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Results for 'integrated services'

Results 1 - 10 of 24

Preventive social care: is it cost effective?

CURRY Natasha
2006

This paper attempts to pull together and review key pieces of evidence about the cost effectiveness of prevention. The findings, which reflect a paucity of quantified information about the effectiveness of preventive interventions, suggest that there is a strong financial case for reducing hospitalisation (particularly through falls) and for reducing the rate of institutionalisation by maintaining independence. Small-scale trials show that small interventions could prevent falls and reduce the rate of institutionalisation. However, establishing a direct causal relationship between such interventions and long-term financial savings has proved problematic although. There is a lack of consensus over the cost effectiveness of intermediate care although there is evidence that it is cost effective when targeting specific groups/illnesses/events such as stroke and falls. Evidence for secondary stroke prevention services is perhaps the strongest, and most widely quantified, body of research. There is some evidence that primary prevention strategies (such as smoking cessation and reduced salt intake) have potential to reduce the incidence of stroke. The paper makes a series of recommendations, calling for a greater focus on low-level interventions, particularly where there is qualitative evidence that they are valued by service users; implementation of promising interventions, even if not supported by robust evidence, accompanying by formal evaluation during roll-out; development of standard outcome measures of prevention; targeting resources to ensure greatest impact; and greater integration between health and social care services as a drive to shift services towards the preventive end of the spectrum.

The (cost‐)effectiveness of preventive, integrated care for community‐dwelling frail older people: a systematic review

LOOMAN Wilhelmina Mijntje, HUIJSMAN Robbert, FABBRICOTTI Isabelle Natalina
2019

Integrated care is increasingly promoted as an effective and cost‐effective way to organise care for community‐dwelling frail older people with complex problems but the question remains whether high expectations are justified. Our study aims to systematically review the empirical evidence for the effectiveness and cost‐effectiveness of preventive, integrated care for community‐dwelling frail older people and close attention is paid to the elements and levels of integration of the interventions. We searched nine databases for eligible studies until May 2016 with a comparison group and reporting at least one outcome regarding effectiveness or cost‐effectiveness. We identified 2,998 unique records and, after exclusions, selected 46 studies on 29 interventions. We assessed the quality of the included studies with the Effective Practice and Organization of Care risk‐of‐bias tool. The interventions were described following Rainbow Model of Integrated Care framework by Valentijn. Our systematic review reveals that the majority of the reported outcomes in the studies on preventive, integrated care show no effects. In terms of health outcomes, effectiveness is demonstrated most often for seldom‐reported outcomes such as well‐being. Outcomes regarding informal caregivers and professionals are rarely considered and negligible. Most promising are the care process outcomes that did improve for preventive, integrated care interventions as compared to usual care. Healthcare utilisation was the most reported outcome but we found mixed results. Evidence for cost‐effectiveness is limited. High expectations should be tempered given this limited and fragmented evidence for the effectiveness and cost‐effectiveness of preventive, integrated care for frail older people. Future research should focus on unravelling the heterogeneity of frailty and on exploring what outcomes among frail older people may realistically be expected.

Disabled Facilities Grant (DFG) and other adaptations: external review

MACKINTOSH Shelia, et al
2018

This review, commissioned by the Department of Health and Social Care, looks at how the Disabled Facilities Grant (DFG) currently operates and makes evidence based recommendations for how it should change in the future. It review aims to develop more effective ways of supporting more people to live in suitable housing so they can stay independent for longer and makes the case for more joint working across housing, health and social care. The focus of the review is on how the disabled or older person can be put at the centre of service provision and what would make it easier for them to access services. It also looks at the role of DFG in prevention and how it can deliver this more effectively. It draws on a range of evidence, including: analysis of data from LOGASnet returns; consultation events attended by local authorities and home improvement agencies; interviews with staff from selected local authorities; and a short review of the academic, policy and practice literature. The conclusions and recommendations include: renaming the grant to reflect that it is part of a broader set interventions to help people remain independent; improved integration of services; better partnership working between health and care and different professions; raising the upper limit of the grant; and changes to the current formula for allocating funding; and updating of the existing means testing regulations. The review also identifies additional research to be carried out.

“It was the whole picture” a mixed methods study of successful components in an integrated wellness service in North East England

CHEETHAM M., et al
2018

Background: A growing number of Local Authorities (LAs) have introduced integrated wellness services as part of efforts to deliver cost effective, preventive services that address the social determinants of health. This study examined which elements of an integrated wellness service in the north east of England were effective in improving health and wellbeing (HWB). Methods: The study used a mixed-methods approach. In-depth semi-structured interviews (IVs) were conducted with integrated wellness service users (n = 25) and focus groups (FGs) with group based service users (n = 14) and non-service users (n = 23) to gather the views of stakeholders. Findings are presented here alongside analysis of routine monitoring data. The different data were compared to examine what each data source revealed about the effectiveness of the service. Results: Findings suggest that integrated wellness services work by addressing the social determinants of health and respond to multiple complex health and social concerns rather than single issues. The paper identifies examples of ‘active ingredients’ at the heart of the programme, such as sustained relationships, peer support and confidence building, as well as the activities through which changes take place, such as sports and leisure opportunities which in turn encourage social interaction. Wider wellbeing outcomes, including reduced social isolation and increased self-efficacy are also reported. Practical and motivational support helped build community capacity by encouraging community groups to access funding, helped navigate bureaucratic systems, and promoted understanding of marginalised communities. Fully integrated wellness services could support progression opportunities through volunteering and mentoring. Conclusions: An integrated wellness service that offers a holistic approach was valued by service users and allowed them to address complex issues simultaneously. Few of the reported health gains were captured in routine data. Quantitative and qualitative data each offered a partial view of how effectively services were working.

Place-based approaches to joint planning, resourcing and delivery: an overview of current practice in Scotland

BACZYK Monika, et al
2016

Sets out the current landscape of place-based approaches to joint planning, resourcing and delivery across Scotland’s local authority areas. The report captures current place-based activities within 27 local authority areas and includes a synthesis of published materials on the subject. As well as undertaking a review of the literature on place-based approaches to service delivery in the UK, the Improvement Service conducted interviews with local authority areas to find out more about local approaches. Whilst there is evidence of a wide variety of approaches being undertaken, the research also highlights a range of common principles that feature across most areas. The study found that the majority of place-based approaches are adopting a holistic approach, focused on reducing inequalities and supporting people, families and communities to improve their life outcomes in the round. Others are focusing on a specific theme, such as family support, health inequalities, physical regeneration and access to services. The report includes a practical checklist that summarises key issues that partnerships may wish to consider, either when embarking upon a new place-based initiative or when reviewing existing activities.

Public health working with the voluntary, community and social enterprise sector: new opportunities and sustainable change

LOCAL GOVERNMENT ASSOCIATION, VOLUNTEERING MATTERS
2017

A collection of case study examples which show how public health and the voluntary, community and social enterprise sector (VCSE) are working together to improve people's health and wellbeing. The case studies cover the themes of: positive partnership and engagement between public health and the VCSE sector; commissioning and new delivery models; supporting a financially sustainable future; integrating services; and community-centred approaches. Case studies include an initiative to tackle social isolation and loneliness in older people; an integrated lifestyle and wellness support services for people at the greatest risk of poor health outcomes; and lonely, and socially isolated a marginalised people. Each case study includes an overview of the service, evaluation findings where available and key learning from the initiative. Suggestions for good practice in partnership working between public health and the VCSE sector are also included.

Stockton Borough Council's Multi-Disciplinary Service

Stockton-on-Tees Borough Council

Stockton Borough Council established a Multi-Disciplinary Service (MDS) in October 2015, as part of their Better Care Fund plan. The process of designing and implementing the service was through creating a partnership with all key stakeholders in across health, social care and the voluntary sector: Hartlepool and Stockton-on-Tees CCG - Health Commissioners; Stockton-on-Tees Borough Council - Social Care; North Tees and Hartlepool FT - Acute and Community Health; Tees Esk and Wear Valleys FT - Mental Health Trust; and the Voluntary Community and Social Enterprise sector. The executive management teams of all partner organisations signed up to the MDS and have continued to support its development though regular updates at the Joint Health and Wellbeing Board.

Quick guide: health and housing

NHS ENGLAND
2016

This is one of a series of quick, online guides providing practical tips and case studies to support health and care systems. It provides practical resources and information for Clinical Commissioning Groups (CCGs) from a range of national and local organisations on how housing and health can work together to prevent and reduce hospital admissions, length of stay, delayed discharge, readmission rates and ultimately improve outcomes. Specifically, the guide describes: how housing can help prevent people from being admitted to hospital – by enabling access to home interventions (social prescribing), improving affordable warm homes (safe, warm housing), improving suitability and accessibility, and providing housing support; how housing can help people be discharged from hospital – through coordination of services, provision of step down services, and accessible housing design; and how housing can support people to remain independent in the community – by enabling informed decisions about home and housing options, providing assistive technology and community equipment, supporting social inclusion, providing supported housing, and promoting healthy lifestyles.

The art of commissioning: how commissioners can release the potential of the arts and cultural sector

SLAY Julia, ELLIS-PETERSEN Madeleine
2016

Drawing the experiences from two pilot sites in Kent and Gloucestershire, this report aims to help commissioners of public services understand how they can improve outcomes for people and communities through closer integration of arts and cultural into public services. As part of the Cultural Commissioning Programme (CCP), New Economics Foundation worked with NHS and local authority partners in Kent and Gloucestershire over an 18 month period. This report brings together examples, case studies, templates and resources that share the successes of, and challenges faced by, the commissioners in the two pilot site. As part of the project the NHS Gloucestershire Clinical Commissioning Group has funded nine projects that are applying arts and culture across a range of clinical pathways including cancer, mental health and diabetes. They are also exploring how arts and cultural activities can be aligned with the county wide social prescribing scheme. Services developed in Kent include community-based mental health service which includes formal arts and cultural organisations, such as local museums and theatres, as well as smaller, informal arts and cultural groups, such as reading groups and dance classes. Kent County Council has also been involving arts and cultural organisations in their early help and preventative service worth around £8 million. Recommendations for other commissioners include: raising awareness within public services bodies of the benefits of working with arts and cultural providers; building provider capacity and knowledge; involving the arts and cultural sector in market engagement; improving procurement processes; and improving monitoring and evaluation processes.

Mental health and housing

SAVAGE Jonny
2016

This study examines how different types of supported accommodation meet the needs of people with mental health problems. Supported accommodation covers a wide range of different types of housing, including intensive 24 hour support, hostel accommodation, and accommodation with only occasional social support or assistance provided. The document focuses on five approaches to providing supported accommodation, including: Care Support Plus; integrated support; housing support for people who have experienced homeless; complex needs; low-level step down accommodation; and later life. The report draws on the expertise of people living and working in these services across England, and presents their views of both building and service related issues. It sets out a number of recommendations, focusing on: quality; co-production; staff recruitment and training; policy informed practice; and resourced, appropriate accommodation.

Results 1 - 10 of 24

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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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