Results for 'prevention'
Results 101 - 106 of 106
MAYO-WILSON Evan, et al
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.
AIDEN Hardeep, BUSH Marc
A third of all people using care services are disabled adults of working age. This pamphlet builds on the analysis in 'The other care crisis', which provided evidence that exposed the £1.2 billion gap in social care spending for disabled adults. Based on new research undertaken by Deloitte, this pamphlet quantifies the long-term savings to individuals and the Government of closing this gap in social care expenditure. It recommends that the Government's Spending Review should commit to establishing a national minimum threshold for eligibility that encourages councils to provide social care to people with ‘moderate’ or equivalent level needs The Government should encourage councils and the NHS to jointly invest in preventative care and support through Health and Wellbeing Boards. The Care Bill should contain a duty on Health and Wellbeing Boards to identify, plan for and commission preventative services that maximise the independence of disabled people. This should be a statutory part of their Joint Strategic Needs Assessments and Health and Wellbeing strategies. The pamphlet has been jointly produced by the National Autistic Society, Mencap, the Lenard Cheshire Disability, Sense, and Scope.
MILLER Robin, et al
Purpose: The purpose of this paper is to explore the delivery of preventative services for older people from third sector organisations (TSOs) and the extent to which current commissioning arrangements enables the aspirations of policy to be achieved.
Design/methodology/approach: Semi-structured interviews with key-contacts within a sample of TSOs which had been identified by directors of Adult Social Services as delivering one of the top three preventative interventions in their local authority area.
Findings: There was evidence of considerable trust between local authorities and TSOs and as a consequence TSOs were given autonomy to develop holistic and integrated models of delivery that supported rather than diverted the TSOs’ core missions. Both sectors found it difficult to set target outcomes and connected performance frameworks for preventative services. As a consequence a major element of the commissioning cycle is not being completed and TSOs cannot be confident that they are using their resources as effectively as possible.
Research limitations/implications: This study was based in one English region, and would benefit from being extended to other English regions and home nations.
Practical implications: Universities, policy makers, commissioners and the third sector need to work together to develop common outcome frameworks for preventative services and to gather consistent data sets that can be more easily synthesised to give a “realistic” understanding of the impact of different interventions and delivery models.
Originality value: The paper contributes to the limited evidence bases of commissioning of TSOs and preventative services.
ABENDSTERN Michele, et al
Prevention, comprising services that seek to delay deterioration of existing conditions and circumstances or prevent their occurrence by early access to support, is recognised as having an important role in adult social care. The gateway to social care services has traditionally been via needs-led assessments undertaken with professionals. In England, self-assessment, promoted as a means of accessing services more independently, has come to the fore in recent years. This article explores the relationship between prevention and self-assessment in practice. Data are derived from interviews with social services managers of five self-assessment projects situated within the adult social care sector that were described as providing a preventative approach, as well as project development documentation. A number of issues are highlighted including for whom self-assessment might be most optimal, the potential of self-assessment to widen access and the role it can play in promoting self-determination. It is argued that a natural relationship exists between self-assessment and prevention and that both concepts are at the core of the personalisation agenda. However, in order to achieve its potential in practice, self-assessment must be offered in conjunction with support and as an additional rather than alternative means of accessing preventative services.
BRITISH RED CROSS
The aim of this report is to illustrate how British Red Cross preventative services providing time-limited practical and emotional support deliver savings for public sector partners including the NHS and local authorities. It presents brief case studies of 5 people who received personalised support from British Red Cross staff and volunteers to help them live independently in their communities. In each case it describes the action taken and the impact of the services and support provided. It includes an independent economic analysis of each case study assessing the costs which could have been incurred by statutory services in delivering care in the absence of the British Red Cross services. It reports that savings of between £700 and over £10,000 were delivered per person, and that this reflects a minimum return on investment of over 3.5 times the cost of the British Red Cross service provided.
NATIONAL INSTITUTE FOR HEALTH RESEARCH. School for Social Care Research
Third sector organisations (TSOs) have historically played a significant role in the delivery of adult social care. Often seen to be associated with qualities such as strong community links, access to disadvantaged groups and innovative practice, TSOs remain a popular choice with local authority commissioners as providers of preventative services. This study explored the views of nine locally commissioned TSOs and two national organisations which provide preventative services for older people. Senior managers were interviewed about their views of the purpose of such services, how the TSO understood their impacts, and their experience of being commissioned by the public sector. The results were added to previous research with local authorities to build a picture of the local authority and third sector relationship. The research identifies positive aspects within the current arrangements, but also gaps in respect of setting and understanding of outcomes and a reliance on personal relationships within the commissioning process.
Results 101 - 106 of 106