Results for 'costs'
Results 1 - 10 of 17
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.
BICKERDIKE Liz, et al
Objectives: Social prescribing is a way of linking patients in primary care with sources of support within the community to help improve their health and well-being. Social prescribing programmes are being widely promoted and adopted in the UK National Health Service and this systematic review aims to assess the evidence for their effectiveness.
Setting/data sources: Nine databases were searched from 2000 to January 2016 for studies conducted in the UK. Relevant reports and guidelines, websites and reference lists of retrieved articles were scanned to identify additional studies. All the searches were restricted to English language only.
Participants: Systematic reviews and any published evaluation of programmes where patient referral was made from a primary care setting to a link worker or facilitator of social prescribing were eligible for inclusion. Risk of bias for included studies was undertaken independently by two reviewers and a narrative synthesis was performed.
Primary and secondary outcome measures: Primary outcomes of interest were any measures of health and well-being and/or usage of health services.
Results: A total of 15 evaluations of social prescribing programmes were included. Most were small scale and limited by poor design and reporting. All were rated as a having a high risk of bias. Common design issues included a lack of comparative controls, short follow-up durations, a lack of standardised and validated measuring tools, missing data and a failure to consider potential confounding factors. Despite clear methodological shortcomings, most evaluations presented positive conclusions.
Conclusions: Social prescribing is being widely advocated and implemented but current evidence fails to provide sufficient detail to judge either success or value for money. If social prescribing is to realise its potential, future evaluations must be comparative by design and consider when, by whom, for whom, how well and at what cost.
Drawing on the findings from a review of evidence on the impact of sheltered housing for older people, this briefing paper provides estimates of the cost savings sheltered housing can achieve for health and social care. The paper gives a conservative estimate of a social value saving made by sheltered housing of nearly half a billion pounds. This figure takes into account costs saved through a reduction in the number of falls by older people, the time spent in hospital, combating loneliness, as well as fewer unnecessary call-outs to emergency services. The paper was commissioned to help Anchor, Hanover and Housing & Care 21 consider the future of sheltered housing.
CAPER Kathleen, PLUNKETT James
Drawing on the results of interviews with 824 general practitioners (GPs) in England carried out in 2015, this briefing looks at the amount of time and money GPs spend dealing with non-health issues. GPs responding to the survey report spending almost a fifth of their time on social issues that are not principally about health, including relationship problems, housing, unemployment and social isolation. This time has an implied cost to the health service of almost £400 million a year. Although approximately half the GPs surveyed said that time spent on non-health issues helped them understand their local community, this can leave less time for other patients' health care needs. In addition, many issues raised with GPs, require specialist knowledge that many GPs do not have. Whist the report acknowledges that discussion of non-health issues can be helpful in developing GP-patient relationships, it concludes that finding other ways to meet some of the non-health demand facing GPs would free up time and money to be reinvested in patient care. Possible suggestions put forward include the co-locating of non-health services and advice services in GP surgeries and ensuring GPs know how to best signpost patients to other local services in the community.
DAMERY Sarah, FLANAGAN Sarah, COMBES Gill
Objective: To summarise the evidence regarding the effectiveness of integrated care interventions in reducing hospital activity.
Design: Umbrella review of systematic reviews and meta-analyses.
Setting: Interventions must have delivered care crossing the boundary between at least two health and/or social care settings.
Participants: Adult patients with one or more chronic diseases.
Data sources: MEDLINE, Embase, ASSIA, PsycINFO, HMIC, CINAHL, Cochrane Library (HTA database,DARE, Cochrane Database of Systematic Reviews), EPPI-Centre, TRIP, HEED, manual screening of references.
Outcome measures: Any measure of hospital admission or readmission, length of stay (LoS), accident and emergency use, healthcare costs.
Results: 50 reviews were included. Interventions focused on case management (n=8), chronic care model (CCM) (n=9), discharge management (n=15), complex interventions (n=3), multidisciplinary teams (MDT) (n=10) and self-management (n=5). 29 reviews
reported statistically significant improvements in at least one outcome. 11/21 reviews reported significantly reduced emergency admissions (15–50%); 11/24 showed significant reductions in all-cause (10–30%) or condition-specific (15–50%) readmissions; 9/16 reported LoS reductions of 1–7 days and 4/9 showed significantly lower A&E use (30–40%). 10/25 reviews reported significant cost reductions but provided little robust evidence. Effective interventions included discharge management with post-discharge support, MDT care with teams that include condition-specific expertise, specialist nurses and/or pharmacists and self-management as an adjunct to broader interventions. Interventions were most effective when targeting single conditions such as heart failure, and when care was provided in patients’ homes.
Conclusions: Although all outcomes showed some significant reductions, and a number of potentially effective interventions were found, interventions rarely demonstrated unequivocally positive effects. Despite the centrality of integrated care to current policy, questions remain about whether the magnitude of potentially achievable gains is enough to satisfy national targets for reductions in hospital activity.
UNITED KINGDOM HOMECARE ASSOCIATION
Drawing on data obtained from freedom of information requests, this report analyses average prices paid by councils for home care services across all four administrations of the United Kingdom. It also provides a breakdown by England’s nine government regions. The data were obtained during a sample week in April 2016 following the introduction of the new National Living Wage. The analysis found that only one in ten authorities paid an average price at or above UKHCA’s minimum price of £16.70 per hour. It also found that seven authorities paid average prices which the UKHCA believe are unlikely even to cover care workers’ wages and on-costs of £11.94 per hour. Only 24 councils had completed calculations for the costs of home care. The report highlights the low rates that many councils are paying independent and voluntary homecare providers. It argues that this underfunding is a root cause of the instability of local homecare markets and the low pay and conditions of the homecare workforce. The analysis also exposes the level of risk that councils place on a system intended to support older and disabled people. The report makes a number of recommendations, which include the need for local authorities to provide calculations of their costs of homecare.
Implementation plan which outlines a roadmap for delivering the commitments made in the Five Year Forward View for Mental Health to people who use services and the public in order to improve care. It prioritises objectives for delivery by 2020/21 and is intended as a blueprint for the changes that NHS staff, other organisations and other parts of the system can make. Key principles of the plan include co-production, working in partnership with local public, private and voluntary sector organisations; early interventions and delivering person-centred care. The plan also gives a clear indication to the public and people who use services what they can expect from the NHS, and when. It also outlines future funding commitments, shows how the workforce requirements will be delivered in these priority areas, and how data and payment will support transparency. Separate sections cover: children and young people’s mental health; perinatal mental health; adult mental health – including community, acute, crisis care and secure care; mental health and justice, and suicide prevention. These individual chapters set out national-level objectives, costs and planning assumptions. Chapters also describe cross-cutting work to help sustain transformation, including testing new models of care and ensuring the health and wellbeing of the NHS workforce.
HARFLETT Naomi, et al
An economic analysis of three schemes from Dorset Partnership for Older People Projects (POPP), focusing on their value and effectiveness in preventing malnutrition and preventing fire related injuries. Dorset POPP schemes use a community led preventative approach and aim to improve the quality of life of older people and to save money by preventing ineffective use of publicly funded services. The report uses published figures of the costs of malnutrition and the economic value of preventing fire injuries and applies the figure to contact monitoring and costs data from three of the Dorset POPP projects to provide an estimate of the potential economic value. The schemes are: the Wayfinder Programme, which provides signposting and support on services such as welfare benefits and pensions, retaining independent living, social activities, telecare and lunch clubs; the Community Initiatives Commissioning Fund (CICF), which funds initiatives identified by local people such as lunch clubs, social clubs, and neighbourcare schemes; and Safe And Independent Living (SAIL) multi-agency referral scheme, which provides a multi-agency referral approach to enabling access to signposting, support, and services. For all of the interventions included in the analysis, just a very small proportion (often less than one per cent) of the contacts or referrals made would be needed to prevent malnutrition or fire related injuries, in order to save money.
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.
HOLLAND Carol, et al
Report presenting findings from a longitudinal study to evaluate whether the ExtraCare Charitable Trust housing approach provides positive outcomes for healthy ageing which also results in health and social care cost savings. For the study 162 volunteer new residents were assessed prior to moving into ExtraCare accommodation in the 14 locations on their health, illness, well-being and level of activity. They were then assessed on the same measures at 6, 12 and 18 months after entry. Residents were compared against 39 control participants. The main focuse was to measure health, illness, well-being, activity and personal perceptions .Qualitative data were also collected through focus groups, interviews, and case studies to gather residents views and perceptions. Statistical modelling was used to identify the most important factors in predicting outcome measures of cost. Key findings identified: significant saving for NHS budgets, with total NHS costs reducing by 38% over a 12-month period for residents in the sample; a reduction in the duration of unplanned hospital stays; potential savings in the cost of social care; improvements in residents who were designated as in a 'pre-frail' state on entry to ExtraCare housing; and improvements in residents psychological wellbeing, memory and social interaction.
Results 1 - 10 of 17