scholarly journals The nature of gambling-related harm for adults with health and social care needs: an exploratory study of the views of key informants

Author(s):  
Stephanie Bramley ◽  
Caroline Norrie ◽  
Jill Manthorpe

Abstract Aim: To explore the views of professionals working within health, care and other agencies about harmful gambling among adults with health and social care needs. Background: Gambling is increasingly seen as a public health rather than an individual problem. Opportunities to gamble have grown in England in the last decade since the liberalisation of the gambling industry meaning that gambling is widely available, accessible and advertised within society. An estimated two million people in the UK are at risk of developing a gambling problem, some of whom may be adults with health and social care needs. Methods: Twenty-three key informants from primary care, social care services and third sector organisations in England were interviewed about their understanding of the risks to adults with health and social care needs from gambling participation. Findings: Thematic analysis revealed four themes: (1) gambling-related harm as a public health problem; (2) identification of groups of adults with health and social care needs who may be vulnerable to gambling-related harm; (3) factors potentially impeding the identification of gambling-related harm among adults with health and social care needs and subsequent help-seeking behaviour and (4) calls for professional development activities. Informants reported a perceived lack of awareness of gambling-related harm and a lack of a clear pathway or guidance which they could follow when supporting individuals experiencing gambling-related harm. Interviewees called for professional development activities to improve their knowledge and expertise in this area.

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
S Ozcurumez ◽  
S Akyuz ◽  
H Bradby

Abstract Background Sexual and gender-based violence affects an unknown proportion of Syrians seeking refuge from the ongoing conflict. Exile implies a vulnerability to gendered harms with consequent health effects over the short- and long-term. Services for refugees tend to presume physical gendered harms accruing to women prior to exile, with little attention paid to the effects on refugees’ settlement in the new society. Methods Interviews with health and social care providers of services to refugees in Sweden (n = 20) and Turkey (n = 20), including international organisations, non-government agencies, municipal and other statutory agents. Results Definitions of sexual and gender-based violence that inform service delivery vary greatly between health and social care service providers, with these definitions proving critical for how services are configured and provided. Service providers may consider longer-term health problems arising from refugees’ experience of sexual and gender-based violence, but refugees’ prospects of integration are rarely explicitly addressed. Refugees’ own views on their health and social care needs do not inform the design or development of service provision. Conclusions The experience of sexual and gender-based violence by refugees from Syria is widely recognised among health and social care providers in Turkey and Sweden. However, the experience of such violence is rarely addressed as a public health problem, that is, as a social determinant of ill health and, furthermore, an impediment to successful integration. The long-term, ill effects of sexual and gender-based violence, as seen over the lifecourse, are over-looked when considering refugees. Key messages Services for refugees who have been subject to sexual and gender-based violence vary in terms of how that violence is understood and which of its outcomes are addressed. Sexual and gender-based violence when experienced by refugees is rarely seen as a public health problem.


The Lancet ◽  
2017 ◽  
Vol 390 (10103) ◽  
pp. 1630-1631 ◽  
Author(s):  
Andrew Dilnot

2018 ◽  
Vol 21 (3/4) ◽  
pp. 108-122
Author(s):  
Patricia Dearnaley ◽  
Joanne E. Smith

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.


2021 ◽  
Vol 4 ◽  
pp. 54
Author(s):  
Aisling M. O'Halloran ◽  
Peter Hartley ◽  
David Moloney ◽  
Christine McGarrigle ◽  
Rose Anne Kenny ◽  
...  

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.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Vladimir Khanassov ◽  
Laura Rojas-Rozo ◽  
Rosa Sourial ◽  
Xin Qiang Yang ◽  
Isabelle Vedel

Abstract Background Persons living with dementia have various health and social care needs and expectations, some which are not fully met by health providers, including primary care clinicians. The Quebec Alzheimer plan, implemented in 2014, aimed to cover these needs, but there is no research on the effect this plan had on the needs and expectations of persons living with dementia. The objective of this study is to identify persons living with dementia and caregivers’ met and unmet needs and to describe their experience. Methods This is a sequential mixed methods explanatory design: Phase 1: cross-sectional study to describe the met and unmet health and social care needs of community-dwelling persons living with dementia using Camberwell Assessment of Need of the Elderly and Carers’ Assessment for Dementia tools. Phase 2: qualitative descriptive study to explore and understand the experiences of persons living with dementia and caregivers with the use of social and healthcare services, using semi-structured interviews. Data from phase 1 was analyzed with descriptive statistics, and from phase 2, with inductive thematic analysis. Results from phases 1 and 2 were compared, contrasted and interpreted together. Results The mean total number of needs reported by the patients was 5.03 (4.48 and 0.55 met and unmet needs, respectively). Caregivers had 0.52 met needs (3.16 unmet needs). The main needs for both were memory, physical health, eyesight/hearing/communication, medication, looking after home, money/budgeting. Three categories were mentioned by the participants: Persons living with dementia and caregiver’s attitude towards memory decline, their perception of community health services and of the family medicine practice. Conclusions Our study confirms the findings of other studies on the most common unmet needs of the patients and caregivers that are met partially or not at all. In addition, the participants were satisfied with access to care, and medical services in primary practices, being confident in their family. Our results indicate persons living with dementia and their caregivers need a contact person, a clear explanation of their dementia diagnosis, a care plan, written information on available services, and support for the caregivers.


BJGP Open ◽  
2020 ◽  
Vol 4 (1) ◽  
pp. bjgpopen20X101013
Author(s):  
Jonathan Donald Kennedy ◽  
Serena Moran ◽  
Sue Garrett ◽  
James Stanley ◽  
Jenny Visser ◽  
...  

BackgroundRefugees and asylum seekers have specific health and social care needs on arrival in a resettlement country. A third group — migrants with a refugee-like background (refugee-like migrants) — are less well defined or understood.AimUsing routinely collected data, this study compared demographics, interpreter need, and healthcare utilisation for cohorts of refugee-like migrants and refugees.Design & settingA retrospective cohort study was undertaken in Wellington, New Zealand.MethodData were obtained for refugee-like migrants and refugees accepted under the national quota system (quota refugees), who enrolled in a New Zealand primary care practice between 2011 and 2015. Data from the primary care practice and nationally held hospital and outpatient service databases, were analysed. Age and sex standardisation adjusted for possible differences in cohort demographic profiles.ResultsThe cohorts were similar in age, sex, deprivation, and interpreter need. Refugee-like migrants were found to have similar, but not identical, health and social care utilisation to quota refugees. Primary care nurse utilisation was higher for refugee-like migrants. Clinical entries in the primary care patient record were similar in rate for the cohorts. Emergency department utilisation and hospital admissions were similar. Hospital outpatient utilisation was lower for refugee-like migrants.ConclusionThis research suggests that health, social care, and other resettlement services should be aligned for refugee-like migrants and quota refugees. This would mean that countries accepting quota refugees should plan for health and social care needs of subsequent refugee-like migrant family migration. Further research should investigate matched larger-scale national health and immigration datasets, and qualitatively explore factors influencing health-seeking behaviour of refugee-like migrants.


2013 ◽  
Vol 1 (5) ◽  
pp. 1-138 ◽  
Author(s):  
J Senior ◽  
K Forsyth ◽  
E Walsh ◽  
K O'Hara ◽  
C Stevenson ◽  
...  

AbstractBackgroundOlder prisoners are the fastest growing subgroup in the English and Welsh prison estate. Existing research highlights that older prisoners have high health and social care needs and that, currently, these needs routinely remain unmet.Objectives(1) To explore the needs of men entering and leaving prison; (2) to describe current provision of services, including integration between health and social care services; and (3) to develop and pilot an intervention for identifying health and social care needs on reception into prison, ensuring that these are systematically addressed during custody.MethodsThe research programme was a mixed-methods study comprising four parts: (1) a study of all prisons in England and Wales housing older adult men, establishing current availability and degree of integration between health and social care services through a national survey and qualitative interviews; (2) establishing the health and social care needs of older men entering prison, including experiences of reception into custody, through structured (n = 100) and semistructured (n = 27) interviews; (3) the development and implementation of an intervention to identify and manage the health, social care and custodial needs of older men entering prison; and (4) exploration of the health and social care needs of older men released from prison into the community through qualitative interviews with older prisoners prior to and following discharge from prison. Descriptive statistics were produced for all quantitative data, and qualitative data were analysed using the constant comparison method.ResultsThe number of older prisoner leads has increased in recent years but they do not all appear always to be active in their roles, nor in receipt of specialist training. Nearly half (44%) of establishments do not have an older prisoner policy. There is a lack of integration between health and social care services because of ambiguity regarding responsibility for older prisoners' social care. The responsible social service may be located a considerable distance from where the prisoner is held; in such instances, local social services do not co-ordinate their care. The most frequent unmet need on prison entry was the provision of information about care and treatment. Release planning for older prisoners was frequently non-existent.LimitationsThe study used a cut-off age of 60 years as the lower limit for the definition of an older prisoner; evidence has emerged that supports a redefinition of that cut-off to 50 years. Our study examined the care provided for men and this should be considered if contemplating using the Older prisoner Health and Social Care Assessment and Plan (OHSCAP) with older women in prison.ConclusionThe OHSCAP, developed as part of this study, provided a feasible and acceptable means of identifying and systematically addressing older prisoners' health and social care needs. Future work will include the conduct of a randomised controlled trial to examine the impact of the OHSCAP in terms of improving a range of outcomes, including economic impact.FundingThe National Institute for Health Research Health Services and Delivery Research programme.


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