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Results for 'integrated services'

Results 11 - 20 of 20

Away from the past and to a sustainable future: how the UK's health and social care systems can be reformed to better align with the needs of today’s society

SMITH Ian R., SMITH Stephen K.
2015

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.

Is integration or fragmentation the starting point to improve prevention?

MILLER Robin
2014

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.

All our futures: housing for ageing

HOUSING AND AGEING ALLIANCE
2015

This report summarises the key messages from the 2015 Housing and Ageing Summit where leading figures from the sectors came together to map out the actions required to address the critical issue of housing for an ageing population. It was agreed that: housing is fundamental to dignity and security in older age; it underpins health and wellbeing; it is the foundation of a sustainable NHS and social care system and needs to be an equal part of the integration agenda; at a time of unprecedented demographic change, housing, planning, health and social care must all systematically address population ageing; housing plays a critical role in the UK economy - older people live in a third of all homes and are the major driver of household growth.

Our support, our lives: joining up the public services used by disabled people

DAVIES Alissa
2015

Examines how health and social care integration can work better for working-age disabled people in the care system and applies key lessons and themes from integrated care and disabled people’s definitions of independent living to a wider range of public services. The report draws on desktop analysis of the impact of current integrated care initiatives on working-age disabled people, findings from interviews and focus groups with disabled adults, and Scope’s Better Care Project research. It argues that while the drivers behind integration have mostly been considered in the context of the ageing population the evidence strongly indicates that disabled adults should become a priority group for integrated care, alongside older people. It suggests that existing integrated care initiatives are not going far enough and considers how the Better Care Fund, Integrated Care Pioneers and Integrated Personal Commissioning can do more to improve outcomes for disabled adults. To help ensure the full potential of integrated care is full realised, the report identifies key action points on the following three fronts: incentives and rewards for independent living; a longer-term approach to risks and benefits; and making it clearer whether schemes apply to disabled adults. The report concludes that future plans for joined up support should apply the lessons from existing integrated care initiatives to the wider integrated support agenda, addressing all the barriers to independent living and encompassing education, work, volunteering, welfare and housing.

Local leadership, new approaches: how new ways of working are helping to improve the health of local communities

PUBLIC HEALTH ENGLAND
2015

Examines how local authorities and health teams are working together to improve the health of local communities through prevention and early intervention. The report features seven case studies. Each one describes a particular programme or close partnership between a local authority and local public health or health care teams, often with the additional support of the voluntary sector. Each initiative focuses on a specific area and/or set of activities, including: integrating wellbeing; transforming the food culture in schools; helping people stay in their own homes; GPs linking people to other sources of support; healthy homes and housing conditions; promoting public health in schools; and active living.

Inclusive integration: how whole person care can work for adults with disabilities

BROADBRIDGE Angela
2014

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.

For future living: innovative approaches to joining up housing and health

DAVIES Bill
2014

Examines older people’s expectations from their housing and housing providers and the choices the UK housing market currently offers older and vulnerable people, and explores innovative housing and care solutions that could meet the demands of an ageing population and more widely support people with other social needs. The study drew on both quantitative surveys and qualitative interviews undertaken in previous research to establish what older groups need and expect from the housing market, and then used statistical methods to create a clear picture of the housing that older people inhabit now and the choices that the English housing market offers to them. Having established that the market presents only a limited range of options to older people, the research explored the international literature to identify different models of housing and support, focusing on countries that face similar demographic challenges. The report considers ideas that could potentially be adopted in England and adapted to an English housing and health context. A number of options were tested with two focus groups, involving over-55s and over-65s. Finally, based on the information drawn from the research, and through consultation with external experts, this report outlines a range of possible policy measures designed to ensure that the current and future stock of housing for older people is more effectively focused on supporting their health requirements.

LGA Adult social care efficiency programme: the final report

LOCAL GOVERNMENT ASSOCIATION
2014

This is the concluding report from the LGA Adult Social Care Efficiency (ASCE) programme. The programme was launched in 2011 in response to the significant cuts to council budgets and their impact on adult social care. The aim of the programme is to support councils to develop transformational approaches to making the efficiency savings required to meet the challenge of reduced funding. The report shares innovative and transformational examples of how councils are bringing together businesses, public sector partners and communities to develop lower-cost solutions to support the most vulnerable in our society. In particular, it outlines some key lessons around developing a new contract with citizens and communities, managing demand, transformation, commissioning, procurement and contract management, and integration. It looks at efficiency approaches in practice, with specific reference to assessment, advice and information, delivering preventative services, avoiding admissions and reducing costs of residential care, reducing costs in domiciliary care and transforming learning disability services. In addition, it considers local approaches to developing effective internal management, reshaping the service and working with partners, customers and suppliers.

Evaluating integrated and community-based care: how do we know it works?

BARDSLEY Martin, et al
2013

Over the last five years the Nuffield Trust has undertaken evaluations of over 30 different community-based interventions. In many cases the authors have been tasked with identifying whether service changes have led to a reduction in emergency admissions and the associated cost to the NHS. Using these indicators, the results have been almost overwhelmingly negative. The one exception was Marie Curie Nursing Services for terminally ill patients. In this paper the authors outline the main community-based interventions they have evaluated and their impact, and identify nine points that may help those designing, implementing and evaluating such interventions in future. The paper could provide useful learning for the new health and social care integration ‘pioneer’ sites that will be appointed by the Department of Health by September 2013.

Singing from the same hymn sheet? commissioning of preventative services from the third sector

MILLER Robin, et al
2013

Purpose: The purpose of this paper is to explore the delivery of preventative services for older people from third sector organisations (TSOs) and the extent to which current commissioning arrangements enables the aspirations of policy to be achieved. Design/methodology/approach: Semi-structured interviews with key-contacts within a sample of TSOs which had been identified by directors of Adult Social Services as delivering one of the top three preventative interventions in their local authority area. Findings: There was evidence of considerable trust between local authorities and TSOs and as a consequence TSOs were given autonomy to develop holistic and integrated models of delivery that supported rather than diverted the TSOs’ core missions. Both sectors found it difficult to set target outcomes and connected performance frameworks for preventative services. As a consequence a major element of the commissioning cycle is not being completed and TSOs cannot be confident that they are using their resources as effectively as possible. Research limitations/implications: This study was based in one English region, and would benefit from being extended to other English regions and home nations. Practical implications: Universities, policy makers, commissioners and the third sector need to work together to develop common outcome frameworks for preventative services and to gather consistent data sets that can be more easily synthesised to give a “realistic” understanding of the impact of different interventions and delivery models. Originality value: The paper contributes to the limited evidence bases of commissioning of TSOs and preventative services.

Results 11 - 20 of 20

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