Delivering Health and Social Care for People with Long-Term Conditions: The Policy Context

Author(s):  
Alistair Hewison
2010 ◽  
Vol 18 (1) ◽  
pp. 45-52 ◽  
Author(s):  
Jessica Abell ◽  
Jane Hughes ◽  
Siobhan Reilly ◽  
Kathryn Berzins ◽  
David Challis

2020 ◽  
pp. 174239532093704
Author(s):  
Amanda Wilkinson ◽  
Janel Atlas ◽  
Katrina Nelson ◽  
Hilda Mulligan

Objectives Health and social care navigation services provide support for people with long-term conditions. Such services are available in the New Zealand (NZ) context. However little is known nationally or internationally about clients’ experience of engaging with such services. This study aimed to describe client perspectives of engaging with a health and social care navigation service in a NZ metropolitan city. Methods The manager and navigators of the service recruited clients who were previous users of the service. We individually interviewed nine clients (F = 7; M = 2; aged between 30–80 years) in their homes. Many of the participants reported social isolation, and some were without regular income. We transcribed interviews verbatim and analysed data thematically. Results There was one overall theme: Restoration of my essence or being (in the Māori language, wairua), and sense of belonging (turangawaewae) through a regenerative approach developed in partnership between the navigator and the client. Thus, participants felt renewed and validated as human beings. Discussion Enabling clients to feel re-valued as human beings captures the concept of personhood whereby a person has capability and capacity for life choices. We suggest enabling a client to feel valued assists in development of self-determination and consequently improved health and well-being.


2006 ◽  
Vol 16 (4) ◽  
pp. 301-312 ◽  
Author(s):  
Ruth Harris ◽  
Roz Ullman ◽  
Peter Griffiths

The involvement of service users as active participants is a stated aim of many current developments within health and social care, and self-assessment has been identified as a key mechanism. For over 15 years, the UK Department of Health has referred to the importance of the service user's views in assessment, and this has been re-emphasized recently in guidance issued to both local authorities social services and the NHS. The concept of the expert patient and the promotion of self-care amongst people with long-term conditions are also highlighted as central to current NHS development. Although not specified as such, self-assessment is an important component of these person-centred initiatives which encourage self-diagnosis, self-monitoring and self-management.


Author(s):  
David Henderson ◽  
Iain Atherton ◽  
Nick Bailey ◽  
Colin McCowan ◽  
Stewart Mercer

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.


2021 ◽  
Author(s):  
Julius Cesar Alejandre ◽  
Sebastien Chastin ◽  
Katherine Irvine ◽  
Michail Georgiou ◽  
Preeti Khanna ◽  
...  

Abstract Background: Nature-based social prescribing programmes such as "bluespace prescription" may promote public health and health improvement of individuals with long-term conditions. However, there is limited systematically synthesised evidence that investigates the contexts and mechanisms of Bluespace Prescription Programmes (BPPs) that could inform programme theories for policy and practice. Methods: We conducted a realist review by searching six databases for articles published between January 2000 and February 2020, in English, about health and social care professionals providing referral to or prescription of blue space activities with health-related outcomes. We developed themes of contextual factors by analysing the contexts of BPPs. We used these contextual factors to develop programme theories describing the mechanisms of BPP implementation. Our study was registered with PROSPERO (CRD42020170660). Results: Fifteen studies with adequate to strong quality were included from 6,736 records. Service users had improvements on their physical, mental, social health, and environmental knowledge after participating in BPPs referred to or prescribed by health and social care professionals. Patient-related contextual factors were referral information, free equipment and transportation, social support, blue space environments, and skills of service providers. Intervention-related contextual factors were communication, multi-stakeholder collaboration, financing, and adequate service providers. Programme theories on patient enrolment, engagement, adherence, communication protocols, and long-term programme sustainability described the mechanisms of BPP implementation. Conclusion: BPPs could support health and social care services if contextual factors influencing patients and intervention delivery are considered for implementation. Our findings have implications in planning, development, and implementation of similar nature-based social prescribing programmes in health and social care settings. Keywords: sustainable healthcare, social prescribing, blue spaces, bluespace prescriptions


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