Objective: Little is known about how to achieve scale and spread beyond the early local adoption of an innovative health care programme. We use the New Care Model - or 'Vanguard' - programme in the English National Health Service to illuminate the process, assessing why only one of five Vanguard programmes was successfully scaled up.
Methods: We interviewed a wide range of stakeholders involved in the Vanguard programme, including programme leads, provider organisations, and policymakers.
Internationally, there is a large body of scientific evidence concerning the benefits of integrating health and social care to ensure that frail older people living in the community receive the assistance they need to maintain independence. In the Brazilian city of Belo Horizonte, located in the state of Minas Gerais, an integrated care intervention has been developed: the (PMC). This programme represents a pioneering example in Brazil of the provision of carers for highly vulnerable older people, through integrated action between public health and social service agencies.
View Article and Find Full Text PDFBackground: With innovation in service delivery increasingly viewed as crucial to the long-term sustainability of health systems, NHS England launched an ambitious new model of care (Vanguard) programme in 2015. Supported by a £350 million transformation fund, 50 Vanguard sites were to act as pilots for innovation in service delivery, to move quickly to change the way that services were delivered, breaking down barriers between sectors and improving the coordination and delivery of care.
Methods: As part of a national evaluation of the Vanguard programme, we conducted an evidence synthesis to assess the nature and quality of locally commissioned evaluations.
Background And Problem Statement: Team climate describes shared perceptions of organisational policies, practices and procedures. A positive team climate has been linked to better interprofessional collaboration and quality of care. Most studies examine team climate health or social care organisations.
View Article and Find Full Text PDFBackground: Despite many studies evaluating the effectiveness of integrated care, evidence remains inconsistent. There is increasing commentary pointing out the mismatch between the ability to capture the somewhat 'illusive' impact of integrated care initiatives and programmes, and the most appropriate way to do this. Focusing on methodology, this paper describes and critically reviews the experiences of SUSTAIN, a Horizon 2020 funded project (2015-2019) with the purpose of advancing knowledge and understanding of cross-European integrated care evaluation.
View Article and Find Full Text PDFContinuity of care is concerned with quality of care over a period of time. It describes a process by which service users and their families are co-operatively involved with health and social care professionals in managing their care needs. Continuity of care can be divided into informational, managerial and relational and has been associated with improved user- and service-related outcomes.
View Article and Find Full Text PDFMoving older patients from hospitals to community services is a critical phase of integrated care. Yet there has been little large-scale research on the quality of these transitions. We investigated how Norwegian nurses working in community care services (N = 4312) and at in-patient wards at hospitals (N = 2421) experienced the quality of transitions of older patients from hospitals to community care.
View Article and Find Full Text PDFCloser integration of health and social care services has become a cornerstone policy in many developed countries, but there is still debate over what population and service level is best to target. In England, the 2019 Long Term Plan for the National Health Service included a commitment to spread the integration prototypes piloted under the Vanguard `New Care Models' programme. The programme, running from 2015 to 2018, was one of the largest pilots in English history, covering around 9 % of the population.
View Article and Find Full Text PDFThe increasing numbers of people at very old ages pose specific policy challenges for health and social care and highlight the need to rethink established models of service provision. The main objective of this paper is to introduce the concept of "avoidable displacement from home" (ADH). The study argues that ADH builds on and adds value to existing concepts, offering a holistic, person-centered framework for integrated health and social care provision for older people.
View Article and Find Full Text PDFObjectives: To synthesise existing literature on interventions addressing a new concept of avoidable displacement from home for older people with multimorbidity or frailty. The review focused on home-based interventions by any type of multidisciplinary team aimed at reducing avoidable displacement from home to hospital settings. A second objective was to characterise these interventions to inform policy.
View Article and Find Full Text PDFIntegrated care programmes are increasingly being put in place to provide care to older people living at home. However, knowledge about further improving integrated care is limited. In fourteen integrated care sites in Europe, plans to improve existing ways of working were designed, implemented and evaluated to enlarge the understanding of what works and with what outcomes when improving integrated care.
View Article and Find Full Text PDFIntroduction: Integrated care programmes are increasingly being put in place to provide care to older people who live at home. Knowledge of how to further develop integrated care and how to transfer successful initiatives to other contexts is still limited. Therefore, a cross-European research project, called Sustainable Tailored Integrated Care for Older People in Europe (SUSTAIN), has been initiated with a twofold objective: 1.
View Article and Find Full Text PDFBackground: Adolescence is a critical developmental stage when young people make lifestyle choices that have the potential to impact on their current and future health and social wellbeing. The relationship between substance use and criminal activity is complex but there is clear evidence that the prevalence of problematic substance use is far higher among adolescent offenders than the general adolescent population. Adolescent offenders are a marginalized and vulnerable population who are significantly more likely to experience health and social inequalities in later life than their non-offending peers.
View Article and Find Full Text PDFInt J Palliat Nurs
January 2017
Background: Death anxiety may interfere with health care workers' (HCW) relationship with patients and their families.
Aims: Evaluate an intervention to address death anxiety and improve HCW skills dealing with patients/families in palliative and end-of-life care.
Design: Quasi-experimental mixed methods approach with a pre-test/post-test design.
Int J Integr Care
April 2014
There is increasing international research into health and social care services for older people in need of long-term care (LTC), but problems remain with respect to acquiring robust comparative information to enable judgements to be made regarding the most beneficial and cost-effective approaches. The project 'INTERLINKS' ('Health systems and LTC for older people in Europe') funded by the EU 7th Framework programme was developed to address the challenges associated with the accumulation and comparison of evidence in LTC across Europe. It developed a concept and method to describe and analyse LTC and its links with the health and social care system through the accumulation of policy and practice examples on an interactive web-based framework for LTC.
View Article and Find Full Text PDFInt J Palliat Nurs
October 2011
Over recent years there have been several political imperatives in the UK directed toward children's palliative care and ensuring that services are high-quality, coordinated, family-centred, and able to meet the needs of children with complex disabilities. In addition, in 2010 the health and social care regulation authority in England-the Care Quality Commission (CQC)-aligned hospices with regulation and inspection requirements. This context has acted as a driver for the creation of effective education and training to ensure a skilled and expert workforce.
View Article and Find Full Text PDFCent Eur J Public Health
June 2010
This article describes health promotion for older people in the Czech Republic from the European perspective. It is based on findings from the European project healthPROelderly. Implementation of health promotion in the Czech republic as a new public health concept is outlined from the historical point of view.
View Article and Find Full Text PDFBackground: : Standards, benchmarking, and audits are integral to quality monitoring in health and social service provision. Recent policy in the UK National Health Service dictating the need for increased consumer involvement necessitates that service users have significant input into the composition of standards for quality of care.
Objective: : To report the authors' recent involvement in research towards developing a set of agreed, measureable statements regarding quality in the provision of continence services using the views of older service users.
Arch Phys Med Rehabil
July 2008
Objective: To understand the experiences of patients who had undergone neurologic rehabilitation.
Design: An interpretative phenomenological analysis of semistructured interviews.
Setting: Neurologic rehabilitation unit.
Eur J Ageing
December 2004
Undertaking projects with European partners is an enterprising and rewarding activity, where societies can start to learn how to transfer knowledge and take advantage of best practices to further the benefits to health and social care service users. However, this can also be a challenging experience, more so when there is scanty guidance about the best way to conduct European partnership research. Using an on-going study of integrated care for older persons as an example (the PROCARE project), this paper provides an account of the methodological strengths and challenges of the qualitative approach used.
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