Training implications of developments in intermediate care

2008 ◽  
Vol 18 (2) ◽  
pp. 159-164 ◽  
Author(s):  
PB Khanna ◽  
B Bhowmick
Keyword(s):  
Social Care ◽  
Geriatric Medicine ◽  
Intermediate Care ◽  
National Service ◽  
Medical Aspect ◽  
Care Services ◽  
National Service Framework ◽  
Health And Social Care ◽  
The Common ◽  
Service Framework

Key strands in developing future services in geriatric medicine in Wales have been the 2000 ‘Review of Health and Social Care in Wales’ by Sir Derek Wanless, the Welsh Assembly Government document ‘Designed for Life’ of May 2005, and the National Service Framework (NSF) For Older People in Wales (published in March 2006). The common theme in these documents is for older people's health and social care issues to be managed nearer to their home, in the community. At present, the development of Intermediate Care Services has been ‘hit and miss’ – fragmented, unevenly developed and delivered with poor integration into mainstream services. The Academy of the Royal College's Medical Aspect of Intermediate Care identifies the lack of specialist medical input as being one of the reasons for the failure of development of Intermediate Care Services. It recommended that geriatricians should be encouraged to undertake well-defined roles in community work in planning and delivery of Intermediate Care Services.

Alternatives to acute hospital care

2001 ◽  
Vol 11 (4) ◽  
pp. 373-378 ◽  
Author(s):  
H Gentles ◽  
J Potter
Keyword(s):  
Older People ◽  
Acute Hospital ◽  
Intermediate Care ◽  
National Service ◽  
Acute Hospital Care ◽  
Department Of Health ◽  
Health Authorities ◽  
National Service Framework ◽  
Hospital Beds ◽  
Service Framework

The National Bed Inquiry indicated that up to 20% of older people might be inappropriately occupying acute hospital beds and could be discharged if alternative services were available. The report proposed the concept of ‘Intermediate Care’ as a scenario that might contribute to resolving issues around the use of acute hospital beds. The Department of Health (DoH) Circular to Health Authorities and Local Councils with regard to Intermediate Care and the publication of the National Service Framework for Older People have brought intermediate care into mainstream health policy.

scholarly journals Medicines reablement in intermediate health and social care services

2017 ◽  
Vol 18 (04) ◽  
pp. 305-315
Author(s):  
Kate Gerrish ◽  
Sara Laker ◽  
Sarah Wright ◽  
Wendy Stainrod
Keyword(s):  
Social Care ◽  
Training Programme ◽  
Care Staff ◽  
Intermediate Care ◽  
Structured Interviews ◽  
Self Administration ◽  
Frontline Staff ◽  
Care Services ◽  
Health And Social Care ◽  
Pharmacy Technicians

Aim To evaluate a medicines reablement initiative involving health and social care, to include consideration of the training package, proportion of patients reabled successfully, and patient and staff perspectives of the service. Background Intermediate care services provide short-term intervention to support patients with chronic conditions transition from hospital to community-based services and involves maximising patients’ independence through reablement. The term ‘medicines reablement’ describes the process of rehabilitating patients to be independent with their medication. Methods Pharmacy technicians led the medicines reablement initiative. They delivered a competency-based training programme for frontline health and social care staff. They assessed and set goals with patients to facilitate independence in self-administration of their medication. The pharmacy technicians provided on-going support to staff helping patients to reable. They reassessed patients after six weeks to determine if medicines reablement had been successful or whether further input was needed. Data were collected by means of a questionnaire and semi-structured interviews with pharmacy technicians, frontline staff, managers, and patients. Findings Twenty per cent of patients discharged from hospital to intermediate care were assessed to be suitable for medicines reablement. Of these patients, 44% were successfully reabled and a further 25% benefited from the input of a pharmacy technician. Patients and staff were positive about medicines reablement, emphasising the importance of patients attaining independence for self-administration of medication. Although following training, health and social care staff felt confident in facilitating medicines reablement they valued on-going access to pharmacy technicians for timely support, help with problem solving, and advice throughout the reablement process. Conclusion Medicines reablement can lead to patients becoming independent with taking medication and contribute to staff satisfaction. Pharmacy technicians can play an important part in delivering medicines reablement training to frontline staff and overseeing the reablement process. Further research examining medicines reablement is needed to develop a stronger evidence base.

scholarly journals Mental health policy reforms and case complexity in CMHTs in England: replication study

2008 ◽  
Vol 32 (2) ◽  
pp. 49-52 ◽  
Author(s):  
Peter Huxley ◽  
Sherrill Evans ◽  
Maria Munroe ◽  
Leticia Cestari
Keyword(s):  
Mental Health ◽  
Mental Health Policy ◽  
National Service ◽  
Policy Reforms ◽  
Mental Health Team ◽  
Complex Problems ◽  
Care Services ◽  
National Service Framework ◽  
The Impact ◽  
Service Framework

Aims and MethodCommunity mental health team (CMHT) services in many Western countries have been remodelled to focus on people with the most severe illnesses and complex problems. Complexity scores using the Matching Resource to Care (MARC2) measure from CMHT cases in 2004–2005 (n=1481) are compared with scores in 1997–1998 (n=3178) in the same locations, before the introduction of the National Service Framework, and before the impact of the creation of integrated mental health trusts in England.ResultsThe 2004–2005 baseline complexity scores are all worse than those in 1997–1998.Clinical ImplicationsIf increased targeting brought about by the National Service Framework and other reforms has led to a greater proportion of people with complex problems in case-loads, what care services, if any, are now being received by people who were in receipt of CMHT services before the reforms?

Organizing geriatric services

2012 ◽  
pp. 13-50
Author(s):  
Lesley K Bowker ◽  
James D Price ◽  
Sarah C Smith
Keyword(s):  
Intensive Care ◽  
Older People ◽  
Intermediate Care ◽  
National Service ◽  
Community Hospitals ◽  
Older Patient ◽  
National Service Framework ◽  
Day Hospitals ◽  
Service Framework

Using geriatric services 14 Acute services for older people 16 The older patient in intensive care 17 The great integration debate 18 Admission avoidance schemes 20 Day hospitals 22 Specialty clinics 24 Intermediate care 26 The National Service Framework for Older People 28 Community hospitals ...

scholarly journals Use of medicines in nursing homes for older people

2002 ◽  
Vol 8 (3) ◽  
pp. 198-204 ◽  
Author(s):  
Lee Furniss
Keyword(s):  
Older People ◽  
Social Care ◽  
Medication Management ◽  
Total Budget ◽  
Department Of Health ◽  
National Service Framework ◽  
Maximum Benefit ◽  
Health And Social Care ◽  
Management Issues ◽  
Service Framework

The National Health Service (NHS) spent £10 billion (40%) of its total budget on people aged 65 and over in 1998/1999. The profile of the health and social care of older people has been raised recently by the publication of the National Service Framework (NSF) for Older People (Department of Health, 2001). The NSF contains standards that older people can expect when they receive health and social care (Box 1). The document also discusses in detail medication management issues in older people. Its two aims in this area are to ensure that older people gain the maximum benefit from their medication in order to maintain or improve quality and duration of life, and do not suffer unnecessarily from illness caused by excessive, inappropriate or inadequate consumption of medicines.

Intermediate care

2001 ◽  
Vol 11 (3) ◽  
pp. 205-207 ◽  
Author(s):  
S Thompson ◽  
P Crome
Keyword(s):  
Older People ◽  
Social Services ◽  
Care Home ◽  
Age Discrimination ◽  
Intermediate Care ◽  
National Service ◽  
Health And Social Services ◽  
Department Of Health ◽  
National Service Framework ◽  
Service Framework

The proportion of older people in our society is increasing more rapidly than any other section of the population. This group uses health and social services more than the young do and this is reflected in the NHS and social service budgets from recent years. For example, 40% of the NHS budget was spent on patients over 65 years in 1998. The much-heralded National Service Framework (NSF) for Older People, recently published by the Department of Health in England, was therefore awaited with much anticipation by all sections of the community concerned with older people’s health. This document is described as the ‘key vehicle for ensuring that the needs of older people are at the heart of the government’s reform programme for health and social services’. It has as its first and fundamental standard ‘rooting out age discrimination’. The sections on prevention and treatment of stroke, general hospital care, the management of falls and mental health have been generally well received and when implemented fully are likely to be beneficial to older people. Some areas such as the treatment of care home residents have not been addressed in nearly enough detail. In contrast, one particular section, that on ‘Intermediate Care’, has been heavily criticized, including a fierce attack by two of the United Kingdom’s leading geriatricians.

Intermediate care in nursing-led units – a comprehensive overview of the evidence base

2006 ◽  
Vol 16 (1) ◽  
pp. 71-77 ◽  
Author(s):  
Peter Griffiths
Keyword(s):  
Older People ◽  
Community Care ◽  
Evidence Base ◽  
Intermediate Care ◽  
Comprehensive Overview ◽  
Care Services ◽  
National Service Framework ◽  
Positive Statements ◽  
The Uk ◽  
Service Framework

The development of intermediate care services, aimed predominantly at older people, formed a significant part of the UK Department of Health's National Service Framework (NSF) designed to guide the development of services for older people at the beginning of the 21st Century. The stated intention was to provide a more appropriate environment of care for some of the large number of elderly patients who occupied acute beds ‘inappropriately’. The goal was to prevent unnecessarily extended stay in acute care, to improve the outcome of the transition between acute and community care and prevent ‘excess’ dependence, including unnecessary hospitalization and iatrogenic dependence. Despite such positive statements of intent, the plan to create 5000 intermediate care beds in the UK by 2004 led some to voice concern that this heralded a return to ‘workhouse’ wards. Fears were expressed that patients would experience inadequate rehabilitation and diagnostic failure due to lack of proper assessment.

scholarly journals The patient advisor, an organizational resource as a lever for an enhanced oncology patient experience (PAROLE-onco): a longitudinal multiple case study protocol

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M. P. Pomey ◽  
M. de Guise ◽  
M. Desforges ◽  
K. Bouchard ◽  
C. Vialaron ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Clinical Oncology ◽  
Patient Experience ◽  
Emotional Support ◽  
Social Care ◽  
Legal Issues ◽  
Care Services ◽  
Health And Social Care ◽  
Ethical And Legal Issues ◽  
The Impact

Abstract Background Quebec is one of the Canadian provinces with the highest rates of cancer incidence and prevalence. A study by the Rossy Cancer Network (RCN) of McGill university assessed six aspects of the patient experience among cancer patients and found that emotional support is the aspect most lacking. To improve this support, trained patient advisors (PAs) can be included as full-fledged members of the healthcare team, given that PA can rely on their knowledge with experiencing the disease and from using health and social care services to accompany cancer patients, they could help to round out the health and social care services offer in oncology. However, the feasibility of integrating PAs in clinical oncology teams has not been studied. In this multisite study, we will explore how to integrate PAs in clinical oncology teams and, under what conditions this can be successfully done. We aim to better understand effects of this PA intervention on patients, on the PAs themselves, the health and social care team, the administrators, and on the organization of services and to identify associated ethical and legal issues. Methods/design We will conduct six mixed methods longitudinal case studies. Qualitative data will be used to study the integration of the PAs into clinical oncology teams and to identify the factors that are facilitators and inhibitors of the process, the associated ethical and legal issues, and the challenges that the PAs experience. Quantitative data will be used to assess effects on patients, PAs and team members, if any, of the PA intervention. The results will be used to support oncology programs in the integration of PAs into their healthcare teams and to design a future randomized pragmatic trial to evaluate the impact of PAs as full-fledged members of clinical oncology teams on cancer patients’ experience of emotional support throughout their care trajectory. Discussion This study will be the first to integrate PAs as full-fledged members of the clinical oncology team and to assess possible clinical and organizational level effects. Given the unique role of PAs, this study will complement the body of research on peer support and patient navigation. An additional innovative aspect of this study will be consideration of the ethical and legal issues at stake and how to address them in the health care organizations.

scholarly journals Occupational therapists’ experiences of enabling people to participate in sport

2020 ◽  
pp. 030802262097394
Author(s):  
Deborah Bullen ◽  
Channine Clarke
Keyword(s):  
Qualitative Study ◽  
Occupational Therapy ◽  
Thematic Analysis ◽  
Social Care ◽  
Occupational Therapists ◽  
Phenomenological Approach ◽  
Scope Of Practice ◽  
Local Populations ◽  
Care Services ◽  
Health And Social Care

Introduction In response to growing demands on health and social care services there is an emphasis on communities addressing the needs of local populations to improve lives and reduce inequalities. Occupational therapists are responding to these demands by expanding their scope of practice into innovative settings, such as working with refugees, the homeless and residents of nursing homes, and within sport and leisure environments. The benefits of sport are widely acknowledged, and this paper argues that occupational therapists could play a pivotal role in enabling people to participate. Method This qualitative study drew on a phenomenological approach and used interviews and thematic analysis to explore five occupational therapists’ experiences of enabling people to participate in sport. Findings Findings revealed that participants demonstrated the uniqueness of occupational therapy when enabling people to participate in sport and practised according to their professional philosophy. There were opportunities to reach wider communities and promote the value of occupational therapy by collaborating with organisations, but there were also challenges when working outside of traditional settings. Conclusion The study emphasises the unique skills occupational therapists can bring to this setting. It highlights opportunities to expand their practice, to forge new partnerships in sports and leisure environments, and to address the national inactivity crisis.

Sign in / Sign up

Export Citation Format

Share Document