scholarly journals Understanding variation in unplanned admissions of people aged 85 and over: a systems-based approach

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e026405 ◽  
Author(s):  
Andrew Wilson ◽  
Richard Baker ◽  
John Bankart ◽  
Jay Banerjee ◽  
Ran Bhamra ◽  
...  
Keyword(s):  
Primary Care ◽  
Social Care ◽  
Primary Care Trust ◽  
Community Health Services ◽  
Shared Vision ◽  
Admission Rates ◽  
Care Services ◽  
Health And Social Care ◽  
Study Sites ◽  
Unplanned Admissions

AimTo examine system characteristics associated with variations in unplanned admission rates in those aged 85+.DesignMixed methods.SettingPrimary care trusts in England were ranked according to changes in admission rates for people aged 85+ between 2007 and 2009, and study sites selected from each end of the distribution: three ‘improving’ sites where rates had declined by more than 4% and three ‘deteriorating’ sites where rates had increased by more than 20%. Each site comprised an acute hospital trust, its linked primary care trust/clinical commissioning group, the provider of community health services and adult social care.ParticipantsA total of 142 representatives from these organisations were interviewed to understand how policies had been developed and implemented. McKinsey’s 7S framework was used as a structure for investigation and analysis.ResultsIn general, improving sites provided more evidence of comprehensive system focused strategies backed by strong leadership, enabling the development and implementation of policies and procedures to avoid unnecessary admissions of older people. In these sites, primary and intermediate care services appeared more comprehensive and better integrated with other parts of the system, and policies in emergency departments were more focused on providing alternatives to admission.ConclusionsHealth and social care communities which have attenuated admissions of people aged 85+ prioritised developing a shared vision and strategy, with sustained implementation of a suite of interventions.

scholarly journals Sharing a vision. Do participants in integrated care programmes have the same goals and objectives?

2019 ◽  
Vol 33 (3) ◽  
pp. 122-129
Author(s):  
Axel Kaehne
Keyword(s):  
Integrated Care ◽  
Social Care ◽  
Care Delivery ◽  
Shared Vision ◽  
Window Of Opportunity ◽  
Care Providers ◽  
Care Services ◽  
The North ◽  
Health And Social Care ◽  
Goals And Objectives

Integrating health and social care services remains one of the most difficult undertakings in the field of care delivery. One of the key requirements for success in integration programmes is a shared vision amongst care providers. Shared visions may contain views as to what the new services should look like, how it should operate and what it should be able to achieve. The paper reports findings of an evaluation of a service integration programme in the North of England. It confirms that a programme consensus on issues such as aims and objectives and programme logics is seen by participants as a key to success. Yet, the study also found that there is a specific window of opportunity in integration programmes when participating organisations start on relatively high levels of commitment and enthusiasm which tend to tail off relatively quickly. The paper closes with a discussion about the implications of the findings for programme designers and service planners.

scholarly journals In adults with multimorbidity, does the provision of social care services have an effect on the use of primary care and secondary care health services?

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
David Henderson
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Secondary Care ◽  
Social Care ◽  
Grey Literature ◽  
Qualitative Synthesis ◽  
Delivery Of Care ◽  
Care Services ◽  
Health And Social Care ◽  
The Relationship

ABSTRACT ObjectivesHealth and social care is an area of high policy importance in the UK. Integration of health boards with local authority provided social care in Scotland in 2016 is a major structural change in delivery of care. Improvements in service and efficiency are expected and indeed required in an era of declining budgets.  Intuitively, health and social care are closely linked, particularly for those with multiple morbidities. However, little is known about the relationship between health and social care services and how usage of one has an impact on the other in terms of outcomes and costs. The study aims to describe the methods that have been used to analyse the relationship between social care, primary care and secondary care services. Findings will inform the analysis of a large linked dataset of health care, social care and benefits data that will investigate the interactions between health and social care, multimorbidity and socioeconomic status. ApproachA Scoping review of literature aiming to identify academic studies that have made an assessment of the relationship between health care and social care. A search of academic databases will be augmented by a search of grey literature aiming to identify the extent, range and nature of studies. Data will be extracted on populations, study designs, results and recommendations. Results will be visualised in charts alongside a descriptive qualitative synthesis. ResultsExpected June 2016

scholarly journals More that unites us than divides us? A qualitative study of integration of community health and social care services

2020 ◽  
Author(s):  
Claire Mitchell ◽  
Abigail Tazzyman ◽  
Susan J. Howard ◽  
Damian Hodgson
Keyword(s):  
Community Health ◽  
Social Care ◽  
National Policy ◽  
Shared Vision ◽  
Relationship Building ◽  
Care Staff ◽  
Structured Interviews ◽  
Care Services ◽  
Effective Discharge ◽  
Health And Social Care

Abstract Background The integration of community health and social care services has been widely promoted nationally as a vital step to improve patient centred care, reduce costs, reduce admissions to hospital and facilitate timely and effective discharge from hospital. The complexities of integration raise questions about the practical challenges of integrating health and care given embedded professional and organisational boundaries in both sectors. We describe how an English city created a single, integrated care partnership organisation, to fully integrate community health and social care services. This led to the development of twelve integrated neighbourhood teams, combining and co-locating professionals across three separate localities. The aim of this research is to identify the context and the factors enabling and hindering integration from a qualitative process evaluation. Methods Twenty-four semi-structured interviews were conducted with equal numbers of health and social care staff at strategic and operational level. The data was subjected to thematic analysis. Results We describe three key themes: 1) shared vision and leadership; 2) organisational factors; 3) professional workforce factors. We found a clarity of vision and purpose of integration throughout the partnership organisation, but there were challenges related to the introduction of devolved leadership. There were widespread concerns that the specified outcome measures did not capture the complexities of integration. Organisational challenges included a lack of detail around clinical and service delivery planning, tensions around variable human resource practices and barriers to data sharing. A lack of understanding and trust meant professional workforce integration remained a key challenge, although integration was also seen as a potential solution to engender relationship building. Conclusions Given the long-term national policy focus on integration this ambitious approach to fully integrate community health and social care has highlighted implications for leadership, organisational design and inter-professional working. Given the ethos of valuing the local assets of individuals and networks within the new partnership organisation we found the integrated neighbourhood teams could all learn from each other. Many of the challenges of integration could benefit from embracing the inherent capabilities across the integrated neighbourhood teams and localities of this city.

De-professionalism as defined by services deemed unconventional, under-performing or ineffectual

2020 ◽  
pp. 121-142
Author(s):  
Nigel Malin
Keyword(s):  
Primary Care ◽  
Critical Care ◽  
Chronic Illness ◽  
Social Care ◽  
Public Spending ◽  
Care Services ◽  
Primary Care Services ◽  
Health And Social Care ◽  
Under Performing

This chapter discusses reports that some hospitals and primary care services are ‘under-performing’ due to a lack of health and social care professionals, particularly in areas like critical care, long-term and chronic illness. Similarly, in schools there are continuing claims that core funding remains a serious issue, that they are struggling to get and keep enough teachers, and standards are threatened as a result. Austerity is an extension of the neo-liberal logic to characterise any form of public spending as ‘unproductive’.

Oxford Handbook of Primary Care and Community Nursing

2020 ◽  
Keyword(s):  
Primary Care ◽  
Good Practice ◽  
Community Setting ◽  
Community Health Services ◽  
Clinical Knowledge ◽  
Long Term Conditions ◽  
Care Services ◽  
Health And Social Care ◽  
And Child Health

Concise and comprehensive, this handbook provides the reader with both evidence-based clinical knowledge as well as the organizational structure of community health services. Chapters range from common adult and child health problems, to more specific targeted advice for service users with extra needs and people with long-term conditions. The handbook includes information on how health and social care services are organized and funded, from common technical care procedures to complex situations, alongside detailed aspects of health promotion in adults, children, and adolescents. This handbook provides an accessible and instant resource, and a benchmark of good practice, for all healthcare professionals working in the primary care and community setting.

Progress Towards Partnership? The Development of Relations between Primary Care Organisations and Social Services Concerning Older People's Services in the UK

2004 ◽  
Vol 3 (1) ◽  
pp. 33-42 ◽  
Author(s):  
Kirstein Rummery
Keyword(s):  
Primary Care ◽  
Older People ◽  
Social Services ◽  
Large Scale ◽  
Social Care ◽  
Theoretical Work ◽  
Care Services ◽  
Care Groups ◽  
Health And Social Care ◽  
The Uk

This paper will present evidence from the interim results of a large scale longitudinal project designed to track the development of partnership working between the new primary care organisations (Primary Care Groups and Trusts) entrusted with the commissioning and in some cases provision of health care, and local authority social services departments, regarding health and social care services for older people in the UK. Drawing on theoretical work concerning the role of partnership working in the governance of welfare, the author uses a framework originally devised by the Nuffield Centre for Health at the University of Leeds to analyse the interim data, and to draw conclusions about the feasibility of current policy pushes towards partnership working and service integration around health and social care for older people.

scholarly journals More that unites us than divides us? A qualitative study of integration of community health and social care services

2020 ◽  
Author(s):  
Claire Mitchell ◽  
Abigail Tazzyman ◽  
Susan J. Howard ◽  
Damian Hodgson
Keyword(s):  
Community Health ◽  
Social Care ◽  
National Policy ◽  
Shared Vision ◽  
Relationship Building ◽  
Care Staff ◽  
Structured Interviews ◽  
Care Services ◽  
Effective Discharge ◽  
Health And Social Care

Abstract Background: The integration of community health and social care services has been widely promoted nationally as a vital step to improve patient centred care, reduce costs, reduce admissions to hospital and facilitate timely and effective discharge from hospital. The complexities of integration raise questions about the practical challenges of integrating health and care given embedded professional and organisational boundaries in both sectors. We describe how an English city created a single, integrated care partnership, to integrate community health and social care services. This led to the development of twelve integrated neighbourhood teams, combining and co-locating professionals across three separate localities. The aim of this research is to identify the context and the factors enabling and hindering integration from a qualitative process evaluation.Methods: Twenty-four semi-structured interviews were conducted with equal numbers of health and social care staff at strategic and operational level. The data was subjected to thematic analysis. Results: We describe three key themes: 1) shared vision and leadership; 2) organisational factors; 3) professional workforce factors. We found a clarity of vision and purpose of integration throughout the partnership, but there were challenges related to the introduction of devolved leadership. There were widespread concerns that the specified outcome measures did not capture the complexities of integration. Organisational challenges included a lack of detail around clinical and service delivery planning, tensions around variable human resource practices and barriers to data sharing. A lack of understanding and trust meant professional workforce integration remained a key challenge, although integration was also seen as a potential solution to engender relationship building. Conclusions: Given the long-term national policy focus on integration this ambitious approach to integrate community health and social care has highlighted implications for leadership, organisational design and inter-professional working. Given the ethos of valuing the local assets of individuals and networks within the new partnership we found the integrated neighbourhood teams could all learn from each other. Many of the challenges of integration could benefit from embracing the inherent capabilities across the integrated neighbourhood teams and localities of this city.

How will dental surgery services be commissioned in the future?

2013 ◽  
Vol 95 (2) ◽  
pp. 71-71
Author(s):  
Bernie Speculand ◽  
Rachel Noble
Keyword(s):  
Primary Care ◽  
Secondary Care ◽  
Social Care ◽  
Dental Services ◽  
Dental Surgery ◽  
Care Services ◽  
Primary Care Services ◽  
Health And Social Care ◽  
The Future

While most secondary care services will be commissioned by GP-led clinical commissioning groups (CCGs), the majority of primary care services – including all primary and secondary care dental services – will be the responsibility of the NHS Commissioning Board (NHS CB). This was first established in shadow form in April 2012, following the passage of the Health and Social Care Act. The Act brings with it a number of new organisations, and several new acronyms to learn.

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