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Results for 'integrated care'

Results 1 - 10 of 54

Evaluation of Leicestershire Local Area Coordination: final report

M·E·L RESEARCH
2020

This evaluation of Leicestershire Local Area Coordination (LAC) has comprised both formative (process) and summative (outcome) elements. LAC is a complex community-based intervention, delivered in 10 very different local areas in four of the County’s Districts, operationally delivered by 8 Coordinators with varied backgrounds and different working styles. It is designed to have an impact on three levels: individual, community, and health and social care integration. The evaluation finds that LAC has been effective in achieving its ‘founding’ aims and strategic objectives for individuals (a strong focus on assets-based approaches and a community model of delivery, aimed at ‘upstream prevention’ working with vulnerable residents at risk of crisis). LAC has been moderately effective in achieving its aims and objectives around HSC integration but has been less effective in delivering its’ community-based objectives. The SROI findings provide positive evidence of measurable outcomes for LAC, demonstrating positive SROI ratio of £4.10 in accumulated benefit for every £1 spent. It has been more challenging to make LAC successful (and therefore LAC is likely to have less impact for residents) in areas with less community infrastructure; and as LAC is not a prescriptive service, the impact of LAC for some beneficiaries may be lessened as they may not be ready to take the steps to help them move forward. The most successful elements of LAC have comprised: the relationships between coordinators, and beneficiaries and local partners – trust, flexibility and effective networking; coordinator knowledge of local assets and ability to match this with beneficiary support needs; coordinators being located within the communities they work; the lack of specific agenda for coordinators making them less threatening; and the personal skills and commitment of the coordinator team.

Prevention in social care: where are we now?

WAVEHILL SOCIAL AND ECONOMIC RESEARCH, SKILLS FOR CARE
2019

This report draws together the main findings from a research study, which aimed to provide an overview of the published and unpublished literature relating to prevention in social care; consult with stakeholders to understand more about engagement with the prevention agenda; and identify examples of practice in England to learn more about how prevention is working in social care. The literature identified five key approaches to prevention: advice and guidance; physical activity promotion; social prescribing; reablement; and asset-based approaches. For each approach, the report provides a brief outline and examples of good practice. The report also looks at the interplay between prevention and the integration agenda, focusing on new care models, wellbeing teams, and new and emerging job roles; explores how to develop capacity in social care, through learning and development resources, use of technology, and commissioning and contracting; and examines the critical factors to effectively implement and embed prevention in practice.

Total transformation of care and support

SOCIAL CARE INSTITUTE FOR EXCELLENCE
2017

This updated version of 'Total transformation of care and support: future of care', originally published in 2016, looks at how transformed and integrated health and care could improve outcomes and cost effectiveness of services. It outlines five areas where transformation needs to take place and where health and care systems can help older and disabled people build a good quality life. It identifies six well-evidenced models, which demonstrate how to combine scarce state resources with the capacity of individuals, families and communities. Using data from Birmingham City Council, it explores the potential for scaling up these six schemes, modelling their outcomes, costs and estimated financial benefits. It also highlights key enablers that could help areas implement each scheme. The models cover an initiative to help isolated older people; the Living Well scheme to improve resilience amongst older people; a service to support adults with learning disabilities to become independent; Shared Lives; a scheme to improve hospital discharge, and support for people following a hospital stay. Appendices include a template to help structure conversations with local citizens and stakeholders about transforming. It is the third of SCIE's Future of care series, which aims to stimulate discussion amongst policy-makers and planners about the future of care and support.

Delivering neighbourhood-level integrated care in Norfolk

COMMUNITY NETWORK
2020

This case study illustrates how integrated services are being delivered in Norfolk. Norfolk Community Health and Care NHS Trust’s vision is to improve the quality of people’s lives in their homes and community through the best in integrated health and social care. The trust works predominantly with 14 primary care networks (PCNs) across the area served by Norfolk and Waveney Clinical Commissioning Group (CCG), and with the Norfolk and Waveney Health and Care Partnership at system level. This includes collaborating with three acute trusts, one mental health trust, Norfolk County Council and the East of England Ambulance Service Trust. Examples of collaborative working include rapid assessment frailty team; early intervention vehicles, involving occupational therapists working with emergency medical technicians; Norfolk escalation avoidance team; and a high intensity user service. Key lessons emerging from this case study are: effective collaborative working requires good relationships across the board; do not underestimate the differences in culture and working practices between different organisations; invest in ensuring there is the right technology available for staff to use; engage with staff in a meaningful way to develop strategies to improve their health and wellbeing as this in turn will lead to improvement in services; and invest in pilot projects to test out integrated working between organisations but plan for how they can be maintained long term.

Quality and cost-effectiveness in long-term care and dependency prevention: the English policy landscape. CEQUA report

MARCZAK Joanna, FERNANDEZ Jose-Luis, WITTENBERG Raphael
2017

This report summarises policy developments in England in relation to quality and cost-effectiveness and dependency prevention in long-term care. These policy aims focus on maximising the cost-effectiveness of the social care system, so that service users’ and carers’ quality of life is maximised within available resources. The report provides an overview of the long-term care system in England. It then reviews key recent policy developments in four areas: reducing dependency cost-effectively; strategies for maximising care coordination; supporting unpaid carers; and use of innovative care models, with a focus on technological solutions and personalisation. An appendix lists key features of the Care Act 2014 and the Better Care Fund relevant to prevention.

Evaluating social care prevention in England: challenges and opportunities

MARCZAK Joanna, WISTOW Gerald, FERNANDEZ Jose-Luis
2019

Context: The Care Act 2014 placed a statutory duty on adult social care (ASC) to prevent and delay the development of needs for care and support. There is little clarity about how to translate this national obligation into effective local practice. Objectives: This exploratory study sought to lay the foundations for understanding approaches to this new duty by identifying: emerging local understandings of prevention; associated implementation strate­gies; and the potential for designing evaluation frameworks. Methods: Local perspectives were secured through: in-depth interviews in six English local authorities; reviews of local strategy, implementation documents and reviews of data sources; and methods for evaluating local initiatives in sampled authorities. Findings: The findings indicate important differences between and within local authorities in conceptuali­sations of prevention. Although willingness to commission services was strongly linked to the availability of evidence on what works in prevention, council conducted limited local evaluations. This study also found limited collaboration between ASC and Health in developing joint prevention approaches, in part due to differ­ences in conceptualisation and also constraints arising from different priorities and information systems. Limitations: The exploratory nature of the study and the small sample size limits the generalisability of its findings. Overall, the number of local authorities and respondents allowed us to explore a range of local views, opinions and practices related to the prevention agenda in a variety of contexts, however the findings are not generalisable to all English local authorities. Implications: This study suggests that the limited local evidence about prevention, combined with finan­cial austerity, may lead to disproportionate investment in a small number of interventions where existing evidence suggests cost-savings potential, which, in turn, may impact authorities’ ability to fulfil their statutory duties related to preventing and delaying the needs for care and support. In this connection, this study highlights the potential for developing local evaluation strategies utilising existing but largely unexploited local administrative data collections.

Interventions to promote early discharge and avoid inappropriate hospital (re)admission: a systematic review

COFFEY Alice, et al
2019

Increasing pressure on limited healthcare resources has necessitated the development of measures promoting early discharge and avoiding inappropriate hospital (re)admission. This systematic review examines the evidence for interventions in acute hospitals including (i) hospital-patient discharge to home, community services or other settings, (ii) hospital discharge to another care setting, and (iii) reduction or prevention of inappropriate hospital (re)admissions. Academic electronic databases were searched from 2005 to 2018. In total, ninety-four eligible papers were included. Interventions were categorized into: (1) pre-discharge exclusively delivered in the acute care hospital, (2) pre- and post-discharge delivered by acute care hospital, (3) post-discharge delivered at home and (4) delivered only in a post-acute facility. Mixed results were found regarding the effectiveness of many types of interventions. Interventions exclusively delivered in the acute hospital pre-discharge and those involving education were most common but their effectiveness was limited in avoiding (re)admission. Successful pre- and post-discharge interventions focused on multidisciplinary approaches. Post-discharge interventions exclusively delivered at home reduced hospital stay and contributed to patient satisfaction. Existing systematic reviews on tele-health and long-term care interventions suggest insufficient evidence for admission avoidance. The most effective interventions to avoid inappropriate re-admission to hospital and promote early discharge included integrated systems between hospital and the community care, multidisciplinary service provision, individualization of services, discharge planning initiated in hospital and specialist follow-up.

The lives we want to lead: the LGA green paper for adult social care and wellbeing

LOCAL GOVERNMENT ASSOCIATION
2018

A consultation paper from the Local Government Association, which seeks views on the future of care and support for adults and their unpaid carers. The paper puts forward options to secure the immediate and long-term funding for adult social care, and makes the case for a shift towards preventative, community-based personalised care, which helps maximise people's health, wellbeing and independence. It also considers the importance of housing, public health, other council services, in supporting wellbeing and prevention. Sections cover: differing views about the future of long-term funding for social care; the wider changes needed across care and health to bring out a greater focus on community-based and person-centred prevention; the role of public health and wider council services in supporting and improving wellbeing; and the nature of the relationship between social care and health, integration, accountability and how the new NHS funding could be used for maximum impact. Thirty consultation questions are included throughout the report. The consultation will run until 26 September 2018.

Review of integrated care: focus on falls

HEALTHCARE INSPECTORATE WALES
2019

Based on a review of integrated care for older people who are at risk of experiencing a fall in Wales, this report highlights learning for staff and for health and social care managers. It focuses on services to help people avoid a fall and how to support people who have had a fall, providing examples of desirable and undesirable pathways through the health and care system. It focuses on the three areas: prevention of falls and promotion of independence, for people living in their own home or in a care home; response to falls when they happen in the community, either for someone living at home or in a care home; and following attendance at hospital due to a fall. It also highlights key themes identified from the review and how the affected service users, service providers and commissioners. The review identified examples of good practice but also found a lack of co-ordination and communication between health, social care and voluntary services could often be a barrier to delivering good quality care. The report has been informed by evidence from six individual falls services, the views of staff and older people. It makes eight recommendations for the Welsh Government, health boards and local authorities. The include a National Falls Framework for Wales, to standardise the approach to preventing, treating and reabling older people who are at risk of falling or have already fallen The report will be relevant for service providers, commissioners and service users.

Health at home: a new health and wellbeing model for social housing tenants

PEABODY
2018

Explores how housing support services and community-based health services can deliver effective services at lower cost; encourage self-care for the most vulnerable customers and reduce dependency on direct support; work with other agencies to ensure a coordinated response to the residents’ complex and multiple health needs. The report sets out the findings of a study which aimed to test a person-centred support model using a randomised control trial of 261 general needs residents aged over 50. The service model employed health navigators and volunteers to coach and connect residents with the relevant health, housing and community services they need. The study used to measurement tools to assess impact: the Patient Activation Measure (PAM) and Coaching for Activation (CFA). The study found that three months of intervention with those who started in PAM Level 2 was sufficient to move them up, on average, an entire PAM level. This increase in activation was sustained for at least nine months after the intervention ended, suggesting that participants gained the skills and confidence to effectively manage their health without further support after the initial intensive intervention. This is significant as one of the largest studies into cost reductions from PAM level changes in the United States found that patients who moved from Level 2 to Level 3 reduced their annual healthcare costs by 12%. Existing evidence also indicates that when people become more active in self-care, they benefit from better health outcomes, and fewer unplanned health admissions. The report concludes that there is a clear and compelling case for continuing to support integrated care and strengthen links between the health and housing agendas.

Results 1 - 10 of 54

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News

Moving Memory

Moving Memory Practice example about how the Moving Memory Dance Theatre Company is challenging perceived notions of age and ageing.

Chatty Cafe Scheme

Chatty Cafe Scheme Practice example about how the Chatty Cafe Scheme is helping to tackle loneliness by bringing people of all ages together

Oomph! Wellness

Oomph! Wellness Practice example about how Oomph! Wellness is supporting staff to get older adults active and combat growing levels of social isolation

KOMP

KOMP Practice example about how KOMP, designed by No Isolation is helping older people stay connected with their families

LAUGH research project

LAUGH research project Practice example about a research project to develop highly personalised, playful objects for people with advanced dementia
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