Does home-based primary care improve patient outcomes?

An Overview Of Home-Based Primary Care: Learning From The Field | Commonwealth Fund

This Commonwealth Fund briefing synthesises the evidence and expert perspectives on how outcomes and costs are affected by utilising home-based primary care for housebound or functionally-limited patients. It finds that successful home-based primary care uses multidisciplinary teams, behavioural insights, social support and rapid response to acute care needs to reduce care costs and improve patient outcomes.

The briefing concludes that successful home-based care practices have achieved robust savings, but the future of the model will rely on innovative payment models and training initiatives.

Support for people with a learning disability

The Public Accounts Committee report, Local support for people with a learning disability, says greater focus is needed on measuring outcomes and improvements to quality of life.

Two years ago, the previous Committee of Public Accounts reported on the Department of Health’s efforts to move people with a learning disability out of mental health hospitals and into the community. At that time, the Committee found that progress had been poor but was promised improvements.

This follow up report finds the Transforming Care programme has moved some people out of hospital, however more needs to be done to address known barriers.  There is also concern that support for people with a learning disability who live in the community is patchy.

Social prescribing: less rhetoric and more reality

Bickerdike, L. et al. (2017) BMJ Open. 7:e013384.

network-1020332_960_720.jpg

Objectives: Social prescribing is a way of linking patients in primary care with sources of support within the community to help improve their health and well-being. Social prescribing programmes are being widely promoted and adopted in the UK National Health Service and so we conducted a systematic review to assess the evidence for their effectiveness.

Conclusions: Social prescribing is being widely advocated and implemented but current evidence fails to provide sufficient detail to judge either success or value for money. If social prescribing is to realise its potential, future evaluations must be comparative by design and consider when, by whom, for whom, how well and at what cost.

Read the full article here

Interventions for single parents should also recognise the needs of lone fathers

Chiu, M. et al. (2017) Journal of Epidemiology & Community Health. 71(5) pp. 417-423

people-1082911_960_720.jpg

Background: Lone parenthood is associated with poorer health; however, the vast majority of previous studies have examined lone mothers and only a few have focused on lone fathers. We aimed to examine the self-rated health and mental health status among a large population-based cross-sectional sample of Canadian lone fathers compared with both partnered fathers and lone mothers.

Conclusions: In this large population-based study, lone fathers had worse self-rated health and mental health than partnered fathers and similarly poor self-rated health and mental health as lone mothers. Interventions, supports and social policies designed for single parents should also recognise the needs of lone fathers.

Read the full article here

Transition from children’s to adult community services

New online learning resource for Community Nurses | The Queens Nursing Institute

The Queen’s Nursing Institute has launched Transition from Children’s to Adult Community Services Learning Resource.

The resource is designed to improve the experience of young people transitioning from children’s services to adult community services.  It contains modules for district nurses, general practice nurses and healthcare educators. To produce the resource, the QNI held ten focus groups in different parts of the country and conducted three online surveys, as well as undertaking wider stakeholder involvement. In all, the views of around 900 people were used to inform the resource.

The QNI also carried out a review of academic literature in this area, which can be downloaded:  Young people’s transition from children’s to adult services in primary and community care settings.

Total transformation of care and support

The Social Care Institute for Excellence has published Creating the five year forward view for social care: how transformed and integrated health and care could improve outcomes and cost-effectiveness.

This updated paper explores the potential for scaling up the most promising examples of care, support and community health services, initially using data from Birmingham City Council, modelling their outcomes and costs.  Originally published in November 2016, it has been updated to include additional models.

The report contains the following chapters:

Vision for transformed care: Re-shaping services around the needs and strengths of individuals, families and communities.

Key messages and summary: Outcomes can be improved, and costs reduced, if the sector scales up promising practice.

Case studies: Six models of care and their potential impact on costs and outcomes.

Models of care: Overview of promising practice that support transformative change in health and social care.

Conclusions and next steps

The paper is available to download here

Shifting the balance of care

Imison C, Curry N, Holder H, et al. Shifting the balance of care: great expectations.  March 2017 | Nuffield Trust.

arrow-1043850_1920

Moving care out of hospitals into the community can deliver holistic, patient-centred care closer to home.  In most cases however, it is unlikely to save money, according to a  report published today by The Nuffield Trust.

The report is based on a review of 27 schemes to reduce hospital activity, which included changes to urgent and emergency care pathways; speeding up discharge; managing ‘at risk’ groups; supported care at home; and cutting down on admissions.

Most of the initiatives demonstrated the potential to improve patient experience, and in some cases, outcomes. The evidence on cost savings was much less clear cut, partly because good economic evaluations have often not been carried out.

Several schemes did seem to be cost-effective in the right circumstances, but where schemes had been evaluated, most were cost neutral or were more expensive.

Download the full report here 

Report summary available here