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Results for 'prevention'

Results 61 - 70 of 77

Predictive validity of tools used to assess the risk of unplanned admissions: a rapid review of the evidence

PATON Fiona, WILSON Paul, WRIGHT Kath
2014

A synthesis of evidence assessing the predictive ability of tools used to identify frail elderly and people living with multiple long-term chronic health conditions who are at risk of future unplanned hospital admissions. There are now a large number of models available that can be used to predict the risk of unplanned hospital admissions and this study aims to provide a summary of their comparative performance. Overall, the models identified in this review show reasonable concordance in terms of their predictive performance (based on c-statistics). Models reporting other performance indications showed that at different thresholds, as sensitivity increased, specificity would decrease. As the algorithms become more complex or incorporate longer term horizons specificity increased but the ability of the models to identify future high cost individuals reduced. It should also be noted that whilst the reported c-statistics are broadly similar, the underlying populations, data sources and coding may differ.

Technical guide: building a business case for prevention

SOCIAL FINANCE
2014

This guide sets out the issues that need to be considered when developing a business case to invest in preventive services and to ensure that any decision are based on robust and reliable data. The guide focuses on the following arguments: the importance of 'investing to save', arguing that prevention is cheaper in the long term; promotion of service innovation; placing the focus of commissioning on outcomes rather than outputs; and managing a shift in spending from acute to prevention to reduce demand over time. The guide outlines key four activities required to build a business case: understanding needs; understanding current costs; assessing possible interventions; and deciding how to measure the value and outcome of the interventions. It also provides a summary business case for prevention and using a Social Impact Bond (SBI) to finance a business case for prevention. An example case study of making a business case for prevention services in early years services in Greater Manchester is included.

Promising returns: a commissioners guide to investing in mentoring and befriending programmes

MENTORING AND BEFRIENDING FOUNDATION
2012

This guide aims to give an overview of the range, diversity and positive impact of mentoring and befriending activity. Using case studies and programme examples, it outlines a range of mentoring and befriending approaches and identifies the key potential outcomes, including reduced offending, improved community cohesion, improved access to employment, reduced social isolation, higher aspirations and increased independence. The document also explains how the Mentoring and Befriending Foundation can support commissioners identify effective programmes.

‘The Billion Dollar Question’: embedding prevention in older people's services—Ten ‘High-Impact’ changes

ALLEN Kerry, GLASBY Jon
2013

With ageing populations, social changes and rising public expectations, many countries are exploring ways of developing a more preventative approach within their health and social care services. In England, this has become a growing priority over time—made even more significant by recent economic change and by the urgent need to reduce public sector spending. However, a key dilemma for policy makers and managers is the patchy nature of the evidence base—with a lack of certainty over how to reform services or prioritise spending in order to develop a more genuinely preventative approach. Against this background, this commentary reviews national and international evidence around ten policy measures and interventions, highlighting some of the most promising approaches as well as the fragmented and contested nature of the evidence base.

Beginning with the end in mind: how outcomes-based commissioning can help unlock the potential of community services

NHS CONFEDERATION. Community Health Services Forum
2014

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.

Prevention services, social care and older people: much discussed but little researched?

NATIONAL INSTITUTE FOR HEALTH RESEARCH. School for Social Care Research
2013

A scoping study investigated approaches to prevention services in local authorities which enable older people to retain their independence for as long as possible to maintain their quality of life and reduce pressure on local authority and NHS budgets. The study involved a survey of Directors of Adult Social Services in 9 local authorities to identify what they viewed as their top 3 investments in prevention services for older people, and interviews with lead managers for each intervention. It also reviewed local and national evidence as to whether these interventions lead to a delay or reduction in uptake of social care services This paper summarises the key findings from the research. It explains that the top 3 interventions were reablement (a top 3 approach for all of the local authorities surveyed), technology-based interventions (among the top 3 interventions in 6 authorities), and information and advice (among the top 3 in 3 authorities), while a number of other prevention interventions were identified by one local authority each. It reports on how local authorities seek evidence and guidance on prevention services and factors influencing how local funding was spent, and on assessment of the outcomes and impact of prevention interventions. It also summarises national and local evidence for the top 3 interventions.

Digital reablement: a personalised service to reduce admissions and readmissions to hospitals and nursing homes

DOUGHTY Kevin, MULVIHILL Patrick
2013

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.

Prevention is better than cure…

WARD Cally, COOPER Vivien
2013

Purpose: The purpose of this article is to provide a perspective from family carers on the promotion of independence and the prevention of avoidable dependency. Design/methodology/approach: Narrative review and discussion. Findings: Family carers frequently experience their own or their relatives’ needs being met only when they have reached crisis point. A shift to a more preventive approach, delivered in a personalised and family-centred manner, could transform the experiences of people with learning disabilities and their families. Originality/value: Attention is drawn to the importance of strengthening the case for a preventive approach and the role of co-ordinated and strategic leadership in its delivery.

New jobs old roles: working for prevention in a whole-system model of health and social care for older people

SMITH Naomi, BARNES Marian
2013

The ‘Partnerships for Older People Projects’ programme provided government funding for local and health authorities to pilot prevention and intervention services in partnership with the voluntary sector and older people between 2006 and 2009. This evaluation of a pilot in southern England used a Theory of Change approach to gather and reflect on data with different groups involved in the delivery of this model of prevention. This whole-system model, although complex and challenging to implement, was considered overall to have been a success and provided significant learning for partners and stakeholders on the challenges and benefits of working across professional and sectoral boundaries. New posts were created as part of the model – two of these, recruited to and managed by voluntary sector partners, were identified as ‘new jobs’, but echoed ‘old roles’ within community and voluntary sector based health and social care. The authors reflect on the parallels of these roles with previously existing roles and ways of working and reflect on how the whole-system approach of this particular pilot enabled these new jobs to develop in appropriate and successful ways.

Right care, first time: services supporting safe hospital discharge and preventing hospital admission and readmission

AGE UK
2012

Older people represent the main in-patient group, at any one time occupying more than two-thirds of acute hospital in-patient beds. Providers and commissioners need to put in place cost-effective, community based services, which can both prevent the need for hospital admission and safely reduce length of stay for older people. A hospital admission can occur when an older person has reached breaking point because of a combination of problems that have been building up before admission: social circumstances (such as living alone or having caring responsibilities) or general frailty. The aim of this publication is to disseminate examples of positive practice in avoiding hospital admission, supporting safe discharge and preventing readmission for older people. This publication highlights 5 examples of local Age UK services, charting the ‘pathway’ of prevention from identifying older people in the local community who may be at risk, to supporting people who are in A&E, and ensuring that discharge from in-patient care is safe and well co-ordinated.

Results 61 - 70 of 77

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