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Housing‐related support funded by Supporting People has developed in line with traditional service areas relating to criminal justice, health and social care. This means…
Housing‐related support funded by Supporting People has developed in line with traditional service areas relating to criminal justice, health and social care. This means that opportunities for developing integrated services geared to meeting the needs of mentally disordered offenders have been limited. Using a case study to explore service needs, a rethink of commissioning and support roles is recommended for forensic mental health services.
Connected Care, Turning Point's model for involving the community in the design and delivery of integrated health and well‐being services, aims to involve the community in…
Connected Care, Turning Point's model for involving the community in the design and delivery of integrated health and well‐being services, aims to involve the community in the commissioning process in a way which fundamentally shifts the balance of power in favour of local people. The model has been tested in a number of areas across the country, and previous articles in the Journal of Integrated Care have charted the progress of the original pilot in Hartlepool. Cost‐benefits of the approach are now becoming clearer. Implementation of a new community‐led social enterprise in Hartlepool began in 2007, and today its Connected Care service provides community outreach, information, access to a range of health and social care services, advocacy, co‐ordination and low‐level support to the people of Owton. Key lessons, from Hartlepool and elsewhere, have centred on the value of making the case for service redesign from the ‘bottom up’ and building the capacity of the community to play a role in service delivery, while also promoting strong leadership within commissioning organisations to build ‘top‐down’ support for the implementation of outcomes defined through intensive community engagement. The new Government's ‘localism’ agenda creates new opportunities for community‐led integration, and the Connected Care pilots provide a number of learning points about how this agenda might be successfully progressed.
This article is the second which the Journal of Integrated Care has published about the Hartlepool connected care pilot. It takes up the narrative from the launch of the…
This article is the second which the Journal of Integrated Care has published about the Hartlepool connected care pilot. It takes up the narrative from the launch of the community audit report in February 2006 to the project's successful bid to become one of the 26 DoH social enterprise pilots some 12 months later. It seeks to understand the barriers encountered as the pilot sought to implement a service model based on an audit of local needs and ambitions. It identifies the need for support outside the local policy systems if holistic, community‐based initiatives are to be initiated and implemented. In addition, it considers some of the implementation dilemmas that the pilot posed for local agencies and that it had itself to face and resolve during this second phase in its development.
Homelessness is a colossal issue, precipitated by a wide array of social determinants, and mirrored in substantial health disparities and a revolving hospital door…
Homelessness is a colossal issue, precipitated by a wide array of social determinants, and mirrored in substantial health disparities and a revolving hospital door. Connecting people to safe and secure housing needs to be part of the health system response. The paper aims to discuss these issues.
This mixed-methods paper presents emerging findings from the collaboration between an inner city hospital, a specialist homeless medicine GP service and Western Australia’s inaugural Housing First collective impact project (50 Lives 50 Homes) in Perth. This paper draws on data from hospitals, homelessness community services and general practice.
This collaboration has facilitated hospital identification and referral of vulnerable rough sleepers to the Housing First project, and connected those housed to a GP and after hours nursing support. For a cohort (n=44) housed now for at least 12 months, significant reductions in hospital use and associated costs were observed.
While the observed reductions in hospital use in the year following housing are based on a small cohort, this data and the case studies presented demonstrate the power of care coordinated across hospital and community in this complex cohort.
This model of collaboration between a hospital and a Housing First project can not only improve discharge outcomes and re-admission in the shorter term, but can also contribute to ending homelessness which is itself, a social determinant of poor health.
Coordinated care between hospitals and programmes to house people who are homeless can significantly reduce hospital use and healthcare costs, and provides hospitals with the opportunity to contribute to more systemic solutions to ending homelessness.
Too many health and social care services are failing to meet people's complex needs. In this paper, ‘complex needs’ is presented as a framework to help understand multiple…
Too many health and social care services are failing to meet people's complex needs. In this paper, ‘complex needs’ is presented as a framework to help understand multiple interlocking needs that span health and social issues. The concept encompasses mental health problems, combined with substance misuse and/or disability, including learning disability, as well as social exclusion. The paper outlines a strategy for promoting the well‐being and inclusion of people with complex needs. At the heart of this strategy is a new kind of delivery model: connected care centres, a type of bespoke social care service, a model which has been endorsed by the Social Exclusion Unit (SEU). In addition, the paper describes how new responses from existing services can promote better support for people with complex needs, such as a reformed commissioning process and a new ‘navigational’ role for the social care worker.
Hartlepool's connected care pilot is a partnership between residents, councillors, Turning Point, the NHS and the local council in one of the most deprived wards in…
Hartlepool's connected care pilot is a partnership between residents, councillors, Turning Point, the NHS and the local council in one of the most deprived wards in England. A local audit was conducted by residents, demonstrating the relevance of information held by the community about its needs, ambitions and interactions with services. A new service model aims to provide integrated responses to complex need, commissioned through a local partnership agreement and delivered through a social enterprise. The implementation will demonstrate how far real power is shifting to local people.
The Equal Pay Act 1970 (which came into operation on 29 December 1975) provides for an “equality clause” to be written into all contracts of employment. S.1(2) (a) of the 1970 Act (which has been amended by the Sex Discrimination Act 1975) provides:
Housing and support are essential if people misusing drugs and alcohol are to address their substance misuse and their other physical, mental and emotional health needs…
Housing and support are essential if people misusing drugs and alcohol are to address their substance misuse and their other physical, mental and emotional health needs. If their housing and related support needs are not addressed at each stage of the treatment journey, they are much less likely to enter or remain in treatment. This article outlines the policy context, discusses barriers in service development, explores the role of housing with support for substance users and gives examples of imaginative commissioning and provision. It is based on recent work for the Department of Health Care Services Improvement Partnership.
The purpose of this study is to develop new type of reverse mortgage contract. How to provide adequate services and housing for an increasing number of people that are…
The purpose of this study is to develop new type of reverse mortgage contract. How to provide adequate services and housing for an increasing number of people that are dependent on the help of others is a crucial question in the European Union (EU). The housing stock in Europe is not fit to support a shift from institutional care to the home-based independent living. Some 90% of houses in the UK and 70%–80% in Germany are not adequately built, as they contain accessibility barriers for people with emerging functional impairments. The available reverse mortgage contracts do not allow for relocation to their own adapted facilities. How to finance the adaptation from housing equity is discussed.
The authors have extended the existing loan reverse mortgage model. Actuarial methods based on the equivalence of the actuarial present values and the multiple decrement approach are used to evaluate premiums for flexible longevity and lifetime long-term care (LTC) insurance for financing adequate facilities.
The adequate, age-friendly housing provision that is appropriate to support the independence and autonomy of seniors with declining functional capacities can lower the cost of health care and improve the well-being of older adults. For financing the development of this kind of facilities for seniors, the authors developed the reverse mortgage scheme with embedded longevity and LTC insurance as a possible financial instrument for better LTC services and housing with care in assisted-living facilities. This kind of facilities should be available for the rapid growth of older cohorts.
The numerical example is based on rather crude numbers, because of lack of data, as the developed reverse mortgage product with LTC insurance is a novelty. Intensity of care and probabilities of care in certain category of care will change after the introduction of this product.
The model results indicate that it is possible to successfully tie an insurance product to the insured and not to the object.
The introduction of this insurance option will allow many older adult with low pension benefits and a substantial home equity to safely opt for a reverse mortgage and benefit from better social care.
While currently available reverse mortgage contracts lapse when the homeowner moves to assisted-living facilities in any EU Member State, in the paper a new method is developed where multiple adjustments of housing to the functional capacities with relocation is possible, under the same insurance and reverse mortgage contract. The case of Slovenia is presented as a numerical example. These insurance products, as a novelty, are portable, so the homeowner can move in own specialised housing unit in assisted-living facilities and keep the existing reverse mortgage contract with no additional costs, which is not possible in the current insurance products. With some small modifications, the method is useful for any EU Member State.
The Government has put emphasis on preventing inappropriate admissions to hospital and long‐term care and helping people to live at home. The National Service Framework…
The Government has put emphasis on preventing inappropriate admissions to hospital and long‐term care and helping people to live at home. The National Service Framework for Older People focuses on promoting older people's independence and fitting services around people's needs. In this climate Housing with Care is presented as an attractive alternative to residential care, mainly for older people. Such schemes maintain people in complexes of purpose‐built flats in the community with care and support on site 24 hours a day. This article looks at the experience of Norfolk County Council in providing Housing with Care for older people.