Social care

With the showers has come a certain malaise tinged with queasy uncertainty.

This could be a post-Bill slump in the NHS, a response to the long grind of making cuts with no end in sight, and the sheer weight of detail to be worked through with respect to the mass reorganisation outlined in the now Health and Social Care Act.

The queasiness extends beyond health, look at local Government for example facing an average six per cent cuts rather than a ‘flat real’ settlement as in health.

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Within the research group of the Nuffield Trust we have a number of studies that use the anonymised linkage of health and social care records. The results of one study are due to be published in the Journal of Health Services Research and Policy (JHSRP) soon but they have left us with a puzzle.

We found that from a population of older people (aged 75+) in four local authority areas, 14 per cent used some form of local authority social care over a one year...

Data from countries within the Organisation for Economic Co-operation and Development (OECD) shows a roughly inverse correlation between spending on health (as a share of GDP) and mortality, and a roughly inverse correlation between growth in spending on health and improvements in mortality (the correlations hold even if the US is excluded).

These glaring facts are likely to force ever more attention on health productivity, health innovation and the adoption of models from elsewhere that can demonstrably...

Earlier this autumn, I had the opportunity to visit the Hospital2Home virtual ward project in New York. Like other virtual wards, this project aims to reduce the risk of unplanned hospital admission for people at high predicted risk of admission. 

I was particularly interested to visit this project because it has strong partnerships with health care, social care and charitable organisations, and it cares for some of the most vulnerable people in...

I recently had the opportunity to visit the Toronto virtual ward as part of my Management Fellowship role working with researchers at the Nuffield Trust who are evaluating the costs and benefits of the virtual wards in Croydon, Devon and Wandsworth.

The virtual wards work just like hospital wards, using the same staffing, systems and daily routines, except that the people being cared for stay in their own homes throughout.

The purpose of...

I was struck by the general appetite for a more open debate about rationing and priority setting at a recent conference on priority setting in health held by the University of Birmingham’s Health Services Management Centre (HSMC) and the Nuffield Trust.

The conference focused on the experiences of primary care trusts (PCTs) in making difficult choices. During the morning session HSMC’s Dr Suzanne Robinson introduced findings from research published by the Nuffield Trust that explored current priority-setting...

Last week saw the publication of the findings from the independent review of palliative care funding led by Tom Hughes-Hallet. 

Here at the Nuffield Trust we have been doing work around social care use at the end of life and it is nice to see that work being used by the report team.

We are also about to publish some work looking at the variation in hospital use in the last 12 months of life. One of the observations from this research is that to change the system you...

The latest Nuffield Trust report has been a long time in gestation.  It is an important piece of work for us as it signalled our first attempts to link together health and social care information at a person level.

The idea behind this work was very simple.  Can we identify people who are at high risk of needing high cost social care in the coming year?  If we can, then we stand a better chance of targeting prevention strategies to help people now.  The result is better quality of care in the short term and lower costs so...

At the Nuffield Trust we have just published a report that uses routine information to offer a new perspective on care services at the end of life.  We were aware of the importance of end of life care, both in terms of problems in the quality of services and the costs of these services.  We also know it’s an area where there is limited information yet a lot of national interest.

Following a meeting with Mike Richards, the National Clinical Director for End of Life Care, and the National End of Life Care Programme team, it became clear...