scholarly journals The Scottish Social Care Survey (SCS) and the Scottish Care Home Census (SCHC)

2019 ◽  
Vol 4 (1) ◽  
Author(s):  
David Alexander Gunn Henderson ◽  
Jennifer Kirsty Burton ◽  
Ellen Lynch ◽  
David Clark ◽  
Julie Rintoul ◽  
...  
Keyword(s):  
Social Care ◽  
Local Authority ◽  
Care Home ◽  
Population Level ◽  
Probabilistic Methods ◽  
Local Authorities ◽  
Term Care ◽  
Match Rate ◽  
Health And Social Care ◽  
Care Survey

IntroductionLinked health care datasets have been used effectively in Scotland for some time. Use of social care data has been much more limited, partly because responsibility for these services is distributed across multiple local authorities. However, there are substantial interactions between health and social care (also known internationally as long-term care) services, and keen policy interest in better understanding these. We introduce two social care resources that can now be linked to health datasets at a population level across Scotland to study these interdependencies. These data emerge from the Scottish Government’s centralised collation of data from mandatory returns provided by local authorities and care homes. MethodsDeterministic and Probabilistic methods were used to match the Social Care Survey (SCS) and Scottish Care Home Census (SCHC) to the Community Health Index (CHI) number via the National Records of Scotland (NRS) Research Indexing Spine. ResultsFor the years 2010/11 to 2015/16, an overall match rate of 91.2% was achieved for the SCS to CHI from 31 of Scotland’s 32 local authority areas. This rate varied from 76.7% to 98.5% for local authority areas. A match rate of 89.8% to CHI was achieved for the SCHC in years 2012/13 to 2015/16 but only 52.5% for the years 2010/11 to 2011/12. ConclusionIndexing of the SCS and SCHC to CHI offers a new and rich resource of data for health and social care research.

scholarly journals Comprehensive assessment of older people with complex care needs: the multi-disciplinarity of the Single Assessment Process in England

2010 ◽  
Vol 30 (7) ◽  
pp. 1115-1134 ◽  
Author(s):  
DAVID CHALLIS ◽  
MICHELE ABENDSTERN ◽  
PAUL CLARKSON ◽  
JANE HUGHES ◽  
CAROLINE SUTCLIFFE
Keyword(s):  
Older People ◽  
Social Care ◽  
Local Authority ◽  
Care Home ◽  
Comprehensive Assessment ◽  
Assessment Process ◽  
Care Plan ◽  
Assessment Practice ◽  
Care Needs ◽  
Health And Social Care

ABSTRACTThe quality of assessment of older people with health and social care needs has for some time been a concern of policy makers, practitioners, older people and carers in the United Kingdom and internationally. This article seeks to address a key aspect of these concerns, namely whether sufficient expertise is deployed when, as a basis for a care plan and service allocation, an older person's eligibility for local authority adult social-care services requires a comprehensive needs assessment of their usually complex and multiple problems. Is an adequate range of professionals engaged, and is a multi-disciplinary approach applied? The Single Assessment Process (SAP) was introduced in England in 2004 to promote a multi-disciplinary model of service delivery. After its introduction, a survey in 2005–06 was conducted to establish the prevalence and patterns of comprehensive assessment practice across England. The reported arrangements for multi-disciplinary working among local authority areas in England were categorised and reviewed. The findings suggest, first, that the provision of comprehensive assessments of older people that require the expertise of multiple professionals is limited, except where the possibility arose of placement in a care-home-with-nursing, and second that by and large a systematic multi-disciplinary approach was absent. Policy initiatives to address the difficulties in assessment need to be more prescriptive if they are to produce the intended outcomes.

scholarly journals Exploring the impacts of the 2012 Health and Social Care Act reforms to commissioning on clinical activity in the English NHS: a mixed methods study of cervical screening

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e024156 ◽  
Author(s):  
Jonathan Hammond ◽  
Thomas Mason ◽  
Matt Sutton ◽  
Alex Hall ◽  
Nicholas Mays ◽  
...  
Keyword(s):  
Quantitative Methods ◽  
Social Care ◽  
Local Authority ◽  
Service Providers ◽  
Cervical Screening ◽  
Unintended Consequences ◽  
Clinical Activity ◽  
Local Authorities ◽  
Health And Social Care ◽  
The Impact

ObjectivesExplore the impact of changes to commissioning introduced in England by the Health and Social Care Act 2012 (HSCA) on cervical screening activity in areas identified empirically as particularly affected organisationally by the reforms.MethodsQualitative followed by quantitative methods. Qualitative: semi-structured interviews (with NHS commissioners, managers, clinicians, senior administrative staff from Clinical Commissioning Groups (CCGs), local authorities, service providers), observations of commissioning meetings in two metropolitan areas of England. Quantitative: triple-difference analysis of national administrative data. Variability in the expected effects of HSCA on commissioning was measured by comparing CCGs working with one local authority with CCGs working with multiple local authorities. To control for unmeasured confounders, differential changes over time in cervical screening rates (among women, 25–64 years) between CCGs more and less likely to have been affected by HSCA commissioning organisational change were compared with another outcome—unassisted birth rates—largely unaffected by HSCA changes.ResultsInterviewees identified that cervical screening commissioning and provision was more complex and ‘fragmented’, with responsibilities less certain, following the HSCA. Interviewees predicted this would reduce cervical screening rates in some areas more than others. Quantitative findings supported these predictions. Areas where CCGs dealt with multiple local authorities experienced a larger decline in cervical screening rates (1.4%) than those dealing with one local authority (1.0%). Over the same period, unassisted deliveries decreased by 1.6% and 2.0%, respectively, in the two groups.ConclusionsArrangements for commissioning and delivering cervical screening were disrupted and made more complex by the HSCA. Areas most affected saw a greater decline in screening rates than others. The fact that this was identified qualitatively and then confirmed quantitatively strengthens this finding. The study suggests large-scale health system reforms may have unintended consequences, and that complex commissioning arrangements may be problematic.

scholarly journals Seniors’ campus continuums: local solutions for broad spectrum seniors care

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Frances Morton-Chang ◽  
Shilpi Majumder ◽  
Whitney Berta
Keyword(s):  
Older Adults ◽  
Social Care ◽  
Care Home ◽  
Well Being ◽  
Social Needs ◽  
System Level ◽  
Organizational Level ◽  
Term Care ◽  
Health And Social Care ◽  
Housing Options

Abstract Background As demand and desire to “age-in-place” grows within an aging population, and new areas of need emerge, governments nationally and internationally are focusing effort and attention on innovative and integrative approaches to health and well-being. Seniors’ Campus Continuums are models of care that seek to broaden access to an array of services and housing options to meet growing health and social needs of aging populations. The objective of this study is to increase understanding of this model and factors that influence their evolution, development, ongoing functioning and capacity to integrate care for older adults wishing to age in their own home and community. Methods This research uses a comparative case study approach across six-bounded cases offering four geographically co-located components (mixed housing options, internal and external community supports, and a long-term care home) in various contexts across Ontario, Canada. Onsite in-person and phone interviews with senior campus staff (N = 30), and campus partners (N = 11), enhanced by direct observation at campuses explored historical and current efforts to offer health, housing and social care continuums for older adults. Results Analysis highlighted eight key factors. Enabling factors include i. rich historical legacies of helping people in need; ii. organizational vision and readiness to capitalize on windows of opportunity; iii. leveraging organizational structure and capacity; iv. intentional physical and social design; v. broad services mix, amenities and innovative partnerships. Impeding factors include vi. policy hurdles and rigidities; vii. human resources shortages and inequities; and viii. funding limitations. A number of benefits afforded by campuses at different levels were also observed. Conclusion Findings from this research highlight opportunities to optimize campus potential on many levels. At an individual level, campuses increase local access to a coordinated range of health and social care services, supports and housing options. At an organizational level, campuses offer enhanced collaboration opportunities across providers and partners to improve consistency and coordination of care, and improved access to shared resources, expertise and infrastructure. At a system level, campuses can address a diversity of health, social, financial, and housing needs to help seniors avoid premature or inappropriate use of higher intensity care settings.

scholarly journals Seniors’ Campus Continuums: Local Solutions for Broad Spectrum Seniors Care

2020 ◽  
Author(s):  
Frances Margaret Morton-Chang ◽  
Shilpi Majumder ◽  
Whitney Berta
Keyword(s):  
Older Adults ◽  
Social Care ◽  
Care Home ◽  
Well Being ◽  
Social Needs ◽  
System Level ◽  
Organizational Level ◽  
Term Care ◽  
Health And Social Care ◽  
Housing Options

Abstract Background: As demand and desire to “age-in-place” grows within an aging population, and new areas of need emerge, governments nationally and internationally are focusing effort and attention on innovative and integrative approaches to health and well-being. Seniors’ Campus Continuums are models of care that seek to broaden access to an array of services and housing options to meet growing health and social needs of aging populations. The objective of this study is to increase understanding of this model and factors that influence their evolution, development, ongoing functioning and capacity to integrate care for older adults wishing to age in their own home and community.Methods: This research uses a comparative case study approach across six-bounded cases offering four geographically co-located components (mixed housing options, internal and external community supports, and a long-term care home) in various contexts across Ontario. Onsite in-person and phone interviews with senior campus staff (N=30), and campus partners (N=11), enhanced by direct observation at campuses explored historical and current efforts to offer health, housing and social care continuums for older adults.Results: Analysis highlighted eight key factors. Enabling factors include i. rich historical legacies of helping people in need; ii. organizational vision and readiness to capitalize on windows of opportunity; iii. leveraging organizational structure and capacity; iv. intentional physical and social design; v. broad services mix, amenities and innovative partnerships. Impeding factors include vi. policy hurdles and rigidities; vii. human resources shortages and inequities; and viii. funding limitations. A number of benefits afforded by campuses at different levels were also observed. Conclusion: Findings from this research highlight opportunities to optimize campus potential on many levels. At an individual level, campuses increase local access to a coordinated range of health and social care services, supports and housing options. At an organizational level, campuses offer enhanced collaboration opportunities across providers and partners to improve consistency and coordination of care, access to shared resources, expertise and infrastructure among other benefits. At a system level, campuses can address a diversity of health, social, financial, and housing needs to help seniors avoid premature or inappropriate use of higher intensity care settings.

scholarly journals Linkage of national health and social care data: a cross-sectional study of multimorbidity and social care use in people aged over 65 years in Scotland

2020 ◽  
Author(s):  
David A G Henderson ◽  
Iain Atherton ◽  
Colin McCowan ◽  
Stewart W Mercer ◽  
Nick Bailey
Keyword(s):  
Social Care ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Term Care ◽  
Logistic Regression Models ◽  
Care Services ◽  
Health And Social Care ◽  
Care Survey ◽  
Average Marginal Effects ◽  
The Relationship

Abstract Background little is known about the relationship between multimorbidity and social care use (also known as long-term care). The aim of this study was to assess the relationship between receipt of formal social care services and multimorbidity. Methods this retrospective data linkage, observational study included all individuals over the age of 65 in the population of Scotland in financial years 2014–15 and 2015–16 (n = 975,265). The main outcome was receipt of social care measured by presence in the Scottish Social Care Survey. Logistic regression models were used to assess the influence of multimorbidity, age, sex and socioeconomic position on the outcome reporting average marginal effects (AME). Findings 93.3% of those receiving social care had multimorbidity, 16.2% of those with multimorbidity received social care compared with 3.7% of those without. The strongest magnitudes of AME for receiving social care were seen for age and multimorbidity (respectively, 50 and 18% increased probability comparing oldest to youngest and most severe multimorbidity to none). A 5.5% increased probability of receiving social care was observed for the most-deprived compared with the least-deprived. Interpretation higher levels of social care receipt are observed in those with increasing age, severe multimorbidity and living in more deprived areas. Multimorbidity does not fully moderate the relationship between social care receipt and either age or deprivation.

scholarly journals Association between receipt of social care and multimorbidity: evidence from a population-sized cohort in Scotland

2019 ◽  
Vol 4 (3) ◽  
Author(s):  
David Henderson ◽  
Iain Atherton ◽  
Nick Bailey ◽  
Colin McCowan ◽  
Stewart Mercer
Keyword(s):  
Social Care ◽  
Developed Countries ◽  
Societal Implications ◽  
Term Care ◽  
Long Term Conditions ◽  
Care Services ◽  
Health And Social Care ◽  
Care Survey ◽  
The Relationship

Multimorbidity, the presence of two or more long-term conditions, is associated with numerous negative outcomes. Little is known, however, about the relationship between multimorbidity and social care use (also known as long-term care). This is important as many developed countries seek to integrate health and social care services as a means of improving quality of services at the same time as making efficiency savings. The aim of the study was to assess the relationship between receipt of formal social care services, sociodemographic variables, and two proxy measures of multimorbidity. For this retrospective population-based observational study including all individuals over the age of 65 in Scotland in financial years 2014/15 and 2015/16 (n= 975,265), we linked the Scottish Social Care Survey (which holds information on those receiving social care from local authorities) to administrative NHS community prescribing and demographic records. The main outcome binary measure was presence or not in the social care survey. Two proxy measures of multimorbidity were derived from prescribing data. We used logistic regression models and report Average Marginal Effects (AME). Fifteen percent of all individuals received formal social care services. After adjustment for other modelled factors, multimorbidity showed an increasing magnitude of effect on receipt of social care (AME 16.4% (95% CI 16.2-16.6%) increased probability for 9+ medicines compared to 0-2 medicines, AME 18.8% (95% CI 18.5-19.1%) increased probability for 6+ BNF chapters compared to 0 BNF chapters). The magnitude of effect of deprivation on social care receipt was lower (AME 5.1% (95% CI 4.8-5.4%) increased probability in the most deprived area decile compared to the most affluent) after adjusting for multimorbidity and other demographic factors. This is one of the first studies to demonstrate an association between multimorbidity and receipt of social care. Increasing prevalence of multimorbidity has greater societal implications than previously described.

scholarly journals Seniors’ Campus Continuums: Local Solutions for Broad Spectrum Seniors Care

2020 ◽  
Author(s):  
Frances Margaret Morton-Chang ◽  
Shilpi Majumder ◽  
Whitney Berta
Keyword(s):  
Older Adults ◽  
Social Care ◽  
Care Home ◽  
Well Being ◽  
Social Needs ◽  
System Level ◽  
Organizational Level ◽  
Term Care ◽  
Health And Social Care ◽  
Housing Options

Abstract Background: As demand and desire to “age-in-place” grows within an aging population, and new areas of need emerge, governments nationally and internationally are focusing effort and attention on innovative and integrative approaches to health and well-being. Seniors’ Campus Continuums are models of care that seek to broaden access to an array of services and housing options to meet growing health and social needs of aging populations. The objective of this study is to increase understanding of this model and factors that influence their evolution, development, ongoing functioning and capacity to integrate care for older adults wishing to age in their own home and community.Methods: This research uses a comparative case study approach across six-bounded cases offering four geographically co-located components (mixed housing options, internal and external community supports, and a long-term care home) in various contexts across Ontario. Onsite in-person and phone interviews with senior campus staff (N=30), and campus partners (N=11), enhanced by direct observation at campuses explored historical and current efforts to offer health, housing and social care continuums for older adults.Results: Analysis highlighted eight key factors. Enabling factors include i. rich historical legacies of helping people in need; ii. organizational vision and readiness to capitalize on windows of opportunity; iii. leveraging organizational structure and capacity; iv. intentional physical and social design; v. broad services mix, amenities and innovative partnerships. Impeding factors include vi. policy hurdles and rigidities; vii. human resources shortages and inequities; and viii. funding limitations. A number of benefits afforded by campuses at different levels were also observed. Conclusion: Findings from this research highlight opportunities to optimize campus potential on many levels. At an individual level, campuses increase local access to a coordinated range of health and social care services, supports and housing options. At an organizational level, campuses offer enhanced collaboration opportunities across providers and partners to improve consistency and coordination of care, access to shared resources, expertise and infrastructure among other benefits. At a system level, campuses can address a diversity of health, social, financial, and housing needs to help seniors avoid premature or inappropriate use of higher intensity care settings.

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.

The association of loneliness with health and social care utilisation in older adults in the general population: A systematic review

2021 ◽  
Author(s):  
Kimberley J Smith ◽  
Christina Victor
Keyword(s):  
Older Adults ◽  
General Population ◽  
Social Care ◽  
Care Home ◽  
Service Utilisation ◽  
Study Quality ◽  
Cross Sectional ◽  
Consistent Finding ◽  
Care Utilisation ◽  
Health And Social Care

Abstract Background and Objectives Loneliness is proposed to be linked with increased service use. This review examined the association of loneliness and health and social care utilisation (HSCU) in older adults from the general population. Research Design and Methods Four databases were screened for studies that examined the association of loneliness (predictor) with HSCU (outcome) in older adults (defined as majority of sample 60 or older). Study quality was assessed with the NIH scale for observational cohorts and cross-sectional studies. Results We identified 32 studies, of which 9 prospective studies were evaluated as being good or good-fair quality. Two good-fair quality studies found loneliness at baseline was associated with subsequent admission to a residential care home. There was emerging evidence that loneliness was associated with emergency department use (n=1), and CVD-specific hospitalisation (n=1). Once adjusted for confounders the highest quality studies found no association of baseline loneliness with physician utilisation, outpatient service utilisation, skilled nursing facility use, and planned or unplanned hospital admissions. The remaining, studies were cross-sectional, or of fair to poor quality, and inadequate to reliably determine whether loneliness was associated with a subsequent change in HSCU. Discussion and implications There was heterogeneity in study design, measurement, and study quality. This generated an inconsistent evidence base where we cannot determine clear inferences about the relationship between loneliness and HSCU. Only one consistent finding was observed between two good-fair quality studies regarding care home admission. To determine clinical implications and make reliable inferences additional good quality longitudinal research is needed.

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