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Article
Publication date: 17 May 2019

Chris Hatton

The purpose of this paper is to examine trends over time in social care usage and expenditure for adults with learning disabilities in England.

Abstract

Purpose

The purpose of this paper is to examine trends over time in social care usage and expenditure for adults with learning disabilities in England.

Design/methodology/approach

Returns from councils with social services responsibilities in England concerning social care usage and expenditure were analysed to examine the national picture and trends over time for adults with learning disabilities.

Findings

In 2017/2018, 147,915 adults with learning disabilities were receiving long-term social care, an increase of 5.7 per cent from 2014/2015. Social care expenditure increased by 10.2 per cent from 2014/2015 to £5.54bn in 2017/2018; adjusted for inflation this was a 2.7 per cent increase. For adults with learning disabilities who receive social care, increasing numbers of people are living with families or in supported accommodation/living, with gradual declines in the number of people living in residential or nursing care. The number of adults with learning disabilities in temporary accommodation is small but increasing.

Social implications

While councils appear to be attempting to protect social care for adults with learning disabilities in the face of cuts to council expenditure, social care expenditure and coverage are not keeping pace with likely increases in the number of adults with learning disabilities requiring social care.

Originality/value

This paper presents in one place statistics concerning long-term social care for adults with learning disabilities in England.

Details

Tizard Learning Disability Review, vol. 24 no. 2
Type: Research Article
ISSN: 1359-5474

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Article
Publication date: 1 April 2007

Jenny Robb and Peter Gilbert

Integration is a watchword in Government policy, designed to give more seamless, and therefore more effective, services to people in need. One concern, though, is that…

Abstract

Integration is a watchword in Government policy, designed to give more seamless, and therefore more effective, services to people in need. One concern, though, is that this is merely a ‘structural’ approach that just rearranges the deckchairs. This paper gives a practical example of a positive, local leadership approach to integration within a national context.

Details

International Journal of Leadership in Public Services, vol. 3 no. 1
Type: Research Article
ISSN: 1747-9886

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Article
Publication date: 28 November 2012

Derek Birrell and Deirdre Heenan

This paper assesses the recommendations and proposals contained in Transforming Your Care, the recent review of health and social care in Northern Ireland, in the context…

Abstract

Purpose

This paper assesses the recommendations and proposals contained in Transforming Your Care, the recent review of health and social care in Northern Ireland, in the context of the existing integrated structures. It is designed to promote a better understanding of the implications of the proposed reconfiguration of health and social care.

Design/methodology/approach

This paper reviews a number of published documents encompassing an independent review and subsequent plans and strategies. It also draws upon a case study of a Rapid Access Clinic undertaken by the authors as part of a wider research project.

Findings

The paper concludes that the planned changes question the ability of an integrated structure operating across primary, secondary and social care. It notes that there are real concerns about the capacity of the social care workforce to deliver services. It is suggested that the proposal for Integrated Care Partnerships can be seen as a reflection of the need for a more localised approach to delivery.

Research limitations/implications

The findings are derived from a small‐scale study and as such may make generalisation difficult. There is a clear need for a more robust evidence‐based approach to the evaluation of structural integration in health and social care and a process for monitoring of this change process.

Originality/value

The article is a reminder of the unique example of structural integration within the UK. As such it could have important lessons for England, Scotland and Wales which are moving in a similar direction.

Details

Journal of Integrated Care, vol. 20 no. 6
Type: Research Article
ISSN: 1476-9018

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Article
Publication date: 1 June 2006

Peter Beresford

This article offers a personal view of the White Paper, Our Health, Our Care, Our Say, from a service user perspective. The Minister for Care Services, Liam Byrne, has…

Abstract

This article offers a personal view of the White Paper, Our Health, Our Care, Our Say, from a service user perspective. The Minister for Care Services, Liam Byrne, has stressed that the philosophy of the White Paper is based on strengthening personal control over support, prevention and the integration of health, social care and other services. This discussion examines the emphasis on health over social care in the presentation of the White Paper. It puts the document in the broader context of social care policy development over the last 20 years, and relates it to the views of service users expressed in consultations leading up to its publication. It considers the White Paper's potential ambiguity, its relation with resource issues and what next steps may be needed to take forward its positive principles.

Details

Journal of Integrated Care, vol. 14 no. 3
Type: Research Article
ISSN: 1476-9018

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Article
Publication date: 14 December 2010

Caroline Glendinning

This article proposes principles for reforming English adult social care by drawing on the experiences of other countries. These illustrate how the funding, organisation…

Abstract

This article proposes principles for reforming English adult social care by drawing on the experiences of other countries. These illustrate how the funding, organisation and delivery of services could be reformed, and shed light on the potential political and social factors affecting implementation of reforms.Reforms in other countries are commonly driven by the desire to develop and/or maintain universal access to social care. Formerly fragmented, un‐co‐ordinated and locally variable arrangements are being replaced with universal schemes, with national eligibility arrangements applicable to everyone regardless of age or ability to pay. Cash payments (personal budgets etc) instead of services in kind are widely used. However, such options can have different aims, including supporting family carers and stimulating local provider markets, as well as offering ‘consumer’ choice. Policies for family carers are usually integral to overall long‐term care arrangements. Finally, even in federal systems like Germany, Austria, Spain and Australia, central governments play a crucial role in ensuring universal, equitable and sustainable social care. Central government leadership: maximises risk pooling; enhances budgetary control mechanisms; safeguards equity and quality control; and provides political legitimacy.

Details

Quality in Ageing and Older Adults, vol. 11 no. 4
Type: Research Article
ISSN: 1471-7794

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Article
Publication date: 26 June 2009

David Hewitt

A recent Law Commission paper claims that the law on adult social care is complex and based on outdated concepts, and therefore needs to be reformed. The boundary between…

Abstract

A recent Law Commission paper claims that the law on adult social care is complex and based on outdated concepts, and therefore needs to be reformed. The boundary between health care and social care services is less clear than it once was, but its existence can be damaging to service users. Although there is good evidence of integrated working, more needs to be done. Existing duties could be consolidated, or health care and social care bodies ‐ and perhaps others ‐ could be placed under a general duty to co‐operate.

Details

Journal of Integrated Care, vol. 17 no. 3
Type: Research Article
ISSN: 1476-9018

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Article
Publication date: 31 December 2009

Brian Cox

The challenge of developing leadership in a mass public service where previous notions of leadership have been narrow and limited only to senior positions is being taken…

Abstract

The challenge of developing leadership in a mass public service where previous notions of leadership have been narrow and limited only to senior positions is being taken up by the National Skills Academy for Social Care. This article describes the leadership development challenge in the English adult care sector, which is undergoing major policy and organisational change as a result of greater control of resources passing directly to people who need care support. The author sets out the initial guiding principles of the Skills Academy for Social Care and their approach to leadership development rooted in the values of the care sector and the reality of care and support work ‐ dispersed, low status, highly skilled and with a strong commitment to rights, entitlements and empowerment. In particular the Academy is adopting an emphasis on behaviours and personal attributes in its leadership approach that are informed by people who use care services who demand more responsive and personalised support. The article sets out a number of key principles on which the Academy will seek partnerships and collaboration to deliver greater engagement with leadership development across all who work in the sector.

Details

International Journal of Leadership in Public Services, vol. 5 no. 4
Type: Research Article
ISSN: 1747-9886

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Article
Publication date: 2 April 2010

Richard Humphries

Social care is likely to be a key campaign issue in the 2010 general election. An overview of the current policy positions of the major political parties suggests a…

Abstract

Social care is likely to be a key campaign issue in the 2010 general election. An overview of the current policy positions of the major political parties suggests a consensus in many areas, notably personalisation, the third sector, reducing bureaucracy, and closer working between health and social care. Differences may be sharper in policy detail and how future funding should be reformed. Irrespective of who wins the election, the forthcoming spending squeeze will focus attention on how to achieve more with fewer resources, and health and social care integration is likely to become a higher policy priority.

Details

Journal of Integrated Care, vol. 18 no. 2
Type: Research Article
ISSN: 1476-9018

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Article
Publication date: 1 December 2005

Steve Iliffe, Kalpa Kharicha, Claire Goodman, Cameron Swift, Danielle Harari and Jill Manthorpe

Successive policy documents concerning older people's health and well‐being have aimed to improve their care, by raising standards and promoting independence. These…

Abstract

Successive policy documents concerning older people's health and well‐being have aimed to improve their care, by raising standards and promoting independence. These policies also emphasise the need for research to prevent disability, and reduce admission to hospitals and long‐term care settings. This paper reports an evaluation in progress of a health technology approach designed to achieve these objectives. An ‘expert system’ is described that is intended to improve older people's access to health and social care information, to enable service providers to review the health and social care needs of older people, and to allow planners to assess the needs of whole populations. The paper ends by inviting discussion and responses from readers of this journal.

Details

Quality in Ageing and Older Adults, vol. 6 no. 4
Type: Research Article
ISSN: 1471-7794

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Article
Publication date: 1 February 2004

Ray Jones

The paper charts ten years of movement in Wiltshire towards greater integration for health and social care, and highlights two important messages for others at different…

Abstract

The paper charts ten years of movement in Wiltshire towards greater integration for health and social care, and highlights two important messages for others at different stages of the process. The first is that while an early strategic vision can create the right conditions, there can be no short cuts to effective integration. The second is that independent evaluation is necessary to produce the evidence to sustain initiatives and promote organisational and professional learning ‐ which are key ingredients of the change process.

Details

Journal of Integrated Care, vol. 12 no. 1
Type: Research Article
ISSN: 1476-9018

Keywords

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