Living well in later life in Scotland

2017 ◽  
Vol 21 (1) ◽  
pp. 22-30 ◽  
Author(s):  
Anne Hendry
Keyword(s):  
Older People ◽  
Social Care ◽  
Action Plan ◽  
Later Life ◽  
Ageing Population ◽  
Content Type ◽  
Living Well ◽  
Care Services ◽  
Health And Social Care ◽  
Scottish Government

Purpose The purpose of this paper is to describe the development, implementation and early impact of a national action plan for active and healthy ageing in Scotland. Design/methodology/approach The Joint Improvement Team, NHS Health Scotland, the Scottish Government and the Health and Social Care Alliance Scotland (ALLIANCE) co-produced the action plan with older people from the Scottish Older People’s Assembly. Together they supported partnerships to embed the action plan as an important element of the reshaping care for older people transformation programme in Scotland. Findings A cross-sector improvement network supported health, housing and care partnerships to use a £300 million Change Fund to implement evidence based preventative approaches to enable older people to live well. Older people in Scotland spent over two million days at home than would have been expected based on previous balance of care and impact of ageing. Practical implications Improving the health and wellbeing of older people is not just the responsibility of health and social care services. Enabling older people to live independent, active and fulfilling lives requires coordinated effort that spans national and local government policy areas, mobilises all sectors of society, and involves all health and care disciplines. Success starts with listening to what matters to older people, and working together, and with older people and local communities, to make that a reality. Originality/value This case study from Scotland offers transferable learning for other systems who have an ageing population and an ambitions to enable them to live well in later life.

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.

New act, new opportunity for integration in Scotland

2015 ◽  
Vol 23 (1) ◽  
pp. 3-9 ◽  
Author(s):  
Alison Taylor
Keyword(s):  
Social Care ◽  
Institutional Care ◽  
Social Implications ◽  
Significant Shift ◽  
Ageing Population ◽  
Local Authorities ◽  
Content Type ◽  
Health And Social Care ◽  
Scottish Government ◽  
Health Boards

Purpose – In this paper, the Scottish Government's approach to improving outcomes for patients and service users by integrating health and social care planning and provision is described. The Scottish Parliament passed primary legislation in February 2014, which places requirements on Health Boards and Local Authorities to work together more closely than ever before. The paper aims to discuss these issues. Design/methodology/approach – This paper sets out the Scottish Government's legislative approach to integrating health and social care, based on previous experience of encouraging better partnership between health and social care working without legislative compulsion. Findings – The Scottish Government has concluded that legislation is required to create the integrated environment necessary for health and social care provision to meet the changing needs of Scotland's ageing population. Research limitations/implications – The paper is confined to experience in Scotland. Practical implications – Legislation is now complete, and implementation of the new arrangements is starting. Evaluation of their impact will be ongoing. Social implications – The new integrated arrangements in Scotland are intended to achieve a significant shift in the balance of care in favour of community-based support rather than institutional care in hospitals and care homes. Its social implications will be to support greater wellbeing, particularly for people with multimorbidities within communities. Originality/value – Scotland is taking a unique approach to integrating health and social care, focusing on legislative duties on Health Boards and Local Authorities to work together, rather than focusing on structural change alone. The scale of planned integration is also significant, with planning for, at least, all of adult social care and primary health care, and a proportion of acute hospital care, included in the new integrated arrangements.

Health and social care for older people: progress, problems and priorities

2015 ◽  
Vol 16 (1) ◽  
pp. 27-31 ◽  
Author(s):  
Richard Humphries
Keyword(s):  
Older People ◽  
Social Care ◽  
Published Data ◽  
Ageing Population ◽  
Coordinated Care ◽  
Content Type ◽  
Track Record ◽  
Health And Social Care ◽  
Care For Older People ◽  
Care System

Purpose – The purpose of this paper is to describe the principal challenges facing the health and care system in England arising from an ageing population, assess the track record of the coalition government in addressing these and offer a perspective on the priorities likely to be faced by the next incoming government in relation to health and social care for older people. Design/methodology/approach – Assessment of key policy documents and legislation and interpretation of published data on trends in health and social care activity and expenditure. Findings – An ageing population requires a fundamental shift towards a new model of care that offers better coordinated care and promotes independence and healthy ageing. The Care Act 2014 is a significant achievement and NHS spending has been protected, but resulting cuts to local government budgets have since sharp reductions in social care for older people. The next incoming government will need to address a deepening financial crisis in health and care system; the increasingly unsustainability of means tested and rationed social care alongside universal free health care; and the need to make faster progress in developing a new models of integrated care closer to home. Originality/value – The issues raised in this paper affect older people as voters, tax payers and as existing or potential users of health and social care services. As a group they will attract significant attention from political parties in the next election campaign.

scholarly journals Housing voices: using theatre and film to engage people in later life housing and health conversations

2019 ◽  
Vol 22 (4) ◽  
pp. 181-192
Author(s):  
Cathy Bailey ◽  
Natalie Forster ◽  
Barbara Douglas ◽  
Claire Webster Saaremets ◽  
Esther Salamon
Keyword(s):  
Older People ◽  
Social Care ◽  
Later Life ◽  
Select Committee ◽  
Content Type ◽  
North East ◽  
The North ◽  
Primary Responsibility ◽  
Health And Social Care ◽  
Types Of Information

Purpose Quality, accessible and appropriate housing is key to older people’s ability to live independently. The purpose of this paper is to understand older people’s housing aspirations and whether these are currently being met. Evidence suggests one in five households occupied by older people in England does not meet the standard of a decent home. The Building Research Establishment has calculated that poor housing costs the English National Health Service £1,4bn annually (Roys et al., 2016). Design/methodology/approach This paper reports on the findings of a participatory theatre approach to engaging with those not often heard from – notably, those ageing without children and older people with primary responsibility for ageing relatives – about planning for housing decisions in later life. The project was led by an older people’s forum, Elders Council, with Skimstone Arts organisation and Northumbria University, in the north east of England. Findings Findings suggest there is an urgent need to listen to and engage with people about their later life housing aspirations. There is also a need to use this evidence to inform housing, health and social care policy makers, practitioners, service commissioners and providers and product and service designers, to encourage older people to become informed and plan ahead. Research limitations/implications Use of a participatory theatre approach facilitated people to explore their own decision making and identify the types of information and support they need to make critical decisions about their housing in later life. Such insights can generate evidence for future housing, social care and health needs. Findings endorse the recent Communities and Local Government (2018) Select Committee Inquiry and report on Housing for Older People and the need for a national strategy for older people’s housing. Originality/value Although this call is evidenced through an English national case study, from within the context of global population ageing, it has international relevance.

Being self in later life: maintaining continuity in the face of change

2016 ◽  
Vol 17 (2) ◽  
pp. 141-150
Author(s):  
Gareth O'Rourke
Keyword(s):  
Qualitative Study ◽  
Older People ◽  
Consumer Choice ◽  
Social Care ◽  
Later Life ◽  
Small Scale ◽  
Care Needs ◽  
Helping Relationships ◽  
Content Type ◽  
Care Services

Purpose – The purpose of this paper is to build upon existing knowledge of personalisation through an improved understanding of how the use of personalised social care services can support older people’s sense of self. It contains perspectives that are helpful to the development of personalisation policy and practice and to the future commissioning of social care services. Design/methodology/approach – The research involved a qualitative study with eight participants in two local authority areas in England. A series of three in-depth interviews conducted with each participant over a four to six week period explored their experience of using (in one case refusing) a direct payment to meet their social care needs. Ethical approval was obtained prior to the start of fieldwork via the research ethics committee of the author’s home university. Findings – Two inter-related themes emerge as findings of the research. First, that the locus of personalisation resides within the interpersonal dynamics of helping relationships; participants experienced personalisation when carers helped to meet needs in ways that validated their narrative of self. Second, whilst the experience of personalisation is not strongly related to consumer choice, it is important that older people are able to exercise control over and within helping relationships. Research limitations/implications – This is a small scale qualitative study conducted with only eight participants. Whilst it offers valid insights into what constitutes personalisation and the processes by which it was achieved for the participants, caution is required in applying the findings more generally. With the exception of one case, the study is focused exclusively on first person accounts of older people. Future studies might usefully be designed to incorporate the accounts of other involved parties such as family members and paid carers. Originality/value – The paper provides an alternative way of approaching personalisation of social care services for older people by exploring it in terms of its impact on self. It identifies the development of accommodations of “special requirements of Self” in helping relationships as a key mechanism of personalisation. This offers a balance to the current focus on consumer choice and control through the development of market like mechanisms.

Commentary on “Assisting individuals ageing with learning disability: support worker perspectives”

2015 ◽  
Vol 20 (4) ◽  
pp. 223-227
Author(s):  
Martin Stevens
Keyword(s):  
Learning Disabilities ◽  
Older People ◽  
Social Care ◽  
Support Worker ◽  
Policy And Practice ◽  
Content Type ◽  
Care Services ◽  
Role Of The State ◽  
Health And Social Care ◽  
The Uk

Purpose – The purpose of this paper is to explore some of the themes identified by Wark et al.’s paper and to highlight commonalities and differences between the Australian and the UK social and health care regimes. It also points to evidence about other implications for policy and practice of the increasing numbers of people growing older who have learning disabilities. Design/methodology/approach – The commentary analyses some policy and practice documents and identifies a range of other research and commentary on this topic. Findings – Wark et al. have identified areas of importance for supporting older people with learning disabilities, particularly access to suitable and acceptable services and the importance of sufficient support worker time. They also identify gaps in the research on people’s needs and service responses. The commentary also highlights other factors for consideration in work with this group of people, particularly the implementation of personalisation policies in social care and integration between health and social care services. Research limitations/implications – There is a need for further research into developing policy and practice for health and social care for older people with learning disabilities. Some of the evidence supports the case for specialist involvement, particularly by nursing professionals. Originality/value – The paper and this commentary highlight the challenges associated with the increasing number of older people with learning disabilities in contemporary debates about the role of the state and professional specialists.

Pursuing collaborative advantage in Swedish care for older people: stakeholders' views on trust

2020 ◽  
Vol 28 (3) ◽  
pp. 231-241
Author(s):  
Inger Kjellberg ◽  
Stefan Szücs
Keyword(s):  
Older People ◽  
Social Care ◽  
Content Type ◽  
Complex Needs ◽  
Collaborative Advantage ◽  
Care Services ◽  
Health And Social Care ◽  
Swedish Experience ◽  
Coordination And Collaboration ◽  
Care For Older People

PurposeThe purpose of this paper is to explore stakeholder views on the policy of integrated health and social care for older people with complex needs in Sweden and the issue of trust in implementing the policy.Design/methodology/approachThe study used a qualitative interview design and interviews with nine strategically selected stakeholders. A thematic analysis focused on trust, as defined in the theory of collaborative advantage, was used.FindingsThis study of health and social care exposed a lack of trust on political, strategic and inter-professional levels. Two opposing lines of argument were identified in the interviews. One advocated a single government authority for health and social care. The other was in accordance with recently implemented national policies, which entailed more collaboration between local government authorities, obliging them to make joint local agreements. The Swedish experience is discussed in an international context, examining the need for collaboration in integrated care services for older people.Research limitations/implicationsAlthough the findings are important for the current adjustment in health and social care for older people, the number of interviewees are limited. Future studies will include more regions and longitudinal studies.Originality/valueSweden is currently undergoing an extensive adjustment in line with recent national government policy which involves more primary health care and a corresponding reduction in the number of hospital beds. The restructuring of the care system for older people with complex needs is a paradox, as it simultaneously increases the need for centralisation while also increasing coordination and collaboration on a local basis.

Off the Radar? Addressing housing disrepair to improve health in later life

2017 ◽  
Vol 21 (4) ◽  
pp. 224-228 ◽  
Author(s):  
Susan Marie Adams
Keyword(s):  
Private Sector ◽  
Older People ◽  
Social Care ◽  
Housing Stock ◽  
Local Level ◽  
Later Life ◽  
Content Type ◽  
Health And Wellbeing ◽  
Health And Social Care ◽  
Housing Services

Purpose The purpose of this paper is to highlight the pivotal role of initiatives that address housing disrepair, home improvements and adaptations as a way of improving health, independence and quality of life in older age. Design/methodology/approach The author uses data from housing and health, combined with the author’s experience of policy formulation as well as working with older people and developing practical services, particularly those which address private sector housing stock condition. Findings As well as its massive economic impact, housing greatly affects people’s health and wellbeing, not only in later life but across the life course. In England, there is a long history of systematic, government backed action to improve and maintain housing stock condition. There are significant economic and social gains from a coherent national response to addressing private sector housing disrepair, including creation of employment opportunities, economic stimulus through enabling best use of assets, as well as health and social care gains. In addition to increasing housing supply through building much needed new homes, existing housing stock disrepair needs once again to be “on the radar” of policy makers operating across health, social care and housing. Concerted action to make homes safe, healthy places to live in later life, whatever an older person’s tenure, requires vision and innovation and is an essential element in the integration of health, social care – and housing. With significant funding constraints in local authorities, especially for adult social care, and in the context of growing pressures on the NHS, sustaining good health in later life is more important than ever. There is a compelling case for cross-sector action to reduce health hazards in ordinary, private housing, given that 79 per cent of older people who live in non-decent homes are owner occupiers. This is an opportune moment for Health and Wellbeing Boards to take a lead on this issue at a local level, as well as time to put housing stock condition back “On the Radar” of national government policy. Social implications There is a need to embed practical housing services in the emerging integrated health and care systems in order to extend healthy later life for the majority of older people who live in mainstream housing. Originality/value The author draws on over 30 years’ experience of innovation, development and evaluation of older people’s housing, services and policy development to provide a vision for greater integration across health, care and housing.

scholarly journals The importance of a room with a view for older people with limited mobility

2018 ◽  
Vol 19 (4) ◽  
pp. 273-285 ◽  
Author(s):  
Charles Musselwhite
Keyword(s):  
Older People ◽  
Design Methodology ◽  
Social Care ◽  
Structured Interviews ◽  
Content Type ◽  
Limited Mobility ◽  
Human Element ◽  
Health And Social Care ◽  
Vantage Points ◽  
Practical Implications

Purpose The purpose of this paper is to examine how older people who are almost entirely housebound use a view from their window to make sense of the world and stay connected to the outside space that they cannot physically inhabit. Design/methodology/approach Semi-structured interviews with 42 individuals were carried out who were living at home, were relatively immobile and had an interesting view outside they liked from one or more of their windows. Findings The findings suggest that immobile older people enjoy watching a motion-full, changing, world going on outside of their own mobility and interact and create meaning and sense, relating themselves to the outside world. Practical implications Findings suggest that those working in health and social care must realise the importance of older people observing the outdoors and create situations where that is enabled and maintained through improving vantage points and potentially using technology. Originality/value This study builds and updates work by Rowles (1981) showing that preference for views from the window involves the immediate surveillance zone but also further afield. The view can be rural or urban but should include a human element from which older people can interact through storytelling. The view often contains different flows, between mundane and mystery and intrigue, and between expected and random.

scholarly journals Social and Behavioural Determinants of the Difference in Survival among Older Adults in Japan and England

Gerontology ◽  
2018 ◽  
Vol 64 (3) ◽  
pp. 266-277 ◽  
Author(s):  
Jun Aida ◽  
Noriko Cable ◽  
Paola Zaninotto ◽  
Toru Tsuboya ◽  
Georgios Tsakos ◽  
...  
Keyword(s):  
Older Adults ◽  
Older People ◽  
Social Relationships ◽  
Evaluation Study ◽  
Ageing Population ◽  
Care Services ◽  
Health And Social Care ◽  
Cross Country ◽  
The Difference ◽  
Family Based

Background: A rapidly ageing population presents major challenges to health and social care services. Cross-country comparative studies on survival among older adults are limited. In addition, Japan, the country with the longest life expectancy, is rarely included in these cross-country comparisons. Objective: We examined the relative contributions of social and behavioural factors on the differences in survival among older people in Japan and England. Methods: We used data from the Japan Gerontological Evaluation Study (JAGES; n = 13,176) and the English Longitudinal Study of Ageing (ELSA; n = 5,551) to analyse all-cause mortality up to 9.4 years from the baseline. Applying Laplace regression models, the 15th survival percentile difference was estimated. Results: During the follow-up, 31.3% of women and 38.6% of men in the ELSA died, whereas 19.3% of women and 31.3% of men in the JAGES died. After adjusting for age and baseline health status, JAGES participants had longer survival than ELSA participants by 318.8 days for women and by 131.6 days for men. Family-based social relationships contributed to 105.4 days longer survival in JAGES than ELSA men. Fewer friendship-based social relationships shortened the JAGES men’s survival by 45.4 days compared to ELSA men. Currently not being a smoker contributed to longer survival for JAGES women (197.7 days) and ELSA men (46.6 days), and having lower BMI reduced the survival of JAGES participants by 129.0 days for women and by 212.2 days for men. Conclusion: Compared to participants in England, Japanese older people lived longer mainly because of non-smoking for women and family-based social relationships for men. In contrast, a lower rate of underweight, men’s better friendship-based social relationships, and a lower smoking rate contributed to survival among participants in England.

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