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Older People

One in three people aged over 65, and half of those aged over 80, fall at least once a year. Falls cost the NHS more than £2 billion per year. With the number of people aged 65 and over predicted to increase by 2 million by 2021, these costs are set to rise further. One way to help design better services with more integrated treatment and rehabilitation for falls patients is to look more closely at where the costs of treating patients are incurred across health, community and social care services. This paper uses Torbay’s unique patient-level linked data set to explore the NHS and social care costs of the care pathway for older people in the 12 months before and after being admitted to hospital as a result of a fall.

Key Findings

  • On average, the cost of hospital, community and social care cost services for each patient who fell were almost four times as much in the 12 months after admission for a fall as the costs of the admission itself.
  • Comparing the 12 months before and after the fall, the most dramatic increase was in community care costs (160 per cent), compared to a 37 per cent increase in social care costs and a 35 per cent increase in acute hospital care costs.
  • While falls patients in this study accounted for slightly more than 1 per cent of Torbay’s over-65 population, in the 12 months that followed a fall, spending on their care accounted for 4 per cent of the whole annual inpatient acute hospital spending, and 4 per cent of the whole local adult social care budget.
  • There was evidence of significant under-coding of co-morbidities for falls patients, particularly for dementia.

This report should be of interest to all those involved in the commissioning of services that deal with 'falls' and more generally health/social care integration.

What are some of the challenges people with autism face in older age and what can government do to address them? These are the questions this report seeks to answer.  Based on interviews, focus groups, surveys and the outcome of evidence sessions held in parliament earlier this year, the Getting on? reports set out some of the key issues facing older people with autism and what government and other bodies need to do to make sure they have the services and support they need. This report should be of interest to those commissioning services for older people, specifically older people with autism.

The Potential Care Needs Index classifies the older population of Bolton (aged 50+) according to their risk of future early reliance upon intensive social care and support services.  The Index has been constructed by combining a range of risk factors known to be associated with early reliance on social care services such as living alone, having alcohol problems, and experiencing reduced daily activities and similar. The aim of the Index is preventative and is designed to target people before they become too ill and need to access social care. A full list of the indicators used and the methodology used to construct the Index is available in the accompanying brochure ‘Supporting independence and preventing the escalation of care need in older people in Bolton’. Below is a full list of all documents & resources linked to the Potential Care Needs Index:

This a case study of the Staying Well project currently being piloted in Bolton.  This is intended to be a snapshot of the project - for a full overview of Staying Well - please view the project brief. The Staying Well projects enables partners across the health and social care system to work together systematically identifying individuals at high risk of developing future health and social care need and providing advice and support to enable them to remain as healthy and independent as possible for as long as possible.

The project brief for the 'Staying Well' project currently being piloted within Bolton. Bolton’s Public Health Department (Staying Well Project), jointly with Adult Social Services, Strategic Housing, NHS Bolton Clinical Commissioning Group and Customer Services Department are currently testing an approach to systematically identify individuals (age 65 & over) at high risk of developing future health and social care need and providing advice, support and assistance to enable people to remain healthy, happy and independent for longer as well as preventing future risk. The brief includes:

  • Overview/Rationale
  • Key Relationships
  • Emerging Findings
  • Evaluation Approach
  • Expected Benefits to Clients

This document should be a must-read for all those involved in the commissioning and delivery of services to vulnerable older people.

Putting People into Personalisation: Relational approaches to social care and housing, argues that social care needs a radical shake up to ensure genuine choice and empowerment for older people. Although not policy, it does present interesting ideas and discussion points for those involved in the commissioning of services to older people and/or housing. The green paper is attached below, and the website can be accessed here: http://bit.ly/5LNFV3

Other Bolton's Health Matters Knowledge Hub resources of relevance:

News

Bolton Council and NHS Bolton are undertaking a joint needs assessment to inform the development of a preventative approach to older people that enables them to remain as independent as possible for as long as possible.  Following on from the market segmentation analysis, that can be viewed by clicking here, carried out earlier this year, Ipsos MORI have recently completed a qualitative research study with older people in Bolton to help us understand their needs and to develop an approach that builds on current assets.  The research included in-depth interviews and focus groups with older people and interviews with stakeholders in 4 case study areas.  The research has highlighted potential challenges and opportunities for developing a preventative approach locally and added more depth to the market segmentation developed previously.  The report is now available via the Bolton’s Health Matters website. 

The research will be used to inform the development of the pilot ‘Staying Well’ project due to start in 6 GP surgeries soon.  It will also inform the Council’s Targeted Prevention Strategy.  For further information about the needs assessment or the Staying Well project please contact Lesley Jones, Deputy Director Public Health 01204 337829 or lesley.jones@bolton.gov.uk.

Attachment

A presentation on the report for Bolton Council examining the outcomes of piece of qualitative research undertaken by Ipsos MORI covering all aspects of helping older people stay independent (for longer) in Bolton. Looked at areas including user aspects, assets, services/supports as well as conclusions and recommendations. This is a key piece of research for anyone who is involved in the commissioning of services aimed at older people and espeically those servcie focusing on enabling independence in older people.

The Potential Care Needs Index classifies the older population of Bolton (aged 50+) according to their risk of future early reliance upon intensive social care and support services.  The Index has been constructed by combining a range of risk factors known to be associated with early reliance on social care services such as living alone, having alcohol problems, and experiencing reduced daily activities and similar. The aim of the Index is preventative and is designed to target people before they become too ill and need to access social care. A full list of the indicators used and the methodology used to construct the Index is available in the accompanying brochure ‘Supporting independence and preventing the escalation of care need in older people in Bolton’.

The Potential Care Needs Index classifies the older population of Bolton (aged 50+) according to their risk of future early reliance upon intensive social care and support services. The Index has been constructed by combining a range of risk factors known to be associated with early reliance on social care services such as living alone, having alcohol problems, and experiencing reduced daily activities and similar. The aim of the Index is preventative and is designed to target people before they become too ill and need to access social care. A full list of the indicators used and the methodology used to construct the Index is available in the accompanying brochure ‘Supporting independence and preventing the escalation of care need in older people in Bolton’.

A survey of the friends and family of residents of residential care in Bolton from September 2011 as part of the wider residential care review. The purpose of the survey was to garner their opinion on the quality of service provided to help inform future residential care development priorities. This will be of use to anyone developing or re-designing residential care services. 

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