Gillian Mary Parker

• BA (Hons), PhD
• Professor at University of York

Reablement – or restorative care – is a central feature of many western governments’ approaches to supporting and enabling older people to stay in their own homes and minimise demand for social care. Existing evidence supports this approach although further research is required to strengthen the certainty of conclusions being drawn. In countries wh...

Carers contribute essential support to enable people with dementia to continue living within the community. Admiral Nurses provide specialist dementia support for carers of people with dementia, including offering expert emotional support and guidance, and work to join up different parts of the health and social care system to address needs in a co...

Background Reablement is an intensive, time-limited intervention for people at risk of needing social care or an increased intensity of care. Differing from home care, it seeks to restore functioning and self-care skills. In England, it is a core element of intermediate care. The existing evidence base is limited. Objectives To describe reablement...

Background Unpaid carers are the mainstay of support for people with dementia. Admiral Nursing (AN) is the only specialist nursing service that specifically focuses on supporting such carers, but evidence of its effectiveness, costs and relationships with other health and social care services is limited. This project aimed to address this gap and e...

Background Two UK academic centres were commissioned to provide a responsive rapid evidence synthesis service. The service covered topics identified by the National Institute for Health Research Health Services & Delivery Research (NIHR HSDR) programme as priorities for the National Health Service or to inform research commissioning. Aims and obje...

Objective To update a 2010 meta-review of systematic reviews of effective interventions to support carers of ill, disabled, or older adults. In this article, we report the most promising interventions based on the best available evidence. Methods Rapid meta-review of systematic reviews published from January 2009 to 2016. Results Sixty-one system...

People with mental health conditions have a lower life expectancy and poorer physical health outcomes than the general population. Evidence suggests this is due to a combination of clinical risk factors, socioeconomic factors, and health system factors, notably a lack of integration when care is required across service settings. Several recent repo...

Unpaid carers are the mainstay of the UK care system for people with dementia. Yet caring can have an impact on the well-being and health of the carer. Admiral Nursing is the only specialist nursing service in the UK that specifically focuses on supporting carers of people with dementia, but evidence of its effectiveness, costs, and relationships t...

Findings: It became apparent through our focus groups that, when people talk about 'life story work', different people mean different things. This related to both process and outcomes. In particular, a person with dementia may have very different views from others about what life story work is for and how their life story products should be used....

· A brief introduction to care closer to home and dementia policy · Findings from research on the role of specialist nurses in supporting transfers between hospital and home for people with dementia · Findings from research on the role of reablement services for people with dementia in smoothing transfers · Questions about service delivery and orga...

Abstract Background Policy and research interest in carers continues to grow. A previous meta-review, published in 2010, by Parker et al. (Parker G, Arksey H, Harden M. Meta-review of International Evidence on Interventions to Support Carers. York: Social Policy Research Unit, University of York; 2010) found little compelling evidence of effective...

Aims: Recent years have seen an increasing shift towards providing care in the community, epitomised by the role of Children's Community Nursing (CCN) teams. However, there have been few attempts to use robust evaluative methods to interrogate the impact of such services. This study sought to evaluate whether reduction in secondary care costs, res...

Background: Reablement is a time-limited intervention that aims to support people to regain independence and enable them to resume their daily activities after they return home from an in-patient care setting, or to maintain independence to enable them to remain at home. There is some evidence that reablement can enhance independence and has the p...

Background Organisational case study proposals can be poorly articulated and methodologically weak, raising the possible need for publication standards in this area. This rapid review and Delphi consensus process sought to develop reporting standards for organisational case study research, with particular application to the UK National Health Servi...

Sight loss is more common among older than younger people. With an ageing population and increasing pressure on health and social care services, preventive and rehabilitation services are being prioritised. However, evidence around community-based vision rehabilitation services is underdeveloped. The focus of this article is on the prevalence, orga...

Background Children’s community nursing (CCN) services support children with acute, chronic, complex and end-of-life care needs in the community. Objectives This research examined the impact of introducing and expanding CCN services on quality, acute care and costs. Methods A longitudinal, mixed-methods, case study design in three parts. The case...

PLEASE NOTE: Full text of this publication is freely available here: https://www.ncbi.nlm.nih.gov/pubmed/27559566 Background Improving dementia care quality is an urgent priority nationally and internationally. Life story work (LSW) is an intervention that aims to improve individual outcomes and care for people with dementia and their carers. LSW...

People with mental health conditions have a lower life expectancy and poorer physical health outcomes than the general population. Evidence suggests that this discrepancy is driven by a combination of clinical risk factors, socioeconomic factors and health system factors. Objective(s) To explore current service provision and map the recent evidenc...

In 2012 the Social Policy Research Unit at the University of York launched the first study of its kind to investigate life story work from first principles. We asked:  What is life story work?  What is considered to be good practice in life story work in dementia care?  How do service providers and family carers use life story work?  Can life s...

Organisational case study proposals can be poorly articulated and methodologically weak, raising the possible need for publication standards in this area. Objectives To develop reporting standards for organisational case study research, with particular application to the UK National Health Service. Design Rapid evidence synthesis and Delphi conse...

Objective: To assess what is known about effective patient and public engagement in health service reconfiguration processes and identify implications for further research and health care practice. Methods: Rapid systematic review of published and grey literature to identify methods or approaches to engagement in decisions about health service reco...

We carried out a review of what, if anything, existing research says about women's experiences. The purpose of this was to provide an initial framework of issues to explore in the narrative element of the project, this would allow us to both build on and, where necessary, challenge what evidence currently exists. We report this review work in this...

Dementia disproportionately affects women but the experiences and voices of women are missing from the research and literature. This project provides a snapshot of the experiences, thoughts and opinions of women affected by dementia: women with a diagnosis of dementia, women who are caring for family or friends, and women working in one of the cari...

Purpose This study aimed to examine the impact of introducing or expanding children’s community nursing (CCN) services, and understand the contextual mechanisms that mediate the success of planning and implementing such service change. This paper presents findings about the identified contextual mechanisms: the perceived factors that mediated effor...

Objective: To assess what is known about effective patient and public engagement in health service reconfiguration processes and identify implications for further research and health care practice. Methods: Rapid systematic review of published and grey literature to identify methods or approaches to engagement in decisions about health service r...

Sight loss affects all aspects of well-being including daily functioning and mental health. Demographic trends suggest that the number of people with visual impairment is set to rise significantly, with many people experiencing an additional disability or health problems. By 2050, the number of blind and partially sighted people in the UK is estima...

Measuring the outcomes that are meaningful to people with long-term neurological conditions (LTNCs) using integrated health and social care services may help to assess the effectiveness of integration. Conventional outcomes tend not to be derived from service user experiences, nor are they able to demonstrate the impact of integrated working. This...

Background: Personal budgets are a key policy priority in adult social care in England and are expected to become increasingly important in the care of adults with mental health problems. Aims: This article systematically reviews evidence for the effectiveness of personal budgets for people with mental health problems across diverse outcomes. M...

Background Failure to demonstrate the effect of integration on service users using conventional outcome measures suggests that research to date has failed to measure the outcomes that actually matter to people with complex long-term conditions and that might result from integrated health and social care. Developing outcome measures that capture the...

This report presents findings from qualitative research into the experiences of people claiming or with an underlying entitlement to Carer's Allowance (CA). The findings are based on in-depth interviews with 44 people who claimed CA or had an underlying entitlement to it, in three areas of the UK in summer 2013. The aim of the research was to bette...

Purpose This paper aims to report results from a national survey of primary care trusts (PCTs) that explored the strategic, organisational and practice context of services for people with long‐term neurological conditions (LTNCs). It seeks to provide benchmarks for integrated service provision and to discuss possible reasons for the variability in...

To gather evidence to support the implementation of standard six of the National Service Framework for Children, Young People and Maternity Services (Department of Health and Department for Education and Skills 2004), which states that care should be provided as close to home as possible. A mixed methods study comprising of a systematic review, a n...

A Continuity of Care Research Programme was undertaken in England in 2000-9. The Programme was informed by a conceptual framework proposed by Freeman and colleagues in an earlier scoping study. At the end of the Programme, a conceptual synthesis was carried out in order to confirm or refine the 'Freeman model' of continuity of care. A conceptual sy...

Promoting 'care closer to home' for ill children is a policy and practice objective internationally. Progress towards this goal is hampered by a perceived lack of evidence on effectiveness and costs. The aim of the work reported here was to establish the strength of current international evidence on the effectiveness and costs of paediatric home ca...

To explore some of the key assumptions underpinning the continued development of general practitioner-led commissioning in health services. Qualitative data from two studies of service improvement in the English NHS were considered against England's plans for GP-led commissioning. These data were collected through in-depth interviews with a total o...

Aims: To identify service models that provided care co-ordination for people with long-term neurological conditions in the U.K. Background: The successful management of long-term neurological conditions needs sophisticated management across several health, social care and other service boundaries, as well as involvement of people with long-term...

Purpose: This paper seeks to report key findings of a study, whose purpose was to: understand what helps or hinders the commissioning and provision of integrated services for people with long-term neurological conditions (LTNCs), identify models of best practice from the perspectives of people with LTNCs and the professionals who work with them, an...

To report findings of a national survey of care closer to home services for children and young people and a typology based on these findings. Providing care closer to home for children is a policy and practice aspiration internationally. While the main model of such services is children's community nursing, other models have also developed. Past re...

Purpose: The SDO funded study 'Integrated services for people with long-term neurological conditions: evaluation of the impact of the National Service Framework' aimed to identify what helps or hinders integrated services and identify models and practice for delivering continuity of care for people with LTNCs. Theory: People's experiences of integr...

Health and social care systems experience difficulty in delivering the continuity of care that service users want. Lack of clarity about what continuity means hinders service organisation and delivery. The NIHR Service Delivery and Organisation programme funded a series of research projects to tackle this conceptual confusion, and subsequently comm...

Current health policy in England regarding the management of childhood illness advocates for care to be delivered as close to home as possible. The aim of this article is to report findings from a qualitative component of a larger study evaluating models of care closer to home (CCTH) for children and young people who are ill. The focus is on parent...

Providing care for children who are ill, as close to home as possible, is an objective of health care providers and policy makers nationally and internationally. The existing evidence base to support development of care closer to home (CCTH) is weak in relation to clinical effectiveness, approaches and models, potential costs and benefits to famili...

Providing care for children who are ill, as close to home as possible, is an objective of health care providers and policy makers nationally and internationally. The existing evidence base to support development of care closer to home (CCTH) is weak in relation to clinical effectiveness, approaches and models, potential costs and benefits to famili...

This report updates and extends a systematic review undertaken in 2000 in order to identify recent evidence on effectiveness and costs of CCTH for children with longterm conditions, and extend the review to CCTH for children with short-term health needs. It also reviews the descriptive literature on CCTH in the UK, focussing particularly on service...

Purpose The purpose of this research was to better understand the outcomes of integration by asking what promotes the experience of continuity of care from the point of view of people with long-term neurological conditions. Theory We used the definitions of continuity of care developed by Freeman et al. [1, 2] as a conceptual framework with which...

Background and aims: Delivering care closer to home (CCTH) for children and young people who are ill is a policy aim in many countries. The evidence base about the costs and effectiveness of CCTH is underdeveloped, as is understanding about best practice in service delivery and organisation.

This paper outlines the results of a national census of practice nursesin England and Wales It not only shows that the numbers of practice nurses have increased dramatically in recent years but also demonstrates how theirrole has evolved Many practice nurses are now involved in health promotion, and home visiting, as well as advice and counselling...

Introduction Long-term neurological conditions are a major cause of disability in the UK and internationally. Their successful management, in order to enhance health and well-being, requires both sophisticated organisation across a number of health, social care and other service boundaries, and the real involvement of people with neurological condi...

Several studies have used secondary data sources in order to learn about outcomes for adults who have been in contact with the care system in childhood. This article discusses two of the large-scale longitudinal datasets in the UK that are available to researchers and which include information on adults who were looked after in childhood: The Natio...

The involvement of users and carers in service planning represents a central plank of reforms in social care, but clear guidance as to what this involvement should entail is absent from the legislation, leaving authorities to develop local involvement strategies. This paper is based on a project mapping the development of services for carers, carri...

To review systematically randomized trials (RCTs) on the effectiveness and costs of paediatric home care. National Health Service (NHS) Centre for Reviews and Dissemination guidelines were followed. In all, 20 electronic and other sources were searched, using specially designed strategies. Economic studies and other selected designs were included,...

Policy on care in the community was founded on the premise that the care of frail elderly people with disabilities would be a joint responsibility for health and social care professionals, and family carers, supported by people within their social networks. The policy assumes that such social networks are common features of all communities in conte...

A major issue for social policy in the twenty-first century will be providing good-quality support and care for older people. However, recent debate about this has been driven more by ideology than by evidence. This paper examines the socio-economic, demographic and policy changes that are influencing the debate, and outlines findings from current...

English Community care policy has, simultaneously, attempted to reduce institutional care, contain costs, and emphasise individual and family responsibility for personal welfare. As a result, disabled people often have no choice about relying on informal carers for the support that enables them to live in their own homes. The implications of New La...

Demographic and socioeconomic changes have increased policy interest in informal carers. However, despite the multicultural nature of British society, most research in this field has been in majority communities. To explore the role of the primary health care team (PHCT) in supporting carers from British South Asian communities. Qualitative study....

This article examines the challenges of and barriers to generating and implementing evidence-based policy and practice in health services. It describes how one of the NHS R&D programmes - on service delivery and organisation - is attempting to get evidence into policy and practice.

Evidence based guidelines are regarded as an appropriate basis for providing effective health care, but few guidelines incorporate the views of users such as carers. To develop guidelines to assist primary health care teams (PHCTs) in their work with carers within South Asian communities. The guidelines were drawn up by a development group consisti...

To assess the evaluative research literature on the costs, quality and effectiveness of different locations of care for older patients. A systematic review of evaluative research from 1988 using CRD4 guidelines. Twenty-five databases were searched, using processes developed specially for this review. Library OPACS, the Internet and research registe...

To compare effectiveness of patient care in hospital at home scheme with hospital care. Pragmatic randomised controlled trial. Leicester hospital at home scheme and the city's three acute hospitals. 199 consecutive patients referred to hospital at home by their general practitioner and assessed as being suitable for admission. Six of 102 patients r...

Objectives. To compare the costs of admission to a hospital at home scheme with those of acute hospital admission. Design. Cost minimisation analysis within a pragmatic randomised controlled trial. Setting. Hospital at home scheme in Leicester and the city's three acute hospitals. Participants. 199 consecutive patients assessed as being suitable fo...

The British welfare state developed as a state-centred response to the problem of handling the risks encountered in a typical life-course. The influential work of Giddens and others implies that the traditional welfare state is under attack from two directions: a changing international politico-economic environment limits the freedom of national go...

Questions about who should provide and pay for long-term care for older people have moved up the policy agenda in the UK over the last 15 years. Concern is often justified, particularly by politicians, as a wise response to the ageing of the population. However, as this process of ageing has been taking place since the turn of the 20th century, why...

Continence advice in England and Wales is a relatively new specialism within nursing and, over the past 20 years, the number of continence advisers has grown substantially. There are, however, no formal qualifications for the role and the service has grown up in a piecemeal fashion. A study carried out by the Social Policy Research Unit of the Univ...

Much literature assesses the impact of various factors on response rates to postal questionnaires. Little work, however, evaluates the effect of `controversial' questions on rates of return. Recent debates suggest that one such question concerns ethnic origin and some writers argue that asking this question could affect response rates. This researc...

This is a book, not an article but it is impossible to change the record within Researchgate!

Despite a large literature on marriage and growing ones on disability and on caring there is little which specifically examines the experience of disability and caring within marriage. This paper draws on evidence from a small-scale qualitative study of couples under pensionable age where one partner had become disabled since marriage. Partners wer...

This is a book not an article but it is impossible to edit the record within Researchgage

The relationship between research and policy making is complex and not always direct. This paper describes disability-related research for policy makers which is carried out at the Social Policy Research Unit (SPRU), University of York. A distinction between the ways in which research is formed and the ways in which it is informed is made. The info...

WilsonGail, Money in the Family: Financial Organisation and Women's Responsibility, Gower Avebury, Aldershot, 1987. 271 pp. £19.50. - Volume 19 Issue 3 - Gillian Parker

DolingF., FordJ. and StaffordB. (eds), The Property Owning Democracy, Avebury, Aldershot, 1988. 250 pp. £22.50. - Volume 19 Issue 3 - Gillian Parker

Updated review of the demography, impact and costs of (informal) caring and of the support provided to carers.