Care Management in Social and Primary Health Care: The Gateshead Community Care Scheme

Author: David Challis
Published: May 2002
Publisher: Ashgate Publishing, Limited
ISBN: 1857422066
Hardcover Book
Number of Pages: 274

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This book provides an evaluation of the Gateshead Community Care Scheme which was devised as an alternative to residential and hospital care for frail elderly people. An important feature of the scheme was the decentralization of control of resources to individual social workers acting as care managers, with defined caseloads and expenditure limits to ensure accountability. The initial social social care scheme was subsequently extended to provide both health and social care to clients from a large general practice based in a health centre. The social care team was enlarged to include a nurse care manager and part-time doctor and physiotherapist.The study examines the operation of care management in both settings, the use of devolved budgets and services developed, the outcomes for clients and carers and the costs of care. Admissions to residential care were reduced and the elderly people who received the scheme's support experienced a better quality of care and greater well-being when compared with elderly people receiving the usual range of services. This was achieved at no greater cost. The characteristics of those for whom the scheme was most appropriate are described. In addition, the pattern of development of the scheme as it was incorporated into the mainstream of the Social Services and after the implementation of the NHS and Community Care Act are examined. Final, the implications for the development of care management are considered. Focusing on care management in the UK, this work examines possibilities for providing a community-based approach to long-term care for frail older people. Of particular importance to the discussion is an examination of the model of care management demonstrated by the Gateshead study, a series of single agency approaches to intensive care management. The social care scheme of the Gateshead study is analyzed and evaluated and implications for current policy and practice developments are explored. David Challis, Director of PSSRU, University of Manchester, John Chesterman, PSSRU, University of Kent, Rosemary Luckett, Gateshead Council, Karen Stewart, PSSRU, University of Manchester and Rosemary Chessum, Gateshead Council

Table of Contents
List of Boxes, Figures and Tables
Preface
1 Care Management, Coordinated and Integrated Care 1
2 Service Context and Research Design 9
3 Care Management in the Social Care Scheme 25
4 The Role of Helpers and their Experience of the Scheme 53
5 Responding to Particular Needs 101
6 Outcomes for Older People 127
7 Outcomes for Carers 143
8 Costs and Outcomes of Care 167
9 Integrated Provision: Bringing Together Social Care and Primary Health Care 199
10 Intensive Care Management and Community Care 223
References 241
Name Index 255
Subject Index 259

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