning. The final sections outline questions for local and national leaders and summarise the key components for effective integration of health and social care.
FENDT-NEWLIN Meredith, et al
Reports on an evidence review to explore the role of UK housing interventions in supporting the mental health and wellbeing of older people and their ability to live well at home. The review was commissioned by HACT and carried out by the Social Care Workforce Research Unit at King’s College London. Part one of the report looks at what is known about UK housing interventions that aim to promote mental health and wellbeing among older people. It provides a description of the evidence and the implications for practice and commissioning under the following themes: Identification, diagnosis and management of symptoms; Environments; and Reducing social isolation and loneliness. Part two explores questions around integration and how health, housing and social care agencies are working together to support older people’s mental wellbeing. It identifies some of the barriers to effective collaboration and looks at how these might be overcome. Three key messages emerged from the review of the evidence: the need for people working in service planning and commissioning to include housing needs in the integration debate; the importance of relationships between managers and practitioners from different sectors at a local level; and the need to take a UK perspective in order to share innovation in social housing happening in different parts of the country.
GREAT BRITAIN. Department of Health, PUBLIC HEALTH ENGLAND, NHS ENGLAND
This joint review sets out the role of the voluntary, community and social enterprise (VCSE) sector in improving health, wellbeing and care outcomes and identifies how the sector can best address potential challenges and maximise opportunities. The report places wellbeing at the centre of health and care services, and making VCSE organisations an integral part of a collaborative system. It makes 28 recommendations for government, health and care system partners, funders, regulatory bodies and the VCSE sector. Chapters: explore the contribution that VCSE organisations can play in reducing the human and financial costs associated with health inequalities, often through peer- and community-led activity; the benefits of partnership working and collaboration between commissioners, VCSE organisations and individuals; the importance of evidence and impact assessment, and how both can be used more effectively in health and care services; and the importance of commissioning practice, identifying a number of key principles that should underpin the funding relationship between public sector bodies and the VCSE sector. Each chapter looks at what is needed to achieve success and includes short case studies. The final chapters discuss the role of VCSE infrastructure bodies and set out the value of the Voluntary Sector Improvement Programme and recommendations for its future focus. Recommendations include the need for health and care services to be co-produced, focussed on wellbeing and valuing individuals' and communities' capacities and for social value to become a fundamental part of health and care commissioning and service provision.
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.
A short guide providing new approaches and practice examples of how Clinical Commissioning Groups and Health Wellbeing Boards can commission and support interventions which embody the principles of collaborative care, individual choice and control and patient and public participation. The six approaches presented are: Experts by experience and self-advocacy; Self-directed support and personal health budgets; Capabilities and asset-based approaches to health and care; Co-production and citizen led commissioning; Community development and building social capital; and Networked models of care. Each includes accompanying practice examples. The guide has been produced by the Inclusive Change partnership of Shared Lives Plus, Community Catalysts, In Control, Inclusion North and Inclusive Neighbourhoods.
LOCAL GOVERNMENT ASSOCIATION
This publication is a call to action to local commissioners, Government and national bodies to support health and wellbeing boards in bringing about a radical transformation in the health of local communities. It has been prepared by the Local Government Association (LGA) and NHS Clinical Commissioners (NHSCC) working jointly in consultation with members of health and wellbeing boards (HWBs) across the country. Among the essential characteristics of effective place-based boards this document highlights: shared leadership; a strategic approach; engaging with communities; and collaborative ways of working. It proposes: a national five-year funding settlement across health and care; freedom for HWBs to determine local priorities; development of a new payment system; enhanced information governance and data sharing; commitment to the principle of subsidiarity in commissioning decisions; a single national outcomes framework for health, public health and social care; and a national strategy for coordinated workforce planning and integrated workforce development across health, public health and social care.
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.
SMITH Ian R., SMITH Stephen K.
This paper explores the nature of the crisis affecting the health and social care systems, suggesting that they are badly misaligned with the needs of the society they serve, its ageing population, the prevalence of chronic ill health, rising demand and fall in funding. The paper diagnoses the reasons behind this misalignment and posits a solution: the introduction of integrated care organisations (ICOs) closely aligned to academic health and science centres (AHSCs). It argues that ICOs will remove the artificial and unhelpful boundaries between different parts of the healthcare service, and between health and social care. They will meet the needs of a population which is living longer and with more chronic conditions, move care away from hospitals, and promote prevention and parity of esteem between mental and physical health. Through alignment of these organisations with academic health and science centres, meanwhile, it will be possible to improve clinical outcomes and deliver precision medicine – and to sustain the UK’s position as one of the world leaders in genetic medicine. The paper also identifies the barriers to instituting such a change and explains how they can be overcome. It concludes with a step by step route map to a better care system, through ICOs and AHSCs.
The importance of health, social care and other sectors working together has been recognised for many decades by governments of all political persuasion. This is true within the current policy environment, in which integration has been proposed as the binding force to connect an increasingly diverse range of providers around individual patients and their families. Initiatives to promote integration are being introduced at all levels of the system, with a patient experience based narrative setting the standard against which success should be judged. This integration is being encouraged not only in respect of statutorily funded clinical, public health and social care services but also with other policy areas such as housing and leisure and other sectors (in particular the third sector). Despite this continued belief in policy that integration will lead to a more preventative focus, there is not a strong research base to support this view. However, accepting the limitations of the evidence base, this Policy Paper looks at five key lessons which can still be drawn for national policy makers with responsibility for promoting integration and prevention. These are to: start with what is fragmented; be clear what is meant (by integration); know what success looks like; understand the impact; and be wary of further change. The paper draws attention to key findings from reviews of integrated care; and notes that the interventions that have been most effective have been those with more preventative approaches. It concludes that patients and service users have to integrate support from statutory services, community resources and their personal networks to improve their quality of life and maintain their health and independence. To understand how and when to integrate, we first need to be clear what links are required and how they could operate in practice. That is why fragmentation rather than integration should be the starting point to achieve a prevention orientated health and social care system. This policy paper is based on a discussion paper which was commissioned by the Institute for Social Change at Manchester University as part of a series of Knowledge Exchange Trials workshops which brought together academics, policy makers and programme stakeholders to facilitate exchange of ideas, expertise and research.
KING'S FUND, LOCAL GOVERNMENT ASSOCIATION
These infographics from the King's Fund and the Local Government Association set out key facts about the public health system and the return on investment for some public health interventions. They show the changing demographics with a growing ageing population and the impact of social and behavioural determinants on people’s health. The document also highlights the costs of key health and social services and estimates the potential returns on investment on preventative interventions. For instance, Birmingham’s Be Active programme of free use of leisure centres and other initiatives returned an estimated £23 in quality of life, reduced NHS use and other gains for every £1 spent. Every £1 spent on improving homes saves the NHS £70 over 10 years. Befriending services have been estimated to pay back around £3.75 in reduced mental health service spending and improvements in health for every £1 spent. Every £1 spent on drugs treatment saves society £2.50 in reduced NHS and social care costs and reduced crime.