scholarly journals How should integrated care address the challenge of people with complex health and social care needs? Emerging lessons from international case studies

2015 ◽  
Vol 15 (3) ◽  
Author(s):  
Nick Goodwin
Keyword(s):  
Integrated Care ◽  
Case Studies ◽  
Social Care ◽  
Care Needs ◽  
Health And Social Care

scholarly journals Complex care needs and devolution in Greater Manchester: a pilot study to explore social care innovation in newly integrated service arrangements for older people

2020 ◽  
Vol 44 (6) ◽  
pp. 838
Author(s):  
Baber Malik ◽  
Jude Wells ◽  
Jane Hughes ◽  
Paul Clarkson ◽  
John Keady ◽  
...  
Keyword(s):  
Older People ◽  
Integrated Care ◽  
Social Care ◽  
Complex Care ◽  
Care Providers ◽  
Care Needs ◽  
Health And Social Care ◽  
Complex Care Needs ◽  
Home Care Providers

ObjectiveThe aim of this study was to describe emergent approaches to integrated care for older people with complex care needs and investigate the viability of measuring integrated care. MethodsA case study approach was used. Sites were recruited following discussion with senior staff in health and social care agencies. Service arrangements were categorised using a framework developed by the researchers. To investigate joint working within the sites, the development model for integrated care was adapted and administered to the manager of each service. Data were collected in 2018. ResultsSix case study sites were recruited illustrating adult social care services partnerships in services for older people with home care providers, mental health and community nursing services. Most were established in 2018. Service arrangements were characterised by joint assessment and informal face-to-face discussions between staff. The development of an infrastructure to promote partnership working was evident between adult social care and each of the other services and most developed with home care providers. There was little evidence of a sequential approach to the development of integrated working practices. ConclusionComponents of partnerships promoting integrated care have been highlighted and understanding of the complexity of measuring integrated care enhanced. Means of information sharing and work force development require further consideration. What is known about the topic?The devolution of health and social care arrangements in Greater Manchester has aroused considerable interest in much wider arenas. Necessarily much of the focus in available material has been upon strategic development, analysis of broader trends and mechanisms and a concern with changes in the healthcare system. What does this paper add?The findings from this study will enable emerging approaches to be described and codified, and permit the specific social care contribution to the new arrangements to be discerned. The findings are relevant beyond the immediate context of Greater Manchester to wider integrated care. The evidence can be used by commissioners and services, providing a sound basis for further work as service systems develop. What are the implications for practitioners?This research is important because it is one of the first pieces of work to examine the new integrated care arrangements in Greater Manchester. By providing guidance to promote evidence-based practice, this study contributes to service development in Greater Manchester and the achievement of the broad national service objectives of improving user and carer experiences and ensuring value for money.

scholarly journals A Community Virtual Ward Supporting Integrated Care for Older Persons with Complex Health and Social Care Needs.

2017 ◽  
Vol 17 (5) ◽  
pp. 269
Author(s):  
Clare Lewis ◽  
Mary McDermott ◽  
Alan Martin ◽  
Declan Patton ◽  
Linda Nugent
Keyword(s):  
Integrated Care ◽  
Older Persons ◽  
Social Care ◽  
Care Needs ◽  
Health And Social Care

scholarly journals The burden of triumph: meeting health and social care needs

The Lancet ◽  
2017 ◽  
Vol 390 (10103) ◽  
pp. 1630-1631 ◽  
Author(s):  
Andrew Dilnot
Keyword(s):  
Social Care ◽  
Care Needs ◽  
Health And Social Care

scholarly journals Exploring, measuring and enhancing the coproduction of health and well-being at the national, regional and local levels through comparative case studies in Sweden and England: the ‘Samskapa’ research programme protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029723 ◽  
Author(s):  
Sofia Kjellström ◽  
Kristina Areskoug-Josefsson ◽  
Boel Andersson Gäre ◽  
Ann-Christine Andersson ◽  
Marlene Ockander ◽  
...  
Keyword(s):  
Case Studies ◽  
Quantitative Methods ◽  
Social Care ◽  
Knowledge Exchange ◽  
Research Programme ◽  
Well Being ◽  
Explanatory Models ◽  
Longitudinal Case Study ◽  
Health And Social Care ◽  
Health And Well Being

IntroductionCocreation, coproduction and codesign are advocated as effective ways of involving citizens in the design, management, provision and evaluation of health and social care services. Although numerous case studies describe the nature and level of coproduction in individual projects, there remain three significant gaps in the evidence base: (1) measures of coproduction processes and their outcomes, (2) mechanisms that enable inclusivity and reciprocity and (3) management systems and styles. By focusing on these issues, we aim to explore, enhance and measure the value of coproduction for improving the health and well-being of citizens.Methods and analysisNine ongoing coproduction projects form the core of an interactive research programme (‘Samskapa’) during a 6-year period (2019–2024). Six of these will take place in Sweden and three will be undertaken in England to enable knowledge exchange and cross-cultural comparison. The programme has a longitudinal case study design using both qualitative and quantitative methods. Cross-case analysis and a sensemaking process will generate relevant lessons both for those participating in the projects and researchers. Based on the findings, we will develop explanatory models and other outputs to increase the sustained value (and values) of future coproduction initiatives in these sectors.Ethics and disseminationAll necessary ethical approvals will be obtained from the regional Ethical Board in Sweden and from relevant authorities in England. All data and personal data will be handled in accordance with General Data Protection Regulations. Given the interactive nature of the research programme, knowledge dissemination to participants and stakeholders in the nine projects will be ongoing throughout the 6 years. External workshops—facilitated in collaboration with participating case studies and citizens—both during and at the end of the programme will provide an additional dissemination mechanism and involve health and social care practitioners, policymakers and third-sector organisations.

Challenging times: building a health, housing and social care local workforce strategy

2018 ◽  
Vol 21 (3/4) ◽  
pp. 108-122
Author(s):  
Patricia Dearnaley ◽  
Joanne E. Smith
Keyword(s):  
Service Delivery ◽  
Older People ◽  
Health Care Services ◽  
Social Care ◽  
Workforce Planning ◽  
Care Needs ◽  
Fiscal Impact ◽  
Content Type ◽  
Care Services ◽  
Health And Social Care

Purpose The purpose of this paper is to stimulate a wider debate around the coordination of workforce planning in non-statutory services (in this case, specialist housing for older people or those with long-term health and social care needs, such as learning disabilities). The authors argue that current NHS reforms do not go far enough in that they fail to include specialist housing and its workforce in integration, and by doing so, will be unable to optimise the potential efficiencies and streamlining of service delivery to this group. Design/methodology/approach The paper used exploratory study using existing research and data, enhanced by documentary analysis from industry bodies, regulators and policy think tanks. Findings That to achieve the greatest operational and fiscal impact upon the health care services, priority must be given to improving the efficiency and coordination of services to older people and those requiring nursing homes or registered care across the public and third sectors through the integration of service delivery and workforce planning. Research limitations/implications Whilst generalisable and achievable, the model proposed within the paper cannot be fully tested theoretically and requires further testing the in real health and social care market to evidence its practicality, improved quality of care and financial benefits. Originality/value The paper highlights some potential limitations to the current NHS reforms: by integrating non-statutory services, planned efficiency savings may be optimised and service delivery improved.

scholarly journals Informing patterns of health and social care utilisation in Irish older people according to the Clinical Frailty Scale

2021 ◽  
Vol 4 ◽  
pp. 54
Author(s):  
Aisling M. O'Halloran ◽  
Peter Hartley ◽  
David Moloney ◽  
Christine McGarrigle ◽  
Rose Anne Kenny ◽  
...  
Keyword(s):  
Older People ◽  
Social Care ◽  
Markov Models ◽  
Classification Tree ◽  
Community Health Services ◽  
Health Services Use ◽  
Care Needs ◽  
Clinical Frailty Scale ◽  
Care Utilisation ◽  
Health And Social Care

Background: There is increasing policy interest in the consideration of frailty measures (rather than chronological age alone) to inform more equitable allocation of health and social care resources. In this study the Clinical Frailty Scale (CFS) classification tree was applied to data from The Irish Longitudinal Study on Ageing (TILDA) and correlated with health and social care utilisation. CFS transitions over time were also explored. Methods: Applying the CFS classification tree algorithm, secondary analyses of TILDA data were performed to examine distributions of health and social care by CFS categories using descriptive statistics weighted to the population of Ireland aged ≥65 years at Wave 5 (n=3,441; mean age 74.5 (SD ±7.0) years, 54.7% female). CFS transitions over 8 years and (Waves 1-5) were investigated using multi-state Markov models and alluvial charts. Results: The prevalence of CFS categories at Wave 5 were: 6% ‘very fit’, 36% ‘fit’, 31% ‘managing well’, 16% ‘vulnerable’, 6% ‘mildly frail’, 4% ‘moderately frail’ and 1% ‘severely frail’. No participants were ‘very severely frail’ or ‘terminally ill’. Increasing CFS categories were associated with increasing hospital and community health services use and increasing hours of formal and informal social care provision. The transitions analyses suggested CFS transitions are dynamic, with 2-year probability of transitioning from ‘fit’ (CFS1-3) to ‘vulnerable’ (CFS4), and ‘fit’ to ‘frail’ (CFS5+) at 34% and 6%, respectively. ‘Vulnerable’ and ‘frail’ had a 22% and 17% probability of reversal to ‘fit’ and ‘vulnerable’, respectively. Conclusions: Our results suggest that the CFS classification tree stratified the TILDA population aged ≥65 years into subgroups with increasing health and social care needs. The CFS could be used to aid the allocation of health and social care resources in older people in Ireland. We recommend that CFS status in individuals is reviewed at least every 2 years.

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