The feasibility and acceptability of specialist and social care team for the promotion of health and independence in ‘at risk’ older adults

Primary Care Nursing Research Unit, Department of Primary Care and Population Sciences, Royal Free and University College Medical School, University College London, Archway Campus, Highgate Hill, London, UK.
Health & Social Care in the Community (Impact Factor: 0.86). 04/2005; 13(2):136-44. DOI: 10.1111/j.1365-2524.2005.00541.x
Source: PubMed


Population ageing, escalating costs in pensions, health-care and long-term care have prompted a new policy agenda for active ageing and quality of life in old age across the European Union and other developed countries. In England, the National Service Framework for Older People (NSF OP) explicitly demands for the first time that the NHS and local authorities, in partnership, agree programmes to promote health ageing and to prevent disease in older people. These programmes are expected to improve access for older people to mainstream health promotion services and also to develop multiagency initiatives to promote health, independence and well-being in old age. This paper describes the evaluation of one interagency project team established to test out mechanisms for addressing health promotion for older people through primary care. A mixed methodology was used to understand the processes of service development, the impact of the team's intervention, and the primary and secondary outcomes for older people. The project demonstrated that multi-agency partnerships have the potential to improve the quality of the lives of older people deemed 'at risk' by their general practitioners, particularly through income generation but also in the identification of medical problems such as unrecognised hypertension, hearing loss and visual loss. It also offered some key learning points for other multi-agency groups developing similar services.

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    • "The elements that service users valued included: responsiveness to their needs through more timely initial assessment and subsequent interventions (Brooks, 2002; McLeod et al., 2003), partnership working and the development of trusting relationships with named key workers (Taylor, 2001; Brooks, 2002); improved communication between the agencies (Freeman and Peck, 2006) help to interpret information and navigate unfamiliar and complex systems (McLeod et al., 2003), and support to maintain independence in the community (Drennan et al., 2005; McCormack et al., 2008). Drennan et al., 2005 illustrate their findings through the comments of a service user who reported: I think it's [the team service] is excellent; it's been a lifesaver for me. It's opened up so many vistas for me. "
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    • "For example, ensuring that there were resources to provide holiday or sickness cover for placement schemes, where social workers work in GP practices, was an important element of their success (Le Mesurier & Cumella 2001). The existence of a unified budget underpinning joint initiatives was regarded as significant (Drennan et al. 2005). Hultberg et al. (2005) reported that having a pooled budget made the process of resource allocation more transparent and equitable. "
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    • "sually a specialist nurse, to provide direct clinical care to patients. Alternatively, in programmes for community-based elderly people with complex conditions, clinical care is usually provided by the patient's general practitioner (GP) or a relevant specialist (Bernabei et al . 1998, Marshall et al . 1999, Hughes et al . 2000, Jiwa et al . 2002, Drennan et al . 2005)."
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