A paper examined the United Kingdom market in care services for older people, ways in which to address market failures in commissioning, and how to reconcile the need of public sector commissioners to contain costs with the need of providers to earn an adequate return. The paper argued for a new style of contracts with social care maintenance organizations (explained as either a not-for-profit or for-profit organization, or a statutory body or arms-length company owned by a statutory body, or a consortium made up by any of these) acting as 'lead provider' for a comprehensive range of social care services for older people with assessed care needs.
Source: William Laing, Strategic Commissioning of Long Term Care for Older People: Can we get more for less?, LaingBuisson
Links: Paper | LaingBuisson press release
Date: 2014-Sep
An article examined the development of 'whole-system' integrated health and social care in England, and the key lessons learned.
Source: Claire Kennedy and Simon Morioka, 'The development of whole-system integrated care in England', Journal of Integrated Care, Volume 22 Number 4
Links: Abstract
Date: 2014-Sep
An article examined findings from an empirical study of relevant government officials from three countries using 'advanced personalization' (Canada, England, and the United States of America), which examined their views on personalization and the remaking of adult social care, and on managing expectations for change. It said that, despite the relative success of personalization, the findings revealed a tempered, cautious account, with respondents aware of risks that were inherent in self-led support, government limitations in changing systems, and the creation of a social care market. It said that the findings supported a strong case for forms of 'progressive localism'.
Source: Andrew Power, 'Personalisation and austerity in the crosshairs: government perspectives on the remaking of adult social care', Journal of Social Policy, Volume 43 Issue 4
Links: Abstract
Date: 2014-Sep
A themed section of a journal examined the development of policy of, and for, information in health and social care over the previous ten years in the United Kingdom and Australia.
Source: Social Policy and Society, Volume 13 Issue 4
Links: Table of contents
Notes: Articles included:
Penelope Hill, 'Supporting personalisation: the challenges in translating the expectations of national policy into developments in local services and their underpinning information systems'
Karin Garrety, Ian McLoughlin, and Gregor Zelle, 'Disruptive innovation in health care: business models, moral orders and electronic records'
Susan Baines, Penelope Hill, and Karin Garrety, 'What happens when digital information systems are brought into health and social care? Comparing approaches to social policy in England and Australia'
Date: 2014-Sep
A report provided findings from a survey of the voluntary and community sector (VCS) in England about how it was engaging with health and well-being boards (HWBs). It said that some good practice was emerging, although reports suggested that the VCS was being under-utilized by local partners in health and care. The report made recommendations to improve links between the VCS and the activity of HWBs.
Source: Supporting Influence on Health and Wellbeing Boards: Report from survey Spring 2014, Regional Voices
Links: Report | Summary | Regional Voices press release
Date: 2014-Sep
An article examined the implementation of one service provider's developments in integrated and personalized care. Drawing on structuration theory, the article explored how policy and legislation were translated into local perspectives and operational practice. It said the evidence suggested a need for better understanding of policy interpretation and translation, as well as the role of information and information services in front line delivery.
Source: Penelope Hill, 'Supporting personalisation: the challenges in translating the expectations of national policy into developments in local services and their underpinning information systems', Social Policy and Society, Volume 13 Issue 4
Links: Abstract
Date: 2014-Sep
A report provided findings of the independent evaluation of the Social Work Practice with Adults (SWPwA) pilots. SWPwAs were organizations independent of local authorities that were contracted to support adults in the community, carrying out functions that were previously the duty of local authorities. Chapter topics included the setting up period, governance and management, SWPwA practice, relationships with commissioning bodies, service user outcomes, and staff perspectives.
Source: Jill Manthorpe, Jess Harris, Shereen Hussein, Michelle Cornes, and Jo Moriarty, Evaluation of the Social Work Practices With Adults Pilots: Final report, Social Care Workforce Research Unit (King's College London)
Links: Report | Community Care report
Date: 2014-Aug
A report examined the early work of the Troubled Families programme, describing the families who entered the programme up to December 2013 and examining the type of presenting issues. Noting caveats regarding the nature of the data, the report discussed the implications of the findings and how local authorities were changing the way they worked with families.
Source: Understanding Troubled Families, Department for Communities and Local Government
Links: Report | DCLG press release
Date: 2014-Jul
A think-tank report examined the scope for partnerships between housing associations and the National Health Service. It said that the existing objectives in health and social care fit well with the capabilities, strengths, and ethos of the social housing sector, and that housing associations providing supported housing could help to deliver the government's health strategy through initiatives such as joint ventures to provide new models of supported housing, step-down and reablement facilities, or extra support and care for people in their own homes. The report was published alongside a further report which discussed the use of surplus National Health Service land for new supported housing provision.
Source: Denise Chevin, Housing Associations and the NHS: New thinking, new partnerships, Smith Institute
Links: Report | Surplus land report
Date: 2014-Jul
A report provided a summary of published reviews on the economic impacts of integrated care approaches, drawing on a systematic search of existing literature. It said that there was a lack of definitional clarity over what constituted integrated care, and over the intended outcomes, that needed to be overcome in order to assess impact. However, it did find evidence that suggested a positive impact of integrated care programmes on the quality of patient care and improved health or patient satisfaction outcomes, and said that some evidence was found of cost-effectiveness of selected integrated approaches.
Source: Ellen Nolte and Emma Pitchforth, What Is the Evidence on the Economic Impacts of Integrated Care?, European Observatory on Health Systems and Policies
Links: Report | EOHSP press release
Date: 2014-Jun
A paper provided an overview of transition planning services provided to young people with learning disabilities as they moved from children's services to adult services in Great Britain, outlining the relevant legislation and policy in England, Scotland, and Wales and highlighting a number of national and local transition planning projects.
Source: Lynda Conlon, Transition Planning for Young People with Learning Disabilities in Great Britain, Research Paper 65/14, Northern Ireland Assembly
Links: Paper
Date: 2014-Jun
An article examined integration in health care in the United States and England. The article applied concepts of economic integration to examine why integration did or did not occur in health settings, and whether expectations of integrating different kinds of providers and health and social services were realistic.
Source: Miriam Laugesen and George France, 'Integration: the firm and the health care sector', Health Economics, Policy and Law, Volume 9 Issue 3
Links: Abstract
Date: 2014-Jun
The government published its response to a consultation on draft regulations that would extend the range of children's social care functions that local authorities could delegate to third party providers. It said that, under new regulations to be introduced in autumn 2014, local authorities would be able to delegate social care functions to mutuals, community interest companies, and other not-for-profit organizations to deliver children's social care, but only bodies working on a not-for-profit basis would be able to take on the functions. The accountability of local authorities and role of Ofsted would remain unchanged.
Source: Consultation on Powers to Delegate Social Care Functions: Government response, Department for Education
Links: Consultation response | Consultation document | DE press release | 4Children press release | Childrens Society press release | Children England press release | Guardian report
Date: 2014-Jun
An article examined the literature around joint working in health and social care for older people and people with mental health problems in the United Kingdom. Updating an earlier literature review, it said there were signs that some joint working or integration initiatives could deliver outcomes desired by government, and some evidence to suggest benefits to service users or carers. However, the authors concluded that the available evidence did not support the current or previous government's faith in the strategy of health and social care integration.
Source: Ailsa Cameron, Lisa Bostock, and Rachel Lart, 'Service user and carers perspectives of joint and integrated working between health and social care', Journal of Integrated Care, Volume 22 Number 2
Links: Abstract
Date: 2014-May
An article examined the relationship between general practitioners (family doctors) and social care professionals. Reflecting on the Home Truths project, that sought to improve joint working between general practice and social care though an action research process, it said that family doctors' knowledge of social care services was poor, they rated their relationship with social workers as poor, and they perceived that social care services were of poor quality. It said that family doctors had expressed a desire to work more closely with social care, but interventions to improve relationships were found to focus on daily practice, rather than introducing new initiatives. The article noted the low response rate of family doctors (10 per cent) and difficulties in outcome measurement.
Source: Catherine Mangan and Robin Miller, 'Time for some home truths – exploring the relationship between GPs and social workers', Journal of Integrated Care, Volume 22 Number 2
Links: Abstract
Date: 2014-May
A report examined the use of, and outcomes from, integrated care funding transfers for 2012-13 and 2013-14, which were granted to support adult social care services that also had a health benefit, encourage health and social care integration, support existing services facing budget pressures, or deliver new services through transformation programmes. Based on freedom of information requests sent to local authorities in England, the report said that funding was used primarily as a means to support existing services, rather than to transform and more closely integrate health and social care services. It said that there was a wide variation in how funding was invested and reported, but it was not sufficient to meet increasing health and social care needs of local populations, there was a lack of robust outcomes data, and less than 4 per cent of funding had gone to local mental health services. The report concluded that, while there had been much support for the integration of health and social care, service change remained subject to significant local variation and the results had important implications for the introduction of the Better Care Fund from 2015.
Source: All in this Together? An analysis of spending on integrated care by commissioners in the new health and social care system, MHP Health
Links: Report | National Care Forum report
Date: 2014-May
The Welsh Assembly approved the Social Services and Well-being (Wales) Act. The Act was designed to bring together a wide range of local authorities' duties and functions in relation to improving the well-being of people who needed care and support, and of carers. The provisions covered assessment procedures and requirements for meeting need, as well as provisions regarding children and young people within the care system, partnership working, and complaints.
Source: Social Services and Well-being (Wales) Act, Welsh Government, TSO
Links: Act | Explanatory notes | Welsh Government press release
Date: 2014-May
A report examined the integration of health and social care, the Better Care Fund, and the role of county councils in shaping the future of care in England. The report drew on the findings of a survey of county councils.
Source: Delivering the Better Care Fund in Counties, County Councils Network
Links: Report | Public Finance report
Date: 2014-May
An article examined the policy of personalization within adult social care, focusing on the implications for social work. Both governments and the disability movement associated personalization with the concept of social citizenship: but it could also be analyzed in terms of neo-liberalism and consumerism. It said that, either way, budget cuts were limiting the opportunities for social workers to practise it.
Source: Mark Lymbery, 'Understanding personalisation: implications for social work', Journal of Social Work, Volume 14 Number 3
Links: Abstract
Date: 2014-Apr
The Welsh Government began consultation on proposals to introduce new arrangements for multi-agency adult practice reviews, to replace the current serious case review policy and procedure. The consultation document was accompanied by draft guidance. The consultation would close on 27 June 2014.
Source: Protecting Adults at Risk in Wales: Arrangements for Multi-Agency Adult Practice Reviews, WG21166, Welsh Government
Links: Consultation document | Draft guidance | Welsh Government press release
Date: 2014-Apr
A report discussed the health and social care system in England and said that it was no longer fit for purpose in the context of an ageing demography and the current funding environment. It called for health and social care provision to be integrated into a single system, with a ring-fenced, singly commissioned budget, and more closely aligned entitlements. The work of the Commission would continue, and a further call for evidence was issued alongside this interim report.
Source: Commission on the Future of Health and Social Care in England, A New Settlement for Health and Social Care: Interim report, King's Fund
Links: Report | Summary and backgound papers | Call for evidence | Kings Fund press release | Age UK press release | Care and Support Alliance press release | CSP press release | BBC report | Guardian report
Date: 2014-Apr
The government began consultation on proposals to widen the range of children's social services functions that a local authority in England might privatize. The draft regulations (published alongside the consultation) would enable all social services functions related to children (with some exceptions) to be discharged by a third party provider. The regulations would also permit the delegation of certain duties of the local authority in relation to co-operation, Children's Trust Boards, and the implementation of Children and Young People's Plans. The consultation would close on 30 May 2014.
Source: Powers to Delegate Children's Social Care Functions, Department for Education
Links: Consultation document | Draft regulations
Date: 2014-Apr
The Public Bodies (Joint Working) (Scotland) Act 2014 was given Royal assent. The Act provided a framework to support the improvement of the quality and consistency of health and social care services, permitting the integration of local authority services with health services, and providing for other joint working arrangements.
Source: Public Bodies (Joint Working) (Scotland) Act 2014, Scottish Parliament, TSO
Links: Act | Explanatory notes
Date: 2014-Apr
An article examined research evidence related to joint working in the field of adult health and social care services, and whether recent reforms to joint working had met the objectives set by policy-makers. There was some indication that recent developments, in particular the drive to greater integration of services, might have positive benefits for organizations as well as for users and carers of services. However, the evidence consistently reported a lack of understanding about the aims and objectives of integration, suggesting that more work needed to be done if the full potential of the renewed policy agenda on integration were to be realized.
Source: Ailsa Cameron, Rachel Lart, Lisa Bostock, and Caroline Coomber, 'Factors that promote and hinder joint and integrated working between health and social care services: a review of research literature', Health and Social Care in the Community, Volume 22 Issue 3
Links: Abstract
Date: 2014-Apr
A report examined health and care services for older people in England, in the context of an ageing population. It said that a fundamental shift was required, moving towards co-ordinating care around individual needs rather than single diseases, alongside the prioritization of prevention and support for maintaining independence. The report outlined areas of good practice, identified aspects of care that required improvement, and highlighted the need for integrated working across teams to ensure that sufficient and appropriate services would be available in the right locations.
Source: David Oliver, Catherine Foot, and Richard Humphries, Making Our Health and Care Systems Fit for an Ageing Population, King's Fund
Links: Report | Kings Fund press release | CSP press release
Date: 2014-Mar
A report provided the findings of the Independent Commission on Whole-Person Care. The commission was established by the Labour Party to make recommendations about how to integrate health and social care services in England, within existing resources and without further reorganization. The report would feed into the ongoing development of party policy.
Source: One Person, One Team, One System, Independent Commission on Whole Person Care
Links: Report | Alzheimers Society press release | Independent Age press release | Kings Fund press release
Date: 2014-Mar
A paper examined the development of accountable care organizations (ACOs) in the United States and considered the implications for integrated care initiatives for England. It said that an ACO generally consisted of a group of providers that agreed with commissioners to provide all care for a certain population for a defined period of time, being held accountable to pre-agreed quality outcomes within a given budget or expenditure target. The paper said that the transfer from the United States to the United Kingdom context was not straightforward, however, and recommended caution in transferring the concept to the English National Health Service.
Source: Stephen Shortell, Rachael Addicott, Nicola Walsh, and Chris Ham, Accountable Care Organisations in the United States and England: Testing, evaluating and learning what works, King's Fund
Links: Paper
Date: 2014-Mar
An article examined the concept of safeguarding children being 'everybody's business'. Drawing on a study in one neighbourhood in south Wales, the discussion examined three overlapping spheres of safeguarding (informal, community, and formal) and the enablers and barriers to relationships between them. The article concluded that the community sector's vital role should be recognized and enhanced, and recommended that statutory social workers should be closely located within their local communities.
Source: Sally Holland, 'Trust in the community: understanding the relationship between formal, semi-formal and informal child safeguarding in a local neighbourhood', British Journal of Social Work, Volume 44 Number 2
Links: Abstract
Date: 2014-Mar
A study examined patterns of health and social care use and costs, to establish which groups of people might benefit from better integration of services. The study drew on data from the South Somerset Symphony project, which was designed to establish greater collaboration between primary, community, acute, and social care, particularly for people with complex conditions.
Source: Panos Kasteridis, Andrew Street, Matthew Dolman, Lesley Gallier, Kevin Hudson, Jeremy Martin, and Ian Wyer, The Importance of Multimorbidity in Explaining Utilisation and Costs Across Health and Social Care Settings: Evidence from South Somerset s Symphony Project, Centre for Health Economics (University of York)
Links: Report
Date: 2014-Mar
A new book examined the impact of the marketisation of social work services in Ireland and England, arguing that it had a negative impact on policy regimes, working conditions, social work practices, and services for vulnerable children and young people.
Source: Paul Michael Garrett (ed.), Children and Families, Policy Press
Links: Summary
Date: 2014-Mar
An article compared the probability of receiving formal and informal care from household members and from others in England, Spain, and the United States of America – three countries with different family structures, living arrangements, and policies supporting the care of people with incapacities.
Source: Aida Sole-Auro and Eileen Crimmins, 'Who cares? A comparison of informal and formal care provision in Spain, England and the USA', Ageing and Society, Volume 34 Issue 3
Links: Abstract
Date: 2014-Mar
A report examined the work of Independent Review Officers in England. All children in care had an IRO, an adult who had oversight of their care plan and was empowered to act on their behalf in challenging the local authority. The report said that IROs could have an impact on managing the review of care plans, and they were able to contribute to improved support and services for looked-after children, but consistent practice was found to be undermined by a range of issues, including high case loads, an inability to assert independence and confront poor practice, and an expectation to conduct other duties outside the IRO remit. The report made recommendations to strengthen independent practice.
Source: Helena Jelicic, Ivana La Valle, Di Hart, and Lisa Holmes, The Role of Independent Reviewing Officers (IROs) in England: Final report, National Children s Bureau
Links: Report | Summary | NCB press release
Date: 2014-Mar
An article examined early findings from the evaluation of pilot Social Work Practices (SWPs), which were established in England in 2009 to deliver social work services to looked-after children and care leavers. It described features of the varied emerging models and their relationships with local authorities. The article concluded that the findings showed some dilution of the original SWP model, although the diversity of pilots allowed benefits of the various formats to emerge.
Source: Nicky Stanley, Helen Austerberry, Andy Bilson, Nicola Farrelly, Katrina Hargreaves, Shereen Hussein, Anne Ingold, Jill Manthorpe, Julie Ridley, and Vicki Strange, 'Establishing Social Work Practices in England: the early evidence', British Journal of Social Work, Volume 44 Number 2
Links: Abstract
Date: 2014-Mar
A report examined the role of integrated financial mechanisms in supporting and incentivizing integrated health and social care. The report was based on a literature review, which found 38 studies across eight countries (including England). It said that schemes that integrated funds and resources seldom led to improved health outcomes and, if schemes were successful in assessing patient needs, they would be likely to identify previously unmet need, thus increasing overall cost. The report said that the evidence from England revealed that outcome evaluation was challenging, as new schemes often emerged in the context of other evolving policy initiatives, and that future policy should bear this in mind.
Source: Anne Mason, Maria Goddard, and Helen Weatherly, Financial Mechanisms for Integrating Funds for Health and Social Care: An evidence review, Centre for Health Economics (University of York)
Links: Report | CHE press release
Date: 2014-Mar
A report provided an overview of the adult social care system in England. It said that care needs were increasing at a time when state spending was falling, and there was unmet need. The report highlighted changes within the care system (including those arising from the Care Bill and the Better Care Fund), challenges faced by local authorities and health commissioners, and risks to safeguarding of vulnerable adults. It said that new monitoring and improvement arrangements were not yet fully established and, as changes took effect, central and local government were at risk as a result of having insufficient evidence on service levels, unmet need, care quality, and value for money.
Source: Adult Social Care in England: Overview, HC 1102 (Session 2013–14), National Audit Office, TSO
Links: Report | Summary | Appendices | NAO press release | Age UK press release | CSP press release
Date: 2014-Mar
An article examined the relationship between personalization reforms of social care services in England and the redevelopment of day centres for older people and people with a disability. It discussed the nature of the narrative of personalization and its relationship with the closure of day care centres and creation of alternative community spaces.
Source: Catherine Needham, 'Personalization: from day centres to community hubs?', Critical Social Policy, Volume 34 Issue 1
Links: Abstract
Date: 2014-Feb
A concordat was signed by organizations from the health, social services, emergency services, and local government sectors in England. The concordat was a shared, agreed statement of intent and common purpose regarding policy-making and spending decisions for services to anticipate and meet the needs of people who had mental health crises. It covered: access to services that prevent crisis; urgent and emergency access to crisis care; the quality of treatment and care while in crisis; and recovery and ongoing prevention. It discussed commissioning and set out a timed action plan.
Source: Mental Health Crisis Care Concordat: Improving outcomes for people experiencing mental health crisis, Department of Health
Links: Concordat | Summary | DH press release | ACPO press release | CMH press release | MHF press release | NHS Confederation press release | NHS England press release | RCN press release | Turning Point press release | Guardian report
Date: 2014-Feb
A report provided a review of research evidence on health and social care integrated practice. Building on an earlier review (An Evidence Base for the Delivery of Adult Services, published in 2011), the report discussed the key dimensions for the effective implementation of change.
Source: Alison Petch, Delivering Integrated Care and Support, Institute for Research and Innovation in Social Services
Links: Report | 2011 report
Date: 2014-Jan
A report examined the impact of advocacy services for people who used social care services in the United Kingdom and Ireland. It said there was a notable lack of published, robust evidence, particularly on cost-effectiveness but also on how advocacy works and its significance for users of social care. The report said it was also difficult to isolate the impact of advocacy work from that of other services, such as advice provision and befriending. The report called for further research to map advocacy organizations, on impact for a range of vulnerable groups, to identify the nature of advocacy, and to conduct cost-benefit analysis.
Source: Alison Macadam, Rich Watts, and Rob Greig, The Impact of Advocacy for People who Use Social Care Services, National Institute for Health Research
Links: Report | NIHR press release | NDTi press release | National Care Forum report
Date: 2014-Jan
The inspectorate for education and children's services said that inspections of local authority private fostering arrangements in England had identified a number of ways to improve the collection and management of information about private fostering so that, nationally, there would be a better understanding of this area. Highlighting a range of key points from recent inspections, it also recommended adjustments to existing requirements for authorities to make an annual review of their arrangements.
Source: Private Fostering: Better information, better understanding, HMI 130249, Office for Standards in Education, Children's Services and Skills
Links: Report | OFSTED press release
Date: 2014-Jan