NHS

HS&DR - 08/1809/228: Understanding and improving transitions of older people: a user and carer centred approach

Project title Understanding and improving transitions of older people: a user and carer centred approach
Research type Primary Research
Status Project complete
Start date November 2008
Publication date

September 2012

Cost £ 350,830.00
Chief Investigator Professor Jon Glasby
Co-investigators Ms Deborah Davidson (University of Birmingham), Dr Joan Durose (University of Birmingham), Dr Jo Ellins, Ms Rosemary Littlechild (University of Birmingham), Dr Shirley McIver (University of Birmingham), Dr Denise Tanner (University of Birmingham)
Contractor University of Birmingham
Plain English summary This project focuses on older people and their transition between different services and agencies in health and social care. Research studies and reports from inspectors have shown that older people experience many problems before, during and after transitions. This project will be conducted in four local areas and has two key aims. First, it will explore what information, support and care is needed by older people (and their carers) as they go through a transition. Second, the project team will work with people and organisations in the four local areas to put the findings into practice. It is increasingly recognised that older people should be involved in improving the quality of services for their use. In this project, older people who are service users and carers will be recruited, trained and supported to participate in the research. They will work with academic researchers to conduct in-depth interviews in order to find out about older people's experiences of a recent care transition. Analysis of the data and presentation of the findings will be carried out jointly by academic and user/carer researchers. The project team will feed back the findings of the interviews in each of the local areas. It will also provide support to people and organisations in these areas to put the findings into practice, in order to improve transitions for older people. In each area, a local advisory group, which include service users and carers, will lead this process. The findings from the in-depth interviews and the local implementation activities will be shared with NHS, social care and other organisations nationally.
Scientific summary Despite a series of positive changes following the 2001 National Service Framework for Older People, research and inspection reports continue to reveal that transition between services is one of the most problematic areas of policy and practice. This project seeks to investigate the information, advice and support needs of older people experiencing a transition between services, as well as conducting the research in a way that helps to embed the findings in health and social care policy and practice. Specifically it aims to: - Explore older people's experiences of moving across service boundaries, identifying positive and negative experiences, information and advice needs, access to services and needs for ongoing support. - Identify how the needs of particular groups of older people may differ from each other, and the different needs of service users and carers. - Investigate these issues over time, to illuminate how previous transitions impact on current and future needs. - Draw out policy and practice implications for the way in which services prepare and support older people and their carers for transition between services. - Support, and share the learning from, implementation of project findings in four health and social care communities. The project will be conducted across four case study areas, which will be purposively chosen to reflect different locality characteristics and focusing on different user/carer groups to include: - An area with a high proportion of older people from a minority ethnic community. - A site where the research focuses of the experiences of people with dementia and their families. - A rural area. - An area with a low proportion of older people. Following a participative action research methodology, service users and carers from each area will be recruited, trained and supported to participate as co-researchers. Working with academic project team members, co-researchers will jointly conduct two waves of in-depth interviews to explore the experience of care transitions from a user/carer perspective. In the final stage of the project, a series of feedback and change management activities will be undertaken to facilitate implementation of the research findings into practice, and support a process of learning about how to improve transitions for older people. The project team will work with local advisory groups and stakeholders to co-design the change processes, so that local capability and capacity is enhanced throughout the process and sustained beyond the research period. In addition, a local and national dissemination strategy will be developed to translate the findings into policy recommendations and usable outputs, as well as sharing learning from the case study examples. Given that poorly managed transitions can lead to a worsening of patient health, increased risk of complications and costly additional care, the study has the potential to support both economic and quality gains in the NHS.
Outputs
  1. Co-research with older people with dementia: experience and reflections

    Authors: Tanner, D

    Reference: Journal of Mental Health 2012;21(3):296-306

  2. Identity, selfhood and dementia: messages for social work

    Authors: Tanner, D

    Reference: European Journal of Social Work 2011;Volume 16, Number 2, 1 May 2013 , pp. 155-170

Documents

Protocol (PDF File - 259.3 KB)

Commissioning Brief (PDF File - 142.9 KB)

Executive Summary (PDF File - 137.3 KB)

Final Report (PDF File - 1.2 MB)

Addendum This project was commissioned by the NIHR Service Delivery and Organisation (NIHR SDO) programme under the management of the National Coordinating Centre for the Service Delivery and Organisation (NCCSDO) which was based at the London School of Hygiene and Tropical Medicine (LSHTM). The project was managed by NCCSDO until 31 March 2009. Management of the NIHR Service Delivery and Organisation (SDO) programme and its portfolio of projects transferred to the National Institute for Health Research Evaluations, Trials and Studies Coordinating Centre (NETSCC) based at the University of Southampton from 1 April 2009.

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