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Results for 'community care'

Results 21 - 29 of 29

Living a normal life: supporting the development of dementia friendly communities

HENWOOD Melanie
2015

An evaluation of a Skills for Care funded a programme of 12 pilot projects, across 11 organisations, for 12 months in 2013/14 designed to support the development of dementia friendly communities (DFCs), by improving community understanding and awareness of dementia and supporting people living with dementia and their carers to participate in their communities. Section 1 of the report provides an introduction both to the underlying objectives of the programme, and to the participating pilot sites. Section 2 presents an overview of the cross-cutting themes and issues identified across the sites, including motivation and engagement, working with the wider community, intergenerational aspects, engaging with GPs and the NHS, and impact and outcomes. The methodology for the evaluation included analysis of written reports; and one to one semi-structured interviews with project leads. The report highlights the importance of motivation and personal engagement as driving forces while suggesting that most projects encountered difficulties – to a greater or lesser extent – in trying to work with the wider community in developing awareness and understanding of dementia. A few of the projects were addressing intergenerational dimensions of dementia awareness and were working with schools, or were planning to develop such work. In working with a range of local partners many projects were deliberately engaging with the NHS in general and with GPs in particular to increase diagnosis rates. The report concludes that equipping people with the skills and understanding to respond to the needs of people with dementia has great potential to bring about transformational change and to enable genuine social inclusion.

A guide to community-centred approaches for health and wellbeing: full report

SOUTH Jane
2015

Outlines a 'family' of approaches for evidence-based community-centred approaches to health and wellbeing. The report presents the work undertaken in phase 1 of the 'Working with communities: empowerment evidence and learning' project, which was initiated jointly by PHE and NHS England to draw together and disseminate research and learning on community-centred approaches for health and wellbeing. The report provides a guide to the case for change, the concepts, the varieties of approach that have been tried and tested and sources of evidence. The new family of community-centred approaches outlined in this document represents some of the available options that can be used to improve health and wellbeing, grouped around four different strands: strengthening communities - where approaches involve building on community capacities to take action together on health and the social determinants of health; volunteer and peer roles - where approaches focus on enhancing individuals' capabilities to provide advice, information and support or organise activities around health and wellbeing in their or other communities; collaborations and partnerships - where approaches involve communities and local services working together at any stage of planning cycle, from identifying needs through to implementation and evaluation; and access to community resources - where approaches connect people to community resources, practical help, group activities and volunteering opportunities to meet health needs and increase social participation.

Avoiding unhappy returns: radical reductions in readmissions, achieved with volunteers

ROYAL VOLUNTARY SERVICE
2014

A summary of the achievements of the Royal Voluntary Service Hospital 2 Home service during its first year. Leicestershire County Council launched the scheme in hospitals in six districts, including the three university hospitals in Leicester in summer 2012. The service provides practical help and support following a discharge from hospital; helps users to regain confidence and reduce anxiety; reduces social isolation; promotes independent living and choice; helps users to maintain day to day activities; provides information/signpost to other organisations; and helps prevent readmissions to hospital. Designed to be short-term, friendly and confidential and people-centred, the service is provided free of charge and is normally available for up to six weeks. Over 600 people have been referred. Among the participants readmission rates to hospital have been very low, with readmissions of older people approximately half national rates.

Local area coordination: from service users to citizens

BROAD Ralph
2012

An exploration of how local area coordination can support people to pursue their vision for a good life, build stronger communities and help reform care services in England and Wales. Local area coordinators, from within their own local communities, provide information, advice and support to help people to solve their own problems. Instead of focusing on deficits, they help people focus on their own vision for a good life, building on their own assets and relationships and acting as a bridge to communities. The model is built on seven key principles, which include: citizenship; relationships; information; the gifts that each member of the community can bring; expertise; leadership; and services as a back up to natural support. The report argues that local area coordination offers the chance for the whole service system to rebalance itself and to focus on local solutions and stronger communities, whilst also offering a powerful catalyst to wider social care system reform.

Going home alone: counting the cost to older people and the NHS

ROYAL VOLUNTARY SERVICE
2014

Assesses the impact of home from hospital services, which focus on supporting older people in their homes following a stay in hospital and seek to reduce the likelihood that they will need to be readmitted to hospital. The report brings together the findings of a literature review (as well as discussions with relevant experts), the results of the survey of 401 people aged 75 or over who had spent at least one night in hospital on one or more occasions within the past five years, and the outputs from a cost-impact analysis using national data and results from the survey. It sets out the policy context in England, Scotland and Wales, with its focus on preventive care, better integration of health and care services, and on shifting care away from the hospital into homes and communities. It then discusses the demand drivers for these schemes, including the ageing population, the growth in hospital readmissions, and decreasing length of stay. The report examines the experiences of older people after leaving hospital, looking at admissions, discharge, need for support following discharge, and type and duration of support. It suggests that home from hospital schemes can help to improve the well-being of their users and to reduce social isolation and loneliness and the number of hospital readmissions, as well as demand for other health and care services. The results of the cost-impact analysis suggest that, were home from hospital schemes appropriately targeted and effective in addressing ‘excess admissions’, they may produce a saving for the NHS of £40.4m per year.

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.

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.

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.

Preventive home visits for mortality, morbidity, and institutionalization in older adults: a systematic review and meta-analysis

MAYO-WILSON Evan, et al
2014

Background: Home visits for older adults aim to prevent cognitive and functional impairment, thus reducing institutionalisation and mortality. Visitors may provide information, investigate untreated problems, encourage medication compliance, and provide referrals to services. Methods and Findings: Data Sources: Ten databases including CENTRAL and Medline searched through December 2012. Study Selection: Randomised controlled trials enrolling community-dwelling persons without dementia aged over 65 years. Interventions included visits at home by a health or social care professional that were not related to hospital discharge. Two authors independently extracted data. Outcomes were pooled using random effects. Main Outcomes and Measures used were mortality, institutionalisation, hospitalisation, falls, injuries, physical functioning, cognitive functioning, quality of life, and psychiatric illness. Results: Sixty-four studies with 28642 participants were included. Home visits were not associated with absolute reductions in mortality at longest follow-up, but some programmes may have small relative effects. There was moderate quality evidence of no overall effect on the number of people institutionalised. There was high quality evidence for number of people who fell, which is consistent with no effect or a small effect, but there was no evidence that these interventions increased independent living. There was low and very low quality evidence of effects for quality of life and physical functioning respectively, but these may not be clinically important. Conclusions: Home visiting is not consistently associated with differences in mortality or independent living, and investigations of heterogeneity did not identify any programmes that are associated with consistent benefits. Due to poor reporting of intervention components and delivery, the authors cannot exclude the possibility that some programmes may be effective.

Results 21 - 29 of 29

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