scholarly journals Remote care technologies, older people and the social care crisis in the United Kingdom: a Multiple Streams Approach to understanding the ‘silver bullet’ of telecare policy

2020 ◽  
pp. 1-22
Author(s):  
Andrew Eccles
Keyword(s):  
Older People ◽  
Information And Communication Technologies ◽  
Social Care ◽  
Multiple Streams ◽  
Care Needs ◽  
Multiple Streams Approach ◽  
Health And Social Care ◽  
Care Relationships ◽  
Remote Care ◽  
Silver Bullet

Abstract The policy announcement in November 2018 by the Secretary of State for Health and Social Care that: ‘from today, let this be clear: tech transformation is coming’ indicates that confidence in care technologies, so apparent over the past decade in policy circles, remains unabated. This article suggests, based on evidence of significant limitations in technological solutions to care needs, that this confidence is misplaced. The focus is on remote care technologies – primarily telecare – which involve the passive or real-time monitoring of recipients, the majority of whom will be older people. These information and communication technologies (ICT) have been heralded by politicians, policy makers and industry interests alike as a solution to the challenges of demographic change and social care demand. While the research evidence suggests telecare works well for some people, in some circumstances, there are also significant complexities in its use, challenges presented to care relationships, and conflicting interpretations around its efficacy and cost-effectiveness. These critical issues have been marginalised in the mainstream discourse around telecare policy. This article explores the dissonance between this policy and the available evidence, drawing on a Multiple Streams Approach to analyse the emergence of, and continued confidence in, telecare policy based on a congruence of views across policy interests. To the extent that social care for older people is now in crisis, the article argues that the discourse around telecare represents an example of ‘silver bullet’ thinking: that is, too much focus on a single policy solution to address complex problems. Accordingly, the crisis in social care has deepened, without alternative policy proposals being available to address it. The renewed push for ICT-based solutions to this crisis in social care ought therefore to be viewed with some concern.

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.

Role of the Single Assessment Process in the Care of Older People. How Will Primary Dental Care Practitioners be Involved?

2006 ◽  
Vol os13 (4) ◽  
pp. 130-134 ◽  
Author(s):  
Elizabeth A Lane ◽  
Jennifer E Gallagher
Keyword(s):  
Older People ◽  
Dental Care ◽  
Social Care ◽  
Assessment Process ◽  
Care Needs ◽  
National Service Framework ◽  
Health And Social Care ◽  
Dental Practitioners ◽  
One Stop

Following the publication of the National Service Framework for Older People, there have been developments across health and social care to facilitate holistic assessment of older people's needs, through what is called a ‘single assessment process’ or ‘SAP’. In this paper, readers are introduced to the SAP. The process can be seen as a ‘one-stop’ approach to the assessment of vulnerable older people that facilitates cross-referral between the agencies involved and triggers access to dental care. The paper explores the benefits of this new way of working in support of older people and how it will provide an opportunity for innovative dental practitioners to integrate oral healthcare for people with complex health and social care needs into the SAP. In concludes that as local commissioning evolves, opportunities for practitioners to develop targeted services for this important patient group should be expanded to improve the uptake of healthcare and oral healthcare.

scholarly journals Comprehensive assessment of older people with complex care needs: the multi-disciplinarity of the Single Assessment Process in England

2010 ◽  
Vol 30 (7) ◽  
pp. 1115-1134 ◽  
Author(s):  
DAVID CHALLIS ◽  
MICHELE ABENDSTERN ◽  
PAUL CLARKSON ◽  
JANE HUGHES ◽  
CAROLINE SUTCLIFFE
Keyword(s):  
Older People ◽  
Social Care ◽  
Local Authority ◽  
Care Home ◽  
Comprehensive Assessment ◽  
Assessment Process ◽  
Care Plan ◽  
Assessment Practice ◽  
Care Needs ◽  
Health And Social Care

ABSTRACTThe quality of assessment of older people with health and social care needs has for some time been a concern of policy makers, practitioners, older people and carers in the United Kingdom and internationally. This article seeks to address a key aspect of these concerns, namely whether sufficient expertise is deployed when, as a basis for a care plan and service allocation, an older person's eligibility for local authority adult social-care services requires a comprehensive needs assessment of their usually complex and multiple problems. Is an adequate range of professionals engaged, and is a multi-disciplinary approach applied? The Single Assessment Process (SAP) was introduced in England in 2004 to promote a multi-disciplinary model of service delivery. After its introduction, a survey in 2005–06 was conducted to establish the prevalence and patterns of comprehensive assessment practice across England. The reported arrangements for multi-disciplinary working among local authority areas in England were categorised and reviewed. The findings suggest, first, that the provision of comprehensive assessments of older people that require the expertise of multiple professionals is limited, except where the possibility arose of placement in a care-home-with-nursing, and second that by and large a systematic multi-disciplinary approach was absent. Policy initiatives to address the difficulties in assessment need to be more prescriptive if they are to produce the intended outcomes.

scholarly journals Supporting shared decision making for older people with multiple health and social care needs: a realist synthesis

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Frances Bunn ◽  
Claire Goodman ◽  
Bridget Russell ◽  
Patricia Wilson ◽  
Jill Manthorpe ◽  
...  
Keyword(s):  
Decision Making ◽  
Older People ◽  
Shared Decision Making ◽  
Social Care ◽  
Realist Synthesis ◽  
Shared Decision ◽  
Care Needs ◽  
Health And Social Care ◽  
Multiple Health

Reducing unplanned hospital admissions in Older people with high needs: a review of local practice in a small sample of primary care patients in an inner London borough.

2016 ◽  
Vol 6 (2) ◽  
pp. 108-118
Author(s):  
Harriet Selina Anne Sinclair ◽  
Alison Furey
Keyword(s):  
Primary Care ◽  
High Risk ◽  
Older People ◽  
Social Care ◽  
Hospital Admissions ◽  
Health Check ◽  
Care Needs ◽  
Health And Social Care ◽  
Risk Patients ◽  
Unplanned Hospital Admissions

Background: Older people with complex health and social care needs are a growing group of people with high use of NHS and social services. In particular, this group account for a large number of unplanned hospital admissions a year.Aims: To evaluate the evidence base for preventing unplanned hospital admissions in this group, to identify their characteristics and to undertake a focussed local review of their primary care management.Methods: A literature review, a review of the Southwark CCG data risk stratification tool and a review of high risk patients and their management at a Southwark GP practice.Results: High risk patients have multiple comorbidities and are frequent users of healthcare services. Although there was in general good involvement with social care services, there were certain areas that could be improved upon. For instance, the referral of frequent fallers to falls services and provision of an older person’s annual health check both offer opportunities for primary prevention.Conclusions: An older person’s annual health check would ensure holistic assessment of their health and social care needs and could then be acted upon to ensure that there is the required level of support in place, including a personalised anticipatory care plan and attention to key preventative measures such as falls prevention, exercise, smoking cessation, medicines optimisation and sensory impairment.

Exploring the health and social care needs of older people with a drug problem

2018 ◽  
Vol 26 (6) ◽  
pp. 493-501 ◽  
Author(s):  
Catriona Matheson ◽  
Emma Hamilton ◽  
Jason Wallace ◽  
David Liddell
Keyword(s):  
Older People ◽  
Social Care ◽  
Drug Problem ◽  
Care Needs ◽  
Health And Social Care
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