This briefing paper reviews the development of employee ownership and social enterprises in health and social care. It looks at the creation of new forms of organisation as alternatives to direct service provision or conventional outsourcing. It is aimed at commissioners and staff interested in engaging in employee ownership and / or social enterprise.

Full Text Link

Reference

Parkin, T. (2012). New organisational models for delivering health and social care: briefing paper. Health and Social Care Partnership South East, February 2012.

The New Dynamics of Ageing (NDA) programme is a seven year multidisciplinary research initiative. The broad aim is to improve the quality of life for older people. This programme involves collaboration between five UK Research Councils (ESRC, EPSRC, BBSRC, MRC and AHRC).

Older people often find that their health problems challenge their sense of independence, dignity and identity. Health care can sometimes not help as expected. According to a research report funded by the NDA programme (available to members only), healthcare providers should avoid a “blanket view” of how to help older people cope with ageing.

Read more: New Dynamics of Ageing.

Background, programme specification:

Full Text Link

Reference

New Dynamics of Ageing: an interdisciplinary research programme. Sheffield: University of Sheffield, 2012.

This economic evaluation of the alternatives to antipsychotic drugs for people with dementia assembles the economic evidence about the benefits of behavioural approaches. NICE guidelines recommend the first line of treatment for behavioural and psychological symptoms of dementia (BPSD) should be psychosocial interventions, whereas until recently antipsychotic drugs have been used as the first line of treatment in practice.

While there are a broad range of behavioural interventions available, this analysis examined the costs and benefits of cognitive stimulation therapy. This report strongly suggests that behavioural interventions are a more efficient use of public money than antipsychotic drugs. This study was commissioned by South Tees Hospitals Foundation Trust and written by Matrix Evidence.

Behavioural interventions cost £27.6 million more per year than antipsychotic drugs for the 133,713 individuals with dementia requiring antipsychotic drugs in England. This additional investment needs to be offset by approximately £70.4 million savings in health care through the reduction in strokes and falls which would otherwise result from the use of antipsychotics. Behavioural interventions would avoid nearly 1,348 cases of stroke and 118 falls compared to using antipsychotic drugs, every year.  Behavioural interventions also promise to generate quality of life improvements, which even if difficult to value monetarily, are estimated to generate a minimum £12.0 million in benefits per annum further.

The report concludes on balance that, combining health care cost savings and quality of life improvements, behavioural interventions might generate a net benefit of £54.9 million per year (taking cognitive stimulation therapy as the model).

Full Text Link (a)

Reference

Matrix Evidence (2012). An economic evaluation of alternatives to antipsychotic drugs for individuals living with dementia.  Coventry: NHS Institute for Innovation and Improvement, October 2011.

Full Text Link (b)

Reference

Rees, E. (2011). A little-known drug-free treatment can have an amazing effect on Alzheimer’s sufferers. So why does a top charity refuse to endorse it? London: Daily Mail, December 13^th 2011.

This report from the Housing Learning and Improvement Network explores the contributions that residents in retirement community settings can make towards supporting their peers. It looks at approaches to building “social capital” in specialist housing for older people, taking examples good practice in volunteering, peer support, social enterprise and co-production.

Living in retirement housing may not always bring about a sense of community and bonding with scheme neighbours. While extra care housing brings new opportunities for social life, the people most likely to continue experiencing social isolation tend to be those with high support needs, particularly those with mobility, dementia and / or sensory impairment issues.

The authors point out the challenges and barriers typically faced by older and vulnerable people and reflect on how to balance being “a good neighbour” with the responsibility for delivery of personal care and support in retirement and extra care housing. Their report discusses related issues, including those touching upon “choice and control”, co-production in micro-communities, mutuality and localism.

Full Text Link

Reference

Blood, I. and Pannell, I. (2012). Building mutual support and social capital in retirement communities. London: Housing Learning & Improvement Network, February 2012. Housing LIN Viewpoint No.23.

This BMJ article (and a Cochrane systematic review) explores the potential use of mental exercises and activities to maintain and improve cognitive function for patients attending memory clinics. Evidence is weak for individual psychological interventions to improve cognition in dementia. Many people with dementia are unable to take part in group therapy due to sensory impairments, unwilling to participate or unable to get to local groups.

A recent six-week study into the potential of online brain training to improve reasoning, memory, planning, visuospatial skills and attention found that specific improvements did not transfer to generalised untrained tasks. The authors of this article reviewed numerous systematic reviews of psychological interventions in dementia. They found that individual cognitive stimulation therapy (usually carer led) might be promising, but it is premature to recommend this treatment routinely in dementia care without for further confirmatory research.

Full Text Link (a)

Reference

Woods, B. Aguirre, E. [and] Spector, AE. [et al] (2012). Cognitive stimulation to improve cognitive functioning in people with dementia. Cochrane database of systematic reviews (Online), February 15^th 2012, Issue 2, No.CD005562. (Click here to view the PubMed abstract).

Full Text Link (b) (Access requires an Athens password or journal subscription).

Reference

Orrell, M. Woods, B. [and] Spector, A. Should we use individual cognitive stimulation therapy to improve cognitive function in people with dementia? BMJ, February 15^th 2012; 344, e633.

See also: Cognitive Stimulation Therapy (http://www.cstdementia.com/).

Approximately 12% – 18% of all NHS expenditure on long-term conditions is linked to poor mental health and wellbeing; this is between £8 billion and £13 billion in England every year. Co-morbid mental health problems are prevalent in hospital settings; approximately one in four acute hospital beds are occupied by people with dementia.

The development of integrated support for people with long-term mental and physical health problems, such as dementia, promises to improve outcomes. Integrated care is the vital ingredient needed to help the NHS meet the challenges of quality, innovation, productivity and prevention (QIPP).

Full Text Link

Reference

Naylor, C. Parsonage, M. [and] McDaid, D. [et al] (2012). Long-term conditions and mental health: the cost of co-morbidities. London: The King’s Fund, 2012. 32p.

This report asserts that older people are let down by fragmented care services. Integrated care and joined-up services would achieve better outcomes for older people while delivering much-needed efficiency savings. See also: Care for Elderly Marred by Fragmented System (BBC News).

Full Text Link (a)

Reference

Great Britain. House of Commons. Health Committee. Dorrell, S. (2012). House of Commons. Social care: fourteenth report of session 2010-2012; HC 1583. Volume I: report, together with formal minutes. London: Stationery Office, 2012. 51p.

The NHS Confederation explained how the main job of acute hospitals has become looking after older people:

“People with long-term conditions are major users of the NHS. Greater life expectancy means patients can typically have several long-term conditions. One of the most challenging of these is dementia. 70% of acute hospital beds are occupied by older people, 20% of acute beds are occupied by people with dementia and 75% of residents of care homes have dementia”. (p.7)

Full Text Link (b)

Reference

Great Britain. House of Commons. Health Committee. Dorrell, S. (2012). House of Commons. Social care: fourteenth report of session 2010-2012; HC 1583-II. Volume II: oral and written evidence. London: Stationery Office, 2012. 237p.

Sources of evidence in Volume II include:

• Department of Health.
• Social Care Institute for Excellence.
• Alzheimer’s Society.
• United for All Ages.
• Age UK.
• The King’s Fund.
• Audit Commission.
• Association of British Insurers.
• Partnership Assurance.
• Professor Ann McDonald.
• Parkinson’s UK.
• Nuffield Council on Bioethics.
• The Princess Royal Trust for Carers and Crossroads Care.
• British Medical Association.
• Carers UK.
• Local Government Association.
• Association of Directors of Adult Social Services (ADASS).
• NHS Confederation.
• SHIP Equity Release.
• The Strategic Society Centre.
• Law Commission.
• National Housing Federation.
• Centre for Social Justice.
• Department of Health supplementary.
• National Housing Federation supplementary.
• FirstStop Advice for Older People.
• Dr Nigel Dudley LLM FRCP.
• English Community Care Association.
• Chartered Insurance Institute.
• British Red Cross.
• NICE.
• Joseph Rowntree Foundation.
• The Henry Spink Foundation.
• Keith Robinson, MA PhD.
• Monitor.
• Papworth Trust.
• Mencap.
• Wendy Regaard.
• Motor Neurone Disease Association.
• United Kingdom Homecare Association.
• National Pensioners Convention.
• Hampshire County Council.
• Royal College of Physicians.
• WRVS.
• Royal National Institute of Blind People and Action for Blind People.
• The Voluntary Organisations Disability Group.
• AKW Medi-Care Limited.
• Turning Point.
• Relatives and Residents Association.
• National AIDS Trust.
• Anchor Trust.
• Investment and Life Assurance Group Ltd.
• Professor Les Mayhew and Dr Ben Rickayzen, Cass Business School, London.
• Royal College of Nursing.
• Consumer Focus.
• The Care and Support Alliance.
• Learning Disability Coalition.
• Sense.
• My Care Umbrella.
• GMB.
• Bupa Care Homes.
• Independent Age.
• Ipsos MORI.
• Barchester Healthcare.
• National Centre for Independent Living, Disability Alliance and Radar.
• Stannah Lifts Holdings Ltd.
• Savitri Hensman.
• Mazars LLP, London.
• Gateshead Council.
• Action on Hearing Loss.
• Ideal Care Homes.
• Care UK.
• Care Quality Commission.
• The Institute and Faculty of Actuaries.
• Leon Smith, Nightingale Care Home.
• South East Strategic Leaders (SESL), South East Councils Adult Social Care.
• Members (SECASC) and South East England Councils (SEEC).
• MS Society.
• McCarthy & Stone.
• Sue Ryder.
• Citizens Advice.
• British Private Equity and Venture Capital Association.
• UNISON.
• Body Positive Cheshire & North Wales.
• Scope.
• University of East Anglia and London School of Economics.

Note: Additional written evidence is contained in Volume III, available on the Committee website at:

• www.parliament.uk/healthcom

The Social Return on Investment (SROI) Network and the Local Government Association have launched their new “Guide to Commissioning for Maximum Value” which relates the principles and practices set out in the Cabinet Office’s 2009 “A Guide to Social Return on Investment” to commissioning. This guide was prepared by the SROI Network as part of the National Programme for Third Sector Commissioning.

Full Text Link

Reference

Inglis, J. Nicholls, J. [and] Ellis, J. (2012). Guide to commissioning for maximum value. London: The SROI Network / Local Government Association (UK), January 2012.

Councils impact on health in many ways; whether in terms of open space, housing, planning, social care, sport or other services. This web service aims to help people get to grips with issues of relevance to health services and the new health and wellbeing boards. Each topic is structured in four sections:

1. Why is this important?
2. The role of the local authority.
3. Key tasks for elected Members.
4. Useful links: where to find out more.

The 20 “must knows” cover the following areas:

1. Keeping up to date on developments.

2. Public health.

3. Health inequalities.

4. The health profile of your area and the wider determinants of health that impact on your population.

5. Mental health and wellbeing.

6. Evidence.

7. Commissioning of health and social care.

8. Commissioning of public health.

9. Outcomes.

10. Partnerships for health and wellbeing.

11. The role of social care in health and wellbeing.

12. Mainstreaming health and wellbeing across your council’s work.

13. The impact on health and wellbeing of the council as an employer.

14. Evaluation.

15. Performance management, regulation and inspection.

16. Involving citizens, service users and carers in health and wellbeing.

17. Scrutiny of health and wellbeing.

18. Safeguarding vulnerable people.

19. The role of your Director of Public Health.

20. Health and wellbeing boards.

The master contents page for this information resource is given below:

Full Text Link

Reference

Twenty “must-knows” on health and wellbeing (web pages). London: Local Government Improvement and Development Agency, 2012.

Somme, D. Trouve, H. Dramé, M. [et al]. Analysis of case management programs for patients with dementia: A systematic review. Alzheimer’s & Dementia: the Journal of the Alzheimer’s Association. January 26th 2012. [Epub ahead of print].

Lee, MS. Choi, J. Posadzki, P. [et al]. Aromatherapy for health care: an overview of systematic reviews. Maturitas. March 2012; 71(3): 257-60. Epub January 27th 2012.

Lee, DR. Taylor, JP. Thomas, AJ. Assessment of cognitive fluctuation in dementia: a systematic review of the literature. International Journal of Geriatric Psychiatry. January 25th 2012. [Epub ahead of print].

Vogels, SC. Emmelot-Vonk, MH. Verhaar, HJ. [et al]. The association of chronic kidney disease with brain lesions on MRI or CT: a systematic review. Maturitas. February 6th 2012. [Epub ahead of print].

Elliott, KE. Scott, JL. Stirling, C. [et al]. Building capacity and resilience in the dementia care workforce: a systematic review of interventions targeting worker and organizational outcomes. International Psychogeriatrics. January 23rd 2012: 1-13. [Epub ahead of print]. Full Text Link.

Hügel, HM. Jackson, N. May, BH. [et al]. Chinese Herbs for Dementia Diseases. Mini Reviews in Medicinal Chemistry. February 3rd 2012. [Epub ahead of print].

Simon, SS. Yokomizo, JE. Bottino, CM. Cognitive intervention in amnestic Mild Cognitive Impairment: a systematic review. Neuroscience and Biobehavioral Reviews. February 1st 2012. [Epub ahead of print].

von Kutzleben, M. Schmid, W. Halek, M. [et al]. Community-dwelling persons with dementia: What do they need? What do they demand? What do they do? A systematic review on the subjective experiences of persons with dementia. Aging & Mental Health. January 18th 2012. [Epub ahead of print].

Brodaty, H. Seeher, K. Gibson, L. Dementia time to death: a systematic literature review on survival time and years of life lost in people with dementia. International Psychogeriatrics. February 13th 2012: 1-12. [Epub ahead of print].

Mazereeuw, G. Lanctôt, KL. Chau, SA. [et al]. Effects of omega-3 fatty acids on cognitive performance: a meta-analysis. Neurobiology of Aging. February 3rd 2012. [Epub ahead of print].

Payne, C. Wiffen, PJ. Martin, S. Interventions for fatigue and weight loss in adults with advanced progressive illness. Cochrane Database of Systematic Reviews (Online). 2012 January 18th ; Issue 1: No.CD008427. Full Text Link.

Ward, A. Arrighi, HM. Michels, S. [et al]. Mild cognitive impairment: Disparity of incidence and prevalence estimates. Alzheimer’s & Dementia: the Journal of the Alzheimer’s Association. January 2012; 8(1): 14-21. Full Text Link.

Elgendi, M. Vialatte, F. Cichocki, A. [et al]. Optimization of EEG frequency bands for improved diagnosis of Alzheimer disease. Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. August 2011; 2011: 6087-91.

Baczek, VL. Chen, WT. Kluger, J. [et al]. Predictors of warfarin use in atrial fibrillation in the United States: a systematic review and meta-analysis. BMC Family Practice. February 3rd 2012; 13(1): 5. [Epub ahead of print]. Full Text Link.

Nicholson, AM. Gass, J. Petrucelli, L. [et al]. Progranulin axis and recent developments in frontotemporal lobar degeneration. Alzheimer’s Research & Therapy. January 23rd 2012; 4(1): 4. [Epub ahead of print].