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Results 1 - 10 of 368

A structured literature review to identify cost-effective interventions to prevent falls in older people living in the community


Summarises the findings from a literature review to identify cost-effective interventions in preventing falls in older people living in the community in England. The review was conducted to inform an economic model to estimate the return on investment of the cost effective interventions across communities in England. The review identified 26 studies, of which 12 were judged to be directly applicable. These included 6 types of interventions: exercise, home assessment and modifications, multifactorial programmes; medicines review and modification to drugs; cardiac pacing and expedited cataract surgery. Based on the evidence, the review recommends interventions to be included in the economic model.

Investing to tackle loneliness: a discussion paper


This paper describes work undertaken with Age UK Herefordshire and Worcestershire to design a service that addresses loneliness, particularly among older people. The first half of the paper examines the potential costs of loneliness and the potential value to the public sector of reducing loneliness. The second half of the paper describes the outcomes-based model used in Worcestershire and sets out initial findings of the service. The service uses a model of commissioning services through a Social Impact Bond (SIB), a contract in which commissioners commit to pay investors for an improvement in social outcomes. The paper sets out some of the benefits of using social investment to fund the upfront cost of delivering a service to reduce loneliness. It also discusses the following elements of the model: measuring loneliness and additional outcomes, delivering support to the population most at risk, considering social investment and agreeing a payment mechanism.

Tapping the potential: lessons from the Richmond Group's practical collaborative work in Somerset


This report captures early learning from a project to building meaningful collaboration between the voluntary and statutory sector in Somerset. It is the latest report from the Doing the Right Thing programme, which aimed to achieve better outcomes for people living with long-term health conditions and reduced demand on health and social care services through collaborative design and delivery. The report identifies benefits of collaboration and system change led by the voluntary and community sector. It also highlights some of the challenges around sustainability, measuring outcomes and ensuring involvement of large national charities is inclusive of the wider voluntary sector in a place. Key findings highlight the benefits of coming to collaboration with no pre-conceived ideas about products or providers; that turning an open-ended conversation between the voluntary sector and public bodies into a productive collaboration requires resource; the benefits of bridging organisations, such as the Richmond Group, and people who make it their job to connect divergent cultures, languages, and priorities; and the agility and stability that voluntary sector leadership can offer to place-based collaborations in a changing healthcare landscape. The report also discusses the wider implications of the research, and the issues it raises around health and care transformation, placed-based collaboration, and evidence for complex interventions. The report will be of particular interest to those seeking to improve collaboration and commission services across the health and care system and also provides practical insights into cross-sector collaboration.

Untapped potential: bringing the voluntary sector's strengths to health and care transformation

WESTON Andrew, et al

This report highlights the potential of the voluntary and community sectors to help shape health and care reform, and identifies the added-value that the sector can bring. The research was commissioned by the Richmond Group of Charities and it assessed the findings of 175 evaluations into how the voluntary sector's offer can be integrated into the health and care system of the future. It also presents a framework for a shared language, to help charities describe their work and its value, and to give commissioners and policymakers a way to identify the aspects of charities’ work that most clearly match their needs. The majority of findings reviewed related to health and wellbeing outcomes. The review found strong evidence that charities achieve health and wellbeing outcomes through direct treatment and support and supported self-management and good evidence that charities deliver health and wellbeing and productivity and efficiency outcomes through system redesign. The report concludes that charities can add value to the health and care system in a range of ways and that charities have a legitimate role in the transformation of the NHS and the wider health and care system in the coming years. The report makes recommendations that could support the voluntary, community and statutory sectors to change their behaviour to support this changes happen at a faster pace.

The UTOPIA project: using telecare for older people in adult social care. The findings of a 2016-17 national survey of local authority telecare provision for older people in England

WOOLHAM John, et al

This report describes how electronic assistive technology and telecare are used by local authorities in England to support older people. It is based on an online survey of local authority telecare managers to identify local authority’s aims when offering telecare to older people, the methods they use to assess whether their objectives are achieved, and how telecare is operationalised and delivered. The context of the research was to explore why the findings of the earlier the Whole System Demonstrator project - which found no evidence that telecare improved outcomes - have been overlooked by local authorities and policy makers, and whether there is other evidence that could account for WSD findings. The survey results found a third of local authorities used research evidence to inform telecare services and half were also aware of the Whole System Demonstrator. It also found that telecare is used in most local authorities to save money. Although there was some evidence of monitoring, there was no evidence of local authorities adopting agreed standards. The final section of the report provides suggestions for improving telecare service practice. They include the areas of using telecare as a substitute for social care; expanding the focus on telecare beyond risk management, safety and cost reduction; the impact of telecare on family members, carrying out effective assessments, and training.

Promising approaches to living well with dementia


This report provides a practical resource for individuals and organisations working in communities to support people living with dementia, and their carers to live well. It identifies interventions that are evidenced, cost effective and scalable, and which could be replicated by NHS Trusts, care providers and primary care services. The services highlighted include counselling for the newly diagnosed; encouraging people to get involved in arts and crafts activities; and helping people to reminisce through dance. It also proposes a framework to help understand these different approaches and the way they can be brought together in communities. This framework covers: Foundation services – which support people with dementia to access direct interventions; Direct interventions - to help support personal wellbeing, positive relationships, and active daily lives; Enabling services, which includes technology, transport and housing and care; and Structural factors - approaches in policy and practice which support effective development of appropriate services and systems., such as rights-based approaches and dementia friendly communities. Twenty five case studies are included to highlight the range of activity across the country. It makes recommendations for people with dementia and their carer, service providers and local authorities and health bodies involved with planning community responses to dementia.

Plymouth: local system review report


This local system review of Plymouth is one of 20 targeted reports to examine how older people move through the health and social care system, with a focus on the interfaces between services. It focuses on three key areas: maintaining the wellbeing of a person in their usual place of residence; crisis management; and step down, return to usual place of residence and/ or admission to a new place of residence. As well as analysis of local data, the review sought feedback from system leaders, people delivering care, and people who use services, their families and carers to examine whether services were: safe, effective, caring, responsive, and well led. The review found there was a shared ambition among system leaders for the integration of service delivery in Plymouth and a clear framework for interagency collaboration. It also found examples of staff working in an integrated way. However the experience of people receiving health and social care services was varied, with some negative experiences of discharge from hospital and missed opportunities to better utilise voluntary and community sector services in terms of maintaining people at home and avoiding hospital admission. Suggested areas for improvement include: more attention to commissioning for prevention and early intervention to improve sub optimal performance and the need for organisational development work to break down any organisational barriers and ensure there is a shared understanding among staff of their role in achieving integration at an operation level.

Learning from the vanguards: supporting people and communities to stay well


This briefing explores how the care vanguard sites have sought to design health and care services around the needs of people who use them, focusing on the outcomes that matter to people and tailoring care to their needs and goals. It also explores how the vanguards have adopted community- and asset-based approaches to consider the broadest possible influencers on health and care. This new approach recognises that services should be designed to support people to be more involved in their own care, challenges the traditional divide between patients and professionals, and offers opportunities for better health through increased prevention and supported self-care. The briefing includes examples of practice from the vanguard sites. The briefing is part of a series developed by the NHS Confederation, NHS Clinical Commissioners, NHS Providers and Local Government Association.

Commissioning community development for health: a concise handbook

CHANAN Gabriel, FISHER Brian

A practical guide to help Clinical Commissioning Groups (CCGs), sustainability and transformation partnerships (STPs) and local authorities to commission community development to support health and wellbeing. The guide looks at the role of community development in health and health policy, explains the main features of community development and the role community-based approaches can play in improving services. It includes a seven step framework for building community-led partnerships with local agencies and suggests key performance indicators that can be used to evaluate progress. It also provides a model contract for provision of the community development project and identifies the skill set for community development leaders and staff. The handbook is tailored to current policy in England, but the key principles have wider relevance.

People powered recovery: social action and complex needs. Findings from a call for evidence


The UK All-Party Parliamentary Group (APPG) on complex needs and dual diagnosis was established in 2007 in recognition of the fact that people seeking help often have a number of over-lapping needs including problems around access to housing, social care, unemployment services, mental health provision or substance misuse support. This report sets out the findings from a call for evidence on how social action can improve outcomes and develop more responsive services for people with complex needs or a dual diagnosis. Social action is about people coming together to tackle an issue, support others or improve their local area, by sharing their time and expertise through volunteering, peer-led groups and community projects. The report provides examples of how social action can support recovery, self-worth and confidence, boost employment prospects and skills, reduce stigma, better shape services to meet people’s needs, contribute to better health and wellbeing and save money. It also looks at how to overcome some of the challenges and barriers to developing social action focused around complex needs. These include resources, stigma, procedural issues, leadership, commissioning structures and demonstrating benefits.

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