scholarly journals Specialist alcohol inpatient treatment admissions and non-specialist hospital admissions for alcohol withdrawal in England: an inverse relationship

2020 ◽  
Vol 56 (1) ◽  
pp. 28-33
Author(s):  
Thomas Phillips ◽  
Chao Huang ◽  
Emmert Roberts ◽  
Colin Drummond
Keyword(s):  
Alcohol Withdrawal ◽  
Hospital Admissions ◽  
Significant Negative Correlation ◽  
Data Sets ◽  
Complex Needs ◽  
Specialist Services ◽  
Health And Social Care ◽  
Specialist Treatment ◽  
The Uk ◽  
The Relationship

ABSTRACT Aims We assessed the relationship between specialist and non-specialist admissions for alcohol withdrawal since the introduction of the UK government Health and Social Care Act in 2012. Methods Using publicly available national data sets from 2009 to 2019, we compared the number of alcohol withdrawal admissions and estimated costs in specialist and non-specialist treatment settings. Results A significant negative correlation providing strong evidence of an association was observed between the fall in specialist and rise in non-specialist admissions. Significant cost reductions within specialist services were displaced to non-specialist settings. Conclusions The shift in demand from specialist to non-specialist alcohol admissions due to policy changes in England should be reversed by specialist workforce investment to improve outcomes. In the meantime, non-specialist services and staff must be resourced and equipped to meet the complex needs of these service users.

scholarly journals The relationship between alcohol-related hospital admission and specialist alcohol treatment provision across local authorities in England since passage of the Health and Social Care Act 2012

2020 ◽  
pp. 1-3 ◽  
Author(s):  
Emmert Roberts ◽  
Matthew Hotopf ◽  
Colin Drummond
Keyword(s):  
Hospital Admission ◽  
Social Care ◽  
Local Authority ◽  
Hospital Admissions ◽  
Alcohol Treatment ◽  
Data Sets ◽  
Treatment Provision ◽  
Health And Social Care ◽  
High Prevalence ◽  
The Uk

Summary To our knowledge no previous studies have been conducted at the local authority level assessing relationships between alcohol-related hospital admission, specialist alcohol treatment provision and socioeconomic deprivation since the UK government passed the Health and Social Care Act in 2012. Our results, using publicly available national data-sets, suggest that the local authority areas in England most in need of adequately funded specialist alcohol treatment, because of high prevalence of alcohol dependence and deprivation, are not receiving targeted increased funding, and that the national rise in alcohol-related hospital admissions may be fuelled by local authority funding cuts to specialist alcohol treatment.

The changing landscape of local authority commissioning

2020 ◽  
pp. 177-196
Author(s):  
Dave Ayre
Keyword(s):  
Academic Research ◽  
The European Union ◽  
Public And Private ◽  
The United Kingdom ◽  
Health And Social Care ◽  
History Of ◽  
The Uk ◽  
Relationship Of ◽  
The Relationship

This chapter assesses the history of the relationship between public and private sectors and the extent to which the political and regulatory environment of governments and institutions such as the European Union (EU) can help or hinder the efforts of public bodies in seeking to deliver services that determine the health and quality of life for communities. The relationship of public and private sectors in the United Kingdom (UK) and the commissioning, procurement, and development of public–private partnerships is driven by the prevailing political and economic environment. However, rigorous academic research on the benefits of partnering to organisations, societies and between countries is limited. Evidence is needed to fill the policy vacuum. A bolder approach is necessary to work with public and private sectors to develop and implement successful partnering alternatives to the outsourcing of public services. The growing catalogue of outsourcing failures in construction, probation, rail franchising, health, and social care is creating an appetite for change, and the exit of the UK from the EU provides the opportunity.

Circumnavigating the world of quality and patient safety: a compendium of highlights and perspectives

2020 ◽  
Vol 65 (1) ◽  
pp. 3-11
Author(s):  
Nancy El-Farargy
Keyword(s):  
Patient Safety ◽  
Workforce Development ◽  
Design Thinking ◽  
Hospital Admissions ◽  
Health Spending ◽  
Healthcare Improvement ◽  
Health And Social Care ◽  
Major Reform ◽  
Quality And Patient Safety ◽  
The Uk

Background In the UK, estimates suggest that approximately 10% of hospital admissions and 1–2% of primary care consultations result in some sort of adverse event. Globally, medication errors cost approximately US$42 billion annually, and 15% of total health spending in Organisation for Economic Cooperation and Development countries is used to deal with adverse events. Method Stemming from the Glasgow 2019 British Medical Journal and Institute for Healthcare Improvement International Forum on Quality and Safety in Healthcare (‘People Make Change’), a review of workforce characteristics, the psychology of change and design thinking in healthcare is presented. The concept of personalised care is also discussed. Conclusion In the last decade, the National Health Service in Scotland has undergone major reform around the integration of health and social care. In tandem with this, there have been a range of national initiatives to support patient safety and quality improvement. Moving forward, there is an increasing realisation of how service design, digital technologies and a national digitised infrastructure can improve services. Implications highlight the role of workforce development and in embedding design thinking in service organisation. This review article therefore presents an anthology of highlights and perspectives in improving healthcare quality and patient safety.

British art librarianship today and tomorrow

1994 ◽  
Vol 19 (3) ◽  
pp. 20-26
Author(s):  
Jan van der Wateren
Keyword(s):  
Visual Arts ◽  
British Library ◽  
Present Position ◽  
25Th Anniversary ◽  
British Art ◽  
Active Player ◽  
Specialist Services ◽  
The Uk ◽  
The Relationship ◽  
Subject Specialist

The National Art Library (NAL) has moved from its former isolation, through the developments of the last decade, to its present position as a focus for and active player in the art library and information community of the UK. The NAL has worked with ARLIS on some of the major co-operative ventures currently preoccupying the art library field. However, there is still a need for further clarification of, and support for, subject specialist services in the national arena, not least the relationship with the British Library. The potential of the proposed Library Commission and Visual Arts Library and Information Plan is still to be realised. Art librarians must work with their users in formulating a more radical and visionary view of their objectives, as they face the challenges of the future.This article is a revised version of a paper delivered to the 25th Anniversary Conference of ARLIS/UK & Ireland, London, 7th-10th April 1994.

scholarly journals Integrated care in mental health: next steps after the NHS Long Term Plan

2019 ◽  
Vol 214 (06) ◽  
pp. 315-317 ◽  
Author(s):  
Derek K. Tracy ◽  
Kara Hanson ◽  
Tom Brown ◽  
Adrian J. B. James ◽  
Holly Paulsen ◽  
...  
Keyword(s):  
Integrated Care ◽  
Royal College ◽  
Ageing Population ◽  
Select Committee ◽  
Complex Needs ◽  
Health And Social Care ◽  
Care Systems ◽  
The Uk

SummaryHealth and social care face growing and conflicting pressures: mounting complex needs of an ageing population, restricted funding and a workforce recruitment and retention crisis. In response, in the UK the NHS Long Term Plan promises increased investment and an emphasis on better ‘integrated’ care. We describe key aspects of integration that need addressing.Declaration of interestD.K.T. and S.S.S. are on the editorial board of the British Journal of Psychiatry and executives of the Academic Faculty at the Royal College of Psychiatrists. A.J.B.J., H.P. and Z.M. have roles at the Royal College of Psychiatrists that include evaluation of integrated care systems. A.J.B.J. is married to Dr Sarah Wollaston, Member of Parliament for Totnes and Chair of the Health Select Committee.

The right to healthcare

2020 ◽  
pp. 195-208
Author(s):  
Ann Marie Gray
Keyword(s):  
Human Rights ◽  
Social Care ◽  
Health And Social Care ◽  
Human Rights Act ◽  
Human Rights Act 1998 ◽  
The Uk ◽  
The Right ◽  
The Impact ◽  
The Relationship

This chapter explores the relationship between human rights and health and social care. It begins by setting out the main international mechanisms, at UN, EU and ECHR levels, and the obligations they place on governments. It then discusses the impact of international and domestic human rights instruments through an examination of developments in social care policy, and with regard to reproductive health care rights in Northern Ireland. It also highlights issues relating to devolution and the implementation of human rights in the UK and in particular the role of the Human Rights Act (1998).

scholarly journals Psychogeriatricians and general practitioners: a national survey

1993 ◽  
Vol 17 (10) ◽  
pp. 592-594 ◽  
Author(s):  
Sube Banerjee ◽  
James Lindesay ◽  
Elaine Murphy
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Social Care ◽  
The Elderly ◽  
Health Care Teams ◽  
Primary Health ◽  
Regular Screening ◽  
Health And Social Care ◽  
The Uk ◽  
The Relationship

Recent changes in the provision of health and social care in the UK such as the institution of a purchaser/provider system and regular screening of the elderly by GPs are of importance to the relationship between primary health care teams (PHCT) and psychogeriatricians. These changes have clarified the necessity for sensitivity by psychogeriatric services to the needs of GPs and commissioning authorities.

scholarly journals Paths to resettlement: understanding the interplay of work and other factors in journeys out of homelessness

2020 ◽  
pp. 1-19
Author(s):  
JENNY MCNEILL ◽  
GRAHAM BOWPITT
Keyword(s):  
Substance Misuse ◽  
Homeless People ◽  
Significant Others ◽  
Work Relationships ◽  
Critical Examination ◽  
Sense Of Control ◽  
Complex Needs ◽  
Integrated Pathway ◽  
The Uk ◽  
The Relationship

Abstract Paid employment has been viewed by successive governments in the UK as critical in making transitions out of homelessness, even when combined with problems like substance misuse, criminality or mental ill health. This article presents evidence from a study that sought to subject this belief to critical examination by exploring the relationship between promoting employability and other aspects of resettlement in the lives of a sample of thirty people experiencing homelessness and complex needs. Participants were interviewed twice at six to nine-month intervals to explore their changing motivations and perceptions of housing, work, relationships and hopes for the future. Analysis used ‘pathways’ imagery to locate participants along an integrated pathway to understand how these factors related to one another in the pursuit of resettlement. We conclude that all respondents valued work, but its pursuit depended on the structural obstacles that participants faced. People’s location along a resettlement pathway was determined by their sense of control over circumstances, their success in overcoming barriers and the presence of significant others in their lives, and the pursuit of employment among homeless people needs to take account of progress in their resettlement journeys and the place of work in their aspirations.

scholarly journals Barriers and facilitators to accessing health and social care services for people living in homeless hostels: a qualitative study of the experiences of hostel staff and residents in UK hostels

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e053185
Author(s):  
Megan Armstrong ◽  
Caroline Shulman ◽  
Briony Hudson ◽  
Patrick Stone ◽  
Nigel Hewett
Keyword(s):  
Social Care ◽  
Barriers And Facilitators ◽  
Complex Needs ◽  
Care Access ◽  
Care Services ◽  
Health And Social Care ◽  
Service Barriers ◽  
The Uk ◽  
The Impact ◽  
Care Support

IntroductionThe number of people living in homeless hostels in the UK has steadily increased over the past decade. Despite people experiencing homelessness often having considerable health problems and a range of complex needs frequently in association with addictions, the experiences of hostel staff and residents especially in relation to accessing health and social care support have seldom been explored. The aim of this paper is to identify the barriers and facilitators to accessing health and social care services for people living in homeless hostels.DesignExploratory qualitative baseline data were collected as part of an intervention to facilitate palliative care in-reach into hostels.Setting/participantsInterviews were conducted with 33 participants; 18 homeless hostel managers/support staff and 15 people experiencing homelessness, from six homeless hostels in London and Kent.ResultsThree themes were identified (1) internal and external service barriers to health and social care access due to stigma, lack of communication and information sharing from services and assumptions around capacity and the role of the hostel, (2) the impact of lack of health and social care support on hostel staff leading to burnout, staff going beyond their job role and continuous support given to residents, (3) potential facilitators to health and social care access such in-reach and support from those who understand this population and hostel staff training.DiscussionResidents have multiple complex needs yet both hostel staff and residents face stigma and barriers accessing support from external services. Positive relationships were described between hostel residents and staff, which can be an essential step in engaging with other services. People experiencing homelessness urgently need better access to person-centred, trauma-informed support ideally via in-reach from people who understand the needs of the population.

scholarly journals Access to specialist community alcohol treatment in England, and the relationship with alcohol-related hospital admissions: qualitative study of service users, service providers and service commissioners

BJPsych Open ◽  
2020 ◽  
Vol 6 (5) ◽  
Author(s):  
Emmert Roberts ◽  
Miriam Hillyard ◽  
Matthew Hotopf ◽  
Stephen Parkin ◽  
Colin Drummond
Keyword(s):  
Hospital Admissions ◽  
Service Providers ◽  
Alcohol Treatment ◽  
Service Level ◽  
Service Users ◽  
Risk Environment ◽  
Structured Interviews ◽  
Treatment Access ◽  
Health And Social Care ◽  
Specialist Treatment

Background Since 2012 England has seen year-on-year reductions in people accessing specialist community alcohol treatment, and year-on-year increases in alcohol-related hospital admissions. Aims We examined perceived barriers to accessing specialist treatment, and perceived reasons behind hospital admission increases. Method We conducted focus groups (n = 4) with service users and semi-structured interviews (n = 16) with service providers and service commissioners at four specialist community alcohol services in England, which experience either high or low rates of alcohol dependence prevalence and treatment access. Themes and subthemes were generated deductively drawing upon Rhodes’ risk environment thesis. Data were organised using the framework approach. Results Data reveal a treatment sector profoundly affected at all levels by changes implemented in the Health and Social Care Act (HSCA) 2012. Substantial barriers to access exist, even in services with high access rates. Concerns regarding funding cuts and recommissioning processes are at the forefront of providers’ and commissioners’ minds. The lack of cohesion between community and hospital alcohol services, where hospital services exist, has potentially created an environment enabling the reduced numbers of people accessing specialist treatment. Conclusions Our study reveals a treatment sector struggling with a multitude of problems; these pervade despite enaction of the HSCA, and are present at the national, service provider and individual service level. Although we acknowledge the problems are varied and multifaceted, their existence is echoed by the united voices of service users, service providers and service commissioners.

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