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Performance measures are an important mediating mechanism that influences the design and delivery of care. Unfortunately, it is still commonly the case that acute care indicators are employed to assess the efficacy of integrated care. This hinders the ability to accurately assess and continuously improve integrated care efforts for priority populations, including older persons who live with complex health and social care requirements. A core set of indicators is needed from which to assess the quality and impact of integrated care on these older persons and care partners.

A modified Delphi process was employed that comprised of the following steps: (1) selection of an indicator inventory (2) defining criteria for ranking and achieving consensus, (3) recruiting participants, (4) iterative voting rounds and analysis and (5) selection of a core indicator set.

The study produced a core set of 16 indicators of integrated care that pertain to older persons who live with health and social care requirements. The set can be applied by health and social care organizations and systems to assess the quality and impact of integrated care for this population across the continuum of care.

Although the gap in the availability of relevant indicators was the impetus for the study, this also meant there was a dearth of validated indicators to draw from. There are significant gaps in commonly used data sets with respect to indicators of integrated care as it relates to older persons and care partner.

The indicator set is intended to follow the older person and care partner throughout their health journey, enabling a whole systems view of their care. The set can be used in full or in part by health and social care systems and organizations across various primary, acute, rehabilitative and community settings for program development and evaluation purposes.

The core set of indicators that emerged out of this study is a first step toward ensuring that older persons who live with complex health and social care requirements and their care partners receive quality integrated care across the continuum of care.

The findings are informed by the perspectives of older persons, care partners and healthcare professionals. Future research is needed to test, validate and potentially expand the indicator set.

This article is concerned with strategies for combating health inequalities for refugees. It explores a service provider's (St Pancras Refugee Centre) response to the mental health and social care needs of refugees in the London Borough of Camden. Drawing on primary and secondary research, the article presents relevant findings and theoretical discourse in this area. It also draws on my own experience of working with refugees, providing a holistic approach to their social care requirements. The main focus is an examination of how social care and mental health needs are addressed. The article argues that providers need to develop services which engage with users on a mutually beneficial level in order to combat health inequalities and provide adequate health and social care provision.

In the context of current developments in children ' s services in the UK and increased emphasis on workforce development, the authors describe a survey of successful completers of a Post-qualifying (PQ) Child Care Award Programme, one of 18 such programmes in England that ran between 2001 and 2006/7. The survey ' s aims were twofold: first, to gather the respondents ' overall evaluations of their PQ training and information about their past and current work circumstances; and second, to explore their knowledge and opinions on the latest developments in children ' s services in relation to their own work practices. The findings from the survey are outlined under four themes, which are then discussed in relation to other relevant studies, reviews on the role and tasks of social workers and current developments associated with the Every Child Matters agenda and the integrated workforce. Concerns are raised about whether social work professionalism is being effectively utilised within the current children ' s services arrangements.

Integrated care continues to be a central aim within health and social care policy in England. Personal budgets and personal health budgets aim to place service users at the centre of decision-making and are part of a wider long-term initiative working towards personalised and integrated care. Personal budgets began in social care with the national pilot programme of individual budgets, which aimed to incorporate several funding streams into one budget, but in practice local authorities limited these to social care expenditure. Personal budgets then moved into the health care sector with the introduction of a three-year personal health budgets pilot programme that started in 2009. The purpose of the paper is to explore the post-pilot implementation of personal health budgets and explore their role in facilitating service integration. We examine this through the RE-AIM framework.

During 2015 and 2016, eight organisational representatives, 23 personal health budget holders and three service providers were interviewed, 42 personal health budget support plans were collected and 14 service providers completed an online survey.

Overall, personal health budgets continued to be viewed positively but progress in implementation was slower than expected. Effective leadership, clear communication and longer-term implementation were seen as vital ingredients in ensuring personal health budgets are fully embedded and contribute to wider service integration.

The paper highlights the importance of policy implementation over the longer-term, while illustrating how the venture of personal health budgets in England could be a mechanism for implementing service integration. The findings can serve to guide future policy initiatives on person-centred care and service integration.

The starting point of the paper is the meteoric rise of care and care work upon the societal and sociological agenda. Referring to Polanyi, the authors argue that this is the manifestation of a new phase of capitalist societalisation (Vergesellschaftung) of social reproduction in the form of an economic shift. The purpose of this paper is to discuss the societal organisation of care and care work and questions of inequality and justice.

The first part of the paper illustrates some facets of the economic shift in the field of care and care work. The second part reconstructs the societal organisation of care and care work in the private sector, state, third sector and private households from the mid-twentieth century in the context of questions of inequality and justice. The third part draws on the institutional logics perspective and French pragmatic sociology and the own case studies on home care agencies (HCA), residential care communities (RCC) and early child care (ECC) in Austria and Germany and shows how conflicting demands give rise to new questions of justice. The paper ends with a short conclusion.

The paper shows how the commodification and de-commodification of care and care work have changed over time and how the economic shift – illustrated in the case of HCA, RCC and ECC – is accompanied by conflicting demands and questions of justice.

A Polanyian perspective on the relation between market and society is combined with the neo-institutionalist and pragmatic idea that orientations rooted in the “logics” of the market, the state, the family and the profession influence how conflicting demands in elder and child care are dealt with and how questions of inequality and justice arise.

The Care Standards Act 2000 is designed to regulate and improve the management of residential care homes and other services. It provides a legislative framework for good practice, testing quality and enforceable minimum standards. In practice, its introduction has been difficult and providers have been closing homes. This article looks at the practical consequences for providers and identifies the positive and negative effects.

This is a report on a recent development of an innovative coordinated care solution named the Care Coordination Centre (CCC), which targets coordinated care arrangements for a populations expected to benefit the most. The purpose of this paper is to identify the patients who might comprise this group, and to assess the best ways to meet their health, community, and social care needs before and after introducing the coordinated care solution across care settings.

This is a summary of the author’s experience in the design and development of a care coordination business model for US providers and UK Clinical Commissioning Groups (CCGs) using coordinated care not only as a cost-cutting tool, but as a mechanism for creating a flexible and responsive patient-centered care. The author makes an assessment of the economic benefits of coordinated care resulting from: the shift to less costly interventions; reduction in readmissions; reduced unplanned admissions; increased time allocation efficiency of healthcare staff; and the overall reduction in per-patient costs.

The health and social care systems in the USA and the UK are facing the biggest challenges in their history. Payers, providers, governments, and communities need to work to build better coordination and integration mechanisms to manage the increasing demand on health and social care in a period of stagnant health and social care budgets. New innovative models of coordinated care have been developed in both countries, at the local economy level, as the health service systems are undergoing crucial transformation from a supply to a demand-based model. In the UK, the Trafford CCG has commissioned a new CCC, responsible for the delivery of high-quality coordinated care. The CCC is designed to function at clinical, service, and community levels across multiple providers to cover, among other tasks, chronic condition patient case management, risk stratification of preventative, elective, and unscheduled care for the whole region.

Insights from the work with Trafford CCG would be of considerable methodological and practical interest to researchers, policy makers, commissioners, healthcare professionals, and innovators.

This paper seeks to discuss the collaborative development and piloting of joint user outcome measures for older adults with mental health problems (OAMH) and their carers. Outcome measures are crucial to measuring the impact of services on people's lives and are central to the new NHS and Adult Social Care (ASC) Outcome Frameworks.

The paper describes the development of a joint user outcome measure based on ASC User Experience Surveys (UES) and User Outcome Measures, and NHS Patient Reported Outcome Measures (PROMS) and Patient Reported Experience Measures (PREMS).

The aim was to supplement existing clinical outcome measures (HONOS65+) with holistic measures of the impact of services on the lives of patients, easy to administer, covering a range of health and social care outcomes and meeting both health and social care outcome requirements.

As far as is known this is one of the first tests of a joint patient reported experience and outcome measure. Such measures may enable joint services to: measure wider outcomes as well as clinical outcomes; meet the new focus on outcomes; and enable more systematic collection of outcome and effectiveness/Value for Money (VFM) data. There are also lessons about collaborative working and development.

This paper aims to whether current public expenditure on adult social care services might be associated with the number of delayed days of care attributable to the social care system in England.

Panel econometric models on data from local authorities with adult social care responsibilities in England between 2013–2014 and 2018–2019.

After controlling for other organisational sources of inefficiency, the level of demand in the area and the income poverty amongst the resident older population, this paper finds that a 4.5% reduction in current spending per head on adult social care per older person in one year is associated with an increase by 0.01 delayed days per head the following year.

Given the costs of adverse outcomes of delayed transfers of care reported in the literature, this paper suggests that budgetary constraints to adult social care services would represent a false economy of public funds.

This is the first paper that models the association between public spending on adult social care and delayed transfers of care due to issues originating in the social care system in England.

The COVID-19 pandemic has shone a light on long-standing, structural race inequality in Britain. This paper aims to review historic patterns of ethnic diversity among the workforce employed in services for older people to present some of the lessons that can be learned from the pandemic.

A historical overview was undertaken of research about ethnic diversity in the social care workforce.

Too often, the ethnic diversity of the social care workforce has been taken as evidence that structural racial inequalities do not exist. Early evidence about the impact of coronavirus on workers from black and minority ethnic groups has led to initiatives aimed at reducing risk among social care employers in the independent sector and in local government. This offers a blueprint for further initiatives aimed at reducing ethnic inequalities and promoting ethnic diversity among the workforce supporting older people.

The increasing ethnic diversity of the older population and the UK labour force highlights the importance of efforts to address what is effective in reducing ethnic inequalities and what works in improving ethnic diversity within the social care workforce and among those using social care services for older people.

The ethnic makeup of the workforce reflects a complex reality based on multiple factors, including historical patterns of migration and gender and ethnic inequalities in the UK labour market.