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Welfare Reform on the Web (April 2006): Care of the Elderly - UK

P. Lowe and L. Speakman (editors)

London: Age Concern, 2006

Rural communities contain a higher proportion of older people than urban or suburban areas. Rural areas offer significant lessons for the rest of England in understanding the implications of demographic aging. Older people are a dynamic force in English rural life, making an increasingly important contribution to local economies, and the cultural and social welfare of their communities. The book intends to help inform the 21st century policy agenda for rural areas and contributes to the debate on how rural communities are changing, and the experience, contributions and needs of the varied groups which make up the older rural population.

Buying time II: an economic evaluation of a joint NHS/social services residential rehabilitation unit for older people on discharge from hospital

A. Ellis and others

Health and Social Care in the Community, vol.14, 2006, p.95-106

The study evaluated the cost effectiveness of an NHS/social services joint rehabilitation unit for older people on discharge from community hospital compared with usual health/domiciliary care services. Details were collated of the NHS and social services resources participants used over a 12 month period. The cost of the resources used was compared between those who went to the unit and those who went straight home. Overall costs were very similar for the two groups. Aggregated NHS/social services costs for the 12 months follow-up were £8542.28 for the intervention group and £8510.68 for the control. However, the cost of the unit option fell more heavily on social services, whereas the cost of the community option impacted more heavily on the NHS.

K. Bryan, H. Gage and J. Gilbert

Health Policy, vol.76, 2006, p.194-201

Health and social care agencies in the UK have come under pressure to reduce delayed discharges of older people from hospital. This local study based on an analysis of records and interviews with managers showed that delays reflect the complex needs of older people and arise from financial and organisational problems at both the planning and implementation stages of a discharge. Budgetary constraints lead to delays in confirming public funding of care for some clients. Shortages of professional staff and care assistants limit the provision of domiciliary packages. The contraction of the residential care sector has reduced the supply of beds and increased the cost of care home placements.

D. Bell and A. Bowes

Joseph Rowntree Foundation, 2006

Report concludes that Scotland’s policy of providing free personal care for older people at home and in care homes has created a fairer system without undue extra public spending. An economic analysis shows that the policy has cost more than expected but the current cost of £140m per year takes only 0.6% of the Scottish Executive’s total £25bn budget, and so only makes a marginal impact on other areas of public spending. The study also concludes that differences between Scotland and the rest of the UK in the public costs of personal and nursing care are smaller than policy debates have suggested. This is because care home residents in Scotland no longer receive attendance allowance, while payments for nursing care are typically more generous in England, Wales and Northern Ireland. Scotland has also managed to reduce its cost profile by making proportionally greater use of home care for frail older people. The report anticipates that a major increase in the numbers of people aged 85 or above might lead to a potential tripling of the public costs of personal care by 2053, but a further shift towards providing more care services at home, combined with policies to promote healthier lifestyles, could reduce the projected bill.

J. C. Hughes (editor)

London: Quay Books, 2006

Palliative care, which includes physical, psychological, social and spiritual aspects, is ideally suited as an approach to the care of people with dementia. The book, which began as a series of articles in ‘Nursing and residential care’, has grown from the experience of providing care to people with severe dementia. It places a heavy emphasis on the difficult and complex ethical issues that arise for professionals and families alike in the care of people with dementia.

L. Brown and J. Cullis

Policy Studies, vol.27, 2006, p.55-69

It is received wisdom that joint working between health and social services must be beneficial, but there is little empirical evidence to support the notion. An evaluation of two integrated health and social care teams in a rural county showed that the delivery of services in this way rather than through traditional arrangements did not lead to more older people living independently in the community. The study was unable to fully explore whether the integrated model of provision was any more cost-effective than the traditional approach. The partial data obtained suggest that the integrated approach was relatively expensive.

Anon.

Caring Times, March 2006, p.12

Responding to the White Paper on healthcare outside of hospitals, the Registered Nursing Homes Association has pointed out that nursing homes could have a key role in bring services for older people into the community. Community health clinics, outpatient services and rehabilitation centres could all be run from nursing homes.

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