Research Programmes and Projects
The PSSRU carries out research in a range of areas of social and health care. This is organised into the broad programmes listed below. Clicking on one of these links will take you to information on projects within these programmes with publications and contact details.
Assessment, Performance Measurement and User Satisfaction in Older People's Services
Assessment approaches in residential and nursing homesDescription: This study involves a survey of homes in the North West. It examines assessment tools in use in care homes, how these are used and how they compare both with the MDS/RAI and the National Service Framework for Older People. An analysis is made of the quality and contents of assessment tools currently in use. The study examines the relationship between quality of assessment tools and other measures of quality of the home.Most homes assessed newly admitted residents and repeated this assessment. Specialist doctors and therapists were rarely consulted. Coverage of key 49 assessment domains was low. No homes were using the assessment tools suggested as part of the Single Assessment Process and there was also little evidence of any of the standardised scales suggested being used. The analysis of documentation also found that some important general health domains were infrequently covered - pain, oral health and foot care. Coverage of preventative health domains was particularly low and history of falls was covered on only 48 per cent of the forms. Most frequently covered items were the activities of daily living (ADLs) with 94 per cent of the documents mentioning mobility. Nearly one third of assessment documents did not mention either cognition or mood state. Project OutlineTowards a National Standard Assessment Instrument in Continuing Care Homes: Use of the MDS/RAI, October 2002. PublicationsStewart, K., Worden, A. and Challis, D. (2003) Assessing the needs of older people in care homes, Nursing and Residential Care, 5, 1, 22-25.
Worden, A., Challis, D. and Pedersen, I. (2006) The assessment of older people's needs in care homes, Aging and Mental Health, 10, 5, 549-557.
Worden, A. and Challis, D. (2006) Assessing Care Home Quality using Routine Regulatory Information, Quality in Ageing, 7, 3, 33-44.
Worden, A. and Challis, D. (2007) Factors associated with higher quality assessment tools in care homes, Journal of Care Services Management, 2, 1, 79-91.
Challis, D. (2008) Assessment of the needs of older people in care homes, Journal of Care Services Management, 2, 2, 108-112.
Project ID: PID257
Funder: South Manchester NHS Primary Care Trust
Contact: Ms Angela Worden
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The quality of life studyDescription: An outcome study of a cohort of elderly people in residential or nursing home care in three areas of North West England, assessing maintenance of physical and mental functioning and quality of life (subjectively and objectively perceived).The study found: there was a low rate of recognition of depression in residents by care staff; a significant number of self-funding residents had low dependency on admission to nursing homes; a majority of residents had evidence of severe cognitive impairment although many of them were able to address questions about their quality of life. Survival generally was strongly associated with dependency level on admission; for residents with less cognitive impairment, likelihood of survival was also associated with greater satisfaction with leisure in the home. PublicationsSutcliffe, C., Burns, A., Challis, D., Godlove Mozley, C., Cordingley, L., Bagley, H. and Huxley, P. (2007) Depressed mood, cognitive impairment and survival in older people admitted to care homes in England, American Journal of Geriatric Psychiatry, 15, 8, 708-715.
Mozley, C., Sutcliffe, C., Bagley, H., Cordingley, L., Challis, D., Huxley, P. and Burns, A. (2004) Towards Quality Care: Outcomes for Older People in Care Homes, Ashgate, Aldershot.
Bagley, H., Cordingley, L., Burns, A., Mozley, C., Sutcliffe, C., Challis, D. and Huxley, P. (2000) Recognition of depression in long term care facilities for older people, Journal of Clinical Nursing, 9, 445-450.
Challis, D., Mozley, C., Sutcliffe, C., Bagley, H., Price, L., Burns, A., Huxley, P. and Cordingley, L. (2000) Dependency in older people recently admitted to care homes, Age and Ageing, 29, 255-260.
Mozley, C., Challis, D., Sutcliffe, C., Bagley, H., Burns, A., Huxley, P. and Cordingley, L. (2000) Psychiatric symptomatology in elderly people admitted to nursing and residential homes, Aging and Mental Health, 4, 136-141.
Mozley, C., Huxley, P., Sutcliffe, C., Bagley, H., Burns, A., Challis, D. and Cordingley, L. (2000) "Not knowing where I am doesn't mean I don't know what I like": Cognitive impariment and quality of life responses in elderly people, International Journal of Geriatric Psychiatry, 14, 776-783.
Sutcliffe, C., Cordingley, L., Burns, A., Mozley, C.G., Bagley, H., Huxley, P. and Challis, D. (2000) A new version of the Geriatric Depression Scale for nursing and residential home populations: the Geriatric Depression Scale (Residential) (GDS-12R), International Psychogeriatrics, 12, 173-178.
Project ID: PID160
Funder: NHS Executive (Northern and Yorkshire Region)
Contact: Miss Caroline Sutcliffe
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Implementing the National Service Framework for Older People: Looking at older people and carer involvementDescription: The study has three stages. In the first stage, the ways in which local implementation teams are currently involving older people and carers will be detailed and the different approaches analysed. The second stage wil examine whether different approaches lead to different outcomes. The final stage will translate evidence about effective involvement from local implementation teams into a good practice guide.Project OutlineImplementing the National Service Framework for Older People: Looking at Older People and Carer Involvement, September 2002. PublicationScott, J. with Bhaduri, R. and Sutcliffe, C. (2004) Clear Voices: A Good Practice Guide to Involving Older People and Carers in Strategic Planning and Service Development, PSSRU, University of Manchester.
Project ID: PID256
Funder: North West NHS Executive
Contact: Ms Jane Hughes
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Performance indicators in social care for older peopleDescription: Project commissioned by a social services department with assistance from the Social Services Inspectorate with the aim of developing, implementing and monitoring a set of performance indicators for services to older people.PublicationsClarkson, P. and Challis, D. (2002) Developing and implementing a local performance measurement system in older people's services, Research, Policy and Planning, 20, 3, 3-16.
Clarkson, P. and Challis, D. (2002) Developing performance indicators for mental health care, Journal of Mental Health, 11, 3, 281-293.
Clarkson, P. and Challis, D. (2003) Quality Assurance practices in care management: a perspective from the United Kingdom, Care Management Journals, 11, 3, 142-151.
Clarkson, P. and Challis, D. (2006) Performance Measurement in Social Care: A Comparison of Efficiency Measurement Methods, Social Policy & Society, 5, 4, 461-477.
Challis, D., Clarkson, P. and Warburton, R. (2006) Performance Indicators in Social Care for Older People, Ashgate, Aldershot.
Project ID: PID205
Funder: Local authority
Contact: Professor David Challis
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Towards a national standard asssessment instrument in continuing care homes: translation of the MDS RAI into a manual for use by staff in the UKDescription: The study examined the possibility of developing a standard assessment instrument for residents in care homes, to assess care needs, assist in care planning and provide information to permit costing of the level of care provided. Stage one involved a review of assessment systems used in continuing care environments. Stage two involved a pilot study in eight care homes to address issues of staff training, the instrument format, staff time and uses of the data. The third stage involved creating a version of the MDS/RAI that was suitable for use in the UK context.Further work involved examining the capacity of the MDS to identify the registered nursing care contribution. In their response to the Royal Commission on Long Term Care the Government committed itself to funding nursing care provided in nursing homes. This study examined the feasibilty of using the MDS to identify the level of the nursing care contribution. The results suggested that use of a systematic assessment tool could improve the reliability of these assessments. PublicationsChallis, D., Stewart, K., Sturdy, D. and Worden, A. (2000) UK Long Term Care Resident Assessment Instrument User's Manual, MDS/RAI UK, InterRai UK, York.
Carpenter, I., Perry, M., Challis, D. and Hope, K. (2002) Identification of registered nursing care of residents in UK nursing homes using the MDS/RAI and Resource Utilisation Groups Version III (RUG III), Age and Ageing, 32, 279-285.
Perry, M., Carpenter, I., Challis, D. and Hope, K. (2003) Understanding the roles of registered general nurses and care assistants in UK nursing homes, Journal of Advanced Nursing. 47, 497-505.
Project ID: PID242
Funder: Joseph Rowntree Foundation
Contact: Professor David Challis
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A randomised controlled study to meet the needs of older people with dementia in residential careDescription: The Audit Commission has highlighted shortcomings in the care of older people with dementia in residential or nursing home care and recommended that specialist mental health professionals provide this expertise to residents. This study seeks to provide an evaluative framework to maximise the effectiveness of their input. It is designed to assess the met and unmet health and social care needs of older people with dementia resident in care homes. The study is being undertaken in three areas in the UK: London and the south-east, Bangor and Manchester, with the lead researcher based at University College, London.The write up of the study is in progress but early findings indicate that the intervention reduced needs at follow up, suggesting that a planned routine assessment and care planning process for care homes could offer a way to improve quality of care. PublicationsHancock, G.A., Woods, B., Challis, D. and Orrell, M. (2006) The needs of older people with dementia in residential care, International Journal of Geriatric Psychiatry, 21, 43-49.
Orrell, M., Hancock, G., Hoe, J., Woods, B., Livingston, G. and Challis, D. (2007) A cluster randomised controlled trial to reduce the unmet needs of people with dementia living in residential care, International Journal of Geriatric Psychiatry, 22, 1127-1134.
Project ID: PID251
Funder: The Wellcome Trust
Contact: Professor David Challis
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A systematic evaluation of the development and impact of the single assessment process in EnglandDescription: This two stage study seeks to evaluate both the development and impact of the Single Assessment Process in England. Stage one comprises a literature review with supplementary focus group material exploring key issues in implementation of the SAP. Stage two, following this, will evaluate the eventual impact of the SAP using a number of data collections from the perspective of different stakeholders. A project outline and research summary are available below.
Project OutlineA Systematic Evaluation of the Development and Implementation of the Single Assessment Process in England, May 2004 [PO60].Research SummariesImplementing the Single Assessment Process: Key Findings from the Literature, October 2005 [RS034].A Systematic Evaluation of the Development and Implementation of the Single Assessment Process in England - Research and Policy Update 1, June 2006.A Systematic Evaluation of the Development and Implementation of the Single Assessment Process in England - Research and Policy Update 2, January 2008
Project ID: PID286
Funder: Department of Health
Contact: Ms Jane Hughes
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Enhancing the efficiency and effectiveness of assessment in community careDescription: Ever since the late 1980s, improving the quality and consistency of assessment has concerned not just the realm of practice but also that of policy. There is a lengthy tradition of research relating to assessment in the Manchester branch. Studies have examined the quality of assessment tools employed in community-based care and in residential and nursing home care. Specialist assessment tools for use in care homes have been developed, representing a technology transfer of work originating from the US. A study of the impact of comprehensive multi-disciplinary assessment in the community indicated the gains from home assessments of vulnerable older people by specialist clinicians such as geriatricians and old age psychiatrists. Current work is evaluating the implementation of the Single Assessment Process in England. Building on this stream of work relating to assessment, PSSRU at Manchester has been awarded further funding to evaluate new developments in assessment. The new work will address developments designed to streamline the assessment process and self assessment approaches in different local authorities. Project OutlineEnhancing the efficiency and effectiveness of assessment in community care, October 2006.
Project ID: PID394
Funder: Department of Health
Contact: Professor David Challis
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The design and use of local metrics to evaluate performance: a comparative analysis of social care organisationsDescription: Performance measures, now available in the UK public sector, are employed primarily on a national basis, often to assist government regulation. However, knowledge of their use locally, particularly in local authority social care is limited. PSSRU at Manchester has been funded by the ESRC to examine local approaches to performance measurement in social care. This two stage study is to examine the use of performance measures and monitoring techniques in local social care services for older people, so at to draw conclusions regarding the future conduct of the performance regime in social care, health and other public services. The first stage will explore the use of measures and their relationship with how organisations are rated on their performance through a questionnaire survey across England and Northern Ireland. The second stage will explore, through management interviews and written material in the UK, and comparatively the design and use of performance measures in Japan, where measures at a more local level are more generally available in this setting. The results of the study will be generalised to other public services in addition to reporting their significance for social care.Project OutlineThe design and use of local metrics to evaluate performance: a comparative analysis of social care organisations, October 2006. Project ReportsThe design and use of local metrics to evaluate performance: a comparative analysis of social care organisations. Literature Review and Planning Document, July 2007.
Project ID: PID405
Funder: ESRC
Contact: Dr Paul Clarkson
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Co-ordinated Care, Care Management, Service Integration and Partnerships
Care management arrangements for older people and those with mental health problems: integration and differentiationDescription: This project aims to identify the distinctive characteristics of different care management arrangements and discriminate between these in terms of their structures, processes and outcomes, in order to identify differences in their relative costs and benefits.There is a significant variation in care management arrangements across England, with very little evidence of the presence of intensive care management or integration of health and social care at this level. A number of studies have been published covering the variation in patterns of care management; the extent to which different models can be identified; integration; and balance of care. Downloadable PublicationsResearch and Policy Update 1
Research and Policy Update 2
Research and Policy Update 3
Research and Policy Update 4 Other PublicationsChallis, D., Weiner, K., Darton, R., Hughes, J. and Stewart, K. (2001) Emerging patterns of care management: Arrangements for older people in England, Social Policy and Administration, 35, 6, 672-687.
Challis, D., Darton, R., Hughes, J., Stewart, K and Weiner, K. (2001) Intensive care management at home: an alternative to institutional care? Age and Ageing, 30, 409-413.
Hughes, J., Stewart, K., Challis, D., Darton, R. and Weiner, K. (2001) Care management and the care programme approach: Towards integration in old age mental health services, International Journal of Geriatric Psychiatry, 16, 3, 266-272.
Challis, D. and Hughes, J. (2002) Frail older people at the margins of care: some recent research findings, British Journal of Psychiatry, 180, 126-130.
Weiner, K., Stewart, K., Hughes, J., Challis, D. and Darton, R. (2002) Care management arrangements for older people in England: Key areas of variation in a national study, Ageing and Society, 22, 419-439.
Stewart, K., Hughes, J., Challis, D., Darton, R., and Weiner, K. (2003) Care Management for Older People: Access, Targeting and the Balance Assessment, Monitoring and Review, Research Policy and Planning, 21, 3, 13-22.
Weiner, K., Hughes, J., Challis, D. and Pedersen, I. (2003) Integrating health and social care at the micro level: Health care professionals as care managers for older people, Social Policy and Administration, 37, 5, 498-515.
Venables, D., Hughes, J., Stewart, K. and Challis, D. (2005) Variations in Care Management Arrangements for People with Mental Health Problems in England, Care Management Journals, 6, 3, 131-138.
Hughes, J., Stewart, K., Challis, D., Jacobs, S. and Venables, D. (2005) Exploring the Factors Influencing Care Management Arrangements in Adult Mental Health Services in England, Research, Policy and Planning, 23, 1, 31-42.
Challis, D., Jacobs, S., Hughes, J., Stewart, K., Venables, D. and Weiner, K. (2005) Are different forms of care management associated with variations in case-mix, service use and care managers' time use in mental health services? Research, Policy and Planning, 23, 2, 71-85.
Challis, D., Stewart, K., Donnelly, M., Weiner, K. and Hughes, J. (2006) Care management for older people: Does integration make a difference?Journal of Interprofessional Care, 20, 4, 335-348.
Jacobs, S., Hughes, J., Challis, D., Stewart, K. and Weiner, K. (2006) Care Manager's Time Use: Differences Between Community Mental Health and Older People's Services in the United Kingdom, Care Management Journals, 7, 4, 169-178.
Venables, D., Hughes, J., Reilly, S., Stewart, K. and Challis, D. (2006) Patterns of Care Management Arrangements for People with Mental Health Problems in England, Australian Journal of Case Management, 7, 2, 3-9.
Jacobs, S., Hughes, J., Challis, D., Stewart, K. and Weiner, K. (2006) From Care Management to Case Management: What can the NHS Learn from the Social Care Experience? Journal of Integrated Care, 14, 3, 22-31.
Reilly, S., Challis, D., Donnelly, M., Hughes, J. and Stewart, K. (2007) Care management in mental health services in England and Northern Ireland: Do integrated organizations promote integrated practice? Journal of Health Service Research and Policy, 12, 4, 236-241
Jacobs, S. and Challis, D. (2007) Assessing the impact of care management in the community: Associations between key organisational components and service outcomesAge and Ageing, 36, 3, 336-339
Challis, D., Hughes, J., Jacobs, S., Stewart, K. and Weiner, K. (2007) Are different forms of care-management for older people in England associated with variations in case-mix, service use and care-managers' use of time?Ageing & Society, 27, 25-48
Project ID: PID034
Funder: Department of Health
Contact: Professor David Challis
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Social care services before the influence of modernisation: A review of the state of service delivery, commissioning and service impactDescription: The aim of this study is to clarify the nature of the current service system, from access to services, through models of service provision to processes of commissioning, so as to establish a baseline from which to measure changes arising from the modernisation process. Project OutlineSocial Care Services Before the Influence of Modernisation: A Review of the State of Service Delivery, Commissioning and Service Impact, October 2003. Executive Summary Social Care Services at the Beginning of the 21st Century - Executive Summary [DP M104].PublicationsXie, C., Hughes, J., Challis, D., Stewart, K. and Cambridge, P. (2008) Care Management Arrangements in Services for People with Intellectual Disabilities: Results of a National Study Journal of Applied Research in Intellectual Disabilities, 21, 156-167.
Project ID: PID258
Funder: Department of Health
Contact: Ms Jane Hughes
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Services for older people with mental health problems: The balance of care in CumbriaDescription: The study aims to consider whether the current mix of services between inpatient, nursing and residential homes on the one hand and community services on the other, is appropriate. The study is comparing the patterns of service allocation and the feasibility of changing the balance of care using expert panels to undertake an 'in vivo' evaluation of alternative modes of care. Project OutlineServices for Older People with Mental Health Problems: The Balance of Care in Cumbria, March 2003. PublicationsTucker, S., Hughes, J., Scott, J., Burns, A. and Challis, D. (2007) Commissioning services for older people with mental health problems: Is there a shared vision? Journal of Integrated Care, 15,2, 3-12.Tucker, S., Hughes, J., Burns, A. and Challis, D. (2008) The balance of care: Reconfiguring services for older people with mental health problems. Aging and Mental Health, 12, 1, 81-91.
Project ID: PID259
Funder: Eden Valley NHS Primary Care Trust
Contact: Ms Sue Tucker
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Evaluation of Lewisham care management scheme for the cognitively impairedDescription: Evaluation of a care management service for elderly people suffering from dementia, based in a multidisciplinary community mental health team.PublicationChallis, D., von Abendorff, R., Brown, P., Chesterman, J. and Hughes, J. (2002) Care management, dementia care and specialist mental health services: an evaluation, International Journal of Geriatric Psychiatry, 17, 315-325.
Project ID: PID064
Funder: Department of Health
Contact: Miss Caroline Sutcliffe
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Eligibility criteria in local authority services for older peopleDescription: National study of eligibility criteria for social services, looking at the different forms of eligibility criteria used by local authorities for different service sectors; the link between eligibility criteria and assessment systems; and the utility of the systems of eligibility and assessment which are in operation and the difficulties associated with their implementation.
PublicationsHughes, J., Challis, D., Gill, J. and Stone, S. (1997) The Eligibility Lottery, Working with Older People, October, 14-16.
Challis, D. and Hughes, J. (2002) Frail older people at the margins of care: some recent research findings, British Journal of Psychiatry,180, 126-130.
Project ID: PID186
Funder: CCC/Age Concern
Contact: Ms Jane Hughes
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The value of specialist clinical assessment of older people prior to placement in care homesDescription: In common with changes in many other countries, the community care reforms in the UK have placed assessment as a cornerstone of good quality care. Recent Department of Health guidelines advocate the development of multi-disciplinary approaches to assessments. The Department of Health has funded a three-year study to evaluate multi-disciplinary assesssments.The aims of the project are: to evaluate the effect of provision of a clinical contribution to the assessment process; and to examine the costs and benefits of this multi-disciplinary process of assessment for older people and their carers, and also for health and social services. Some older people referred to the social services department placement panel for residential or nursing home placements will have a medical report based upon an assessment by a senior geriatrician or old age psychiatrist. The others will receive the usual process of assessment and documentation. These older people and their carers will also be seen by the research team and followed up again six months later. Project OutlineThe Value of Multidisciplinary Assessment of Vulnerable Older People, January 2001 [PO37]. PublicationsWeinberg, A., Williamson, J., Challis, D. and Hughes, J. (2003) What do care managers do? A study of working practice in older peoples' services, British Journal Social Work, 33, 901-919.
Challis, D., Clarkson, P., Williamson, J., Hughes, J., Venables, D., Burns, A. and Weinberg, A. (2004) The value of specialist clinical assessment of older people prior to entry to care homes, Age and Ageing, 33, 1-10.
Clarkson, P., Venables, D., Hughes, J., Burns, A. and Challis, D. (2006) Integrated specialist assessment of older people and predictors of care-home admission, Psychological Medicine, 36, 1011-1021.
Venables, D., Clarkson, P., Hughes, J., Burns, A. and Challis, D. (2006) Specialist clincial assessment of vulnerable older people: outcomes for carers from a randomised controlled trial, Ageing and Society, 26, 867-882.
Project ID: PID196
Funder: Department of Health
Contact: Professor David Challis
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Study of old age psychiatry services in EnglandDescription: Aims to identify the patterns of organisation and working of old age psychiatry services in England, as a key component of integrated care for older people with mental health problems. Three main features evaluated are patterns of professional roles, community orientation and degree of service integration. A comparison was also made between services in England and Northern Ireland to examine the impact of integration on the operation of old age mental health services.PublicationsChallis, D., Reilly, S., Hughes, J., Burns, A., Gilchrist, H. and Wilson, K. (2002) Policy, organisation and practice of specialist old age psychiatry in England, International Journal of Geriatric Psychiatry, 17, 4, 1018-1026.
Reilly, S., Challis, D., Burns, A. and Hughes, J. (2003) Does integration really make a difference?: A comparison of old age psychiatry services in England and Northern Ireland, International Journal of Geriatric Psychiatry, 18, 887-893.
Reilly, S., Challis, D., Burns, A. and Hughes, J. (2004) The use of assessment scales in Old Age Psychiatry Services in England and Northern Ireland, Aging & Mental Health, 8, 249-255.
Project ID: PID243
Funder: North West NHS Executive
Contact: Professor David Challis
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Estimating the effects of proposals to change the residential allowance in services for older peopleDescription: This study was commissioned by the Department of Health as part of the implementation schedule of the White Paper - Modernising Social Services. Its purpose was to explore the potential impact of plans to abolish the residential allowance and replace it by a special grant to local authorities. There were two elements to the study: the first involved using estimates obtained from local authority managers; the second involved frontline staff in a simulation of decision making processes in a post change environment.PublicationsClarkson, P., Hughes, J. and Challis, D. (2003) Public funding for residential and nursing home care: Projection of the potential impact of proposals to change the residential allowance in services for older people, International Journal of Geriatric Psychiatry, 18, 3, 211-216.
Clarkson, P., Hughes, J. and Challis, D. (2005) The potential impact of changes in public funding for residential and nursing home care in the United Kingdom: the residential allowance, Ageing and Society, 25, 159-180.
Project ID: PID244
Funder: Department of Health
Contact: Ms Jane Hughes
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Training requirements of care staff in nursing and residential care homesDescription: The study had two stages: first, a training needs analysis of care staff in residential and nursing homes; second, the creation of an evidence-based handbook for training in dementia care for nursing and care assistants in continuing care homes.PublicationsBhaduri, R. (ed.) (2002) Caring with Confidence. A Handbook for Training in Dementia Care for Nursing and Care Assistants in Continuing Care Homes, PSSRU, University of Manchester.
Bhaduri, R. (2004) Caring with confidence: training in dementia care, Nursing and Residential Care, May, 2004, 6, 5, 244-245.
Bhaduri, R. and Sutcliffe, C. (2007) Implementing evidence-based training in dementia care for frontline workers in the social care workforce: Reaching for horizons? Journal of Care Services Management, 1, 3, 294-302.
Project ID: PID245
Funder: North West NHS Exec
Contact: Professor David Challis
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Mapping specialist dementia services in North West EnglandDescription: Explores the existing configuration of services and particularly the opportunities for service substitution within and between providers of health and social care.Project OutlineMapping Specialist Dementia Services in the North West of England, October 2002.Reports from the StudyCare Homes for Older People with DementiaDay Care Services for Older People with DementiaHome Care Services for Older People with DementiaProfessional Community Based Teams for Older People with DementiaOther PublicationsVenables, D., Reilly, S., Challis, D., Hughes, J. and Abendstern, M. (2006) Standards of care in home care services: A comparison of generic and specialist services for older people with dementia, Aging and Mental Health, 10, 2, 187-194.
Abendstern, M., Reilly, S., Hughes, J., Venables, D. and Challis, D. (2006) Levels of integration and specialisation witin professional community teams for people with dementia, International Journal of Geriatric Psychiatry, 21, 77-85.
Reilly, S., Venables, D., Hughes, J., Challis, D. and Abendstern, M. (2006) Standards of care in day hospitals and day centres: a comparison of services for older people with dementia, International Journal of Geriatric Psychiatry, 21, 460-468.
Reilly, S., Abendstern, M., Hughes, J., Challis, D., Venables, D. and Pedersen, I. (2006) Quality in long-term care homes for people with dementia: an assessment of specialist provision, Ageing and Society, 26, 4, 649-668..
Project ID: PID246
Funder: North West NHS Executive
Contact: Dr Michele Abendstern
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Changing patterns of old age psychiatry: The impact of the National Service Framework for Older PeopleDescription: This study has been commissioned by the Royal College of Psychiatrists and will incorporate a survey of clinicians specialising in the mental health of older people. It is designed to provide a view of the way in which mental health services for older people have responded to the proposals for change outlined in the NSFOP. The aim of the study is to explore developments in three areas: first, the nature of the work undertaken by staff in mental health services for older people; second, the range of services available to older people with mental health problems in other sectors of the NHS; and third, the pace of service development. Project OutlineServices for Older People with Mental Health Problems: The Impact of the National Service Framework, October 2002. PublicationTucker, S., Baldwin, R., Hughes, J., Benbow, S., Barker, A., Burns, A. and Challis, D. (2007) Old age mental health services in England: implementing the National Service Framework for Older People, International Journal of Geriatric Psychiatry, 22, 211-217.
Project ID: PID260
Funder: Royal College of Psychiatrists
Contact: Ms Sue Tucker
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Delayed discharges from hospitalDescription: People over the age of 65 years are the largest proportion of patients discharged from hospital. The Community Care (Delayed Discharges) Act 2003 placed new requirements upon local authorities providing social care and the NHS so as to reduce the scale of delay in discharge from acute beds. The study is being undertaken in Stockport with the aim of identifying patients at high risk of delayed discharge at the point of admission to hospital. Project OutlineDelayed Discharges from Hospital, January 2005. Executive SummaryDelayed Discharges from Hospital - Executive Summary, November 2007.
Project ID: PID321
Funder: Delayed Transfers of Care Steering Group in Stockport (Stockport Primary Care Trust, Stockport NHS Foundation Trust and Social Services Department
Contact: Ms Jane Hughes
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National Trends and Local Delivery in Old Age Mental Health Services: Towards an Evidence BaseDescription: This 40-month programme of work will explore the most appropriate and cost-effective ways of organising and delivering services for older people with mental health problems through a series of distinct, but interlinked, projects. It has three main objectives: To identify key patterns of national variation in the range, delivery and organisation of mental health services for older people; To identify whether, how, and at what cost the mix of institutional and community-based services could be more optimally developed in Manchester; and To explore the costs and benefits of different models of community mental health teams for older people (CMHTsOP).Project OutlineNational Trends and Local Delivery in Old Age Mental Health Services, August 2008.
Project ID: PID452
Funder: NIHR Programme Grant
Contact: Mr Mark Wilberforce
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Commissioning and Performance
The Commissioning and Performance programme endeavours to describe and evaluate the mixed economy of care in England, particularly focused on commissioning, providing, market development and choice. This work builds on the programme previously called ‘the mixed economy of care’ which sought to describe and evaluate the development, structure and performance of social care markets. There is a particular focus on:
the approaches and perspectives of purchasers;
the characteristics, motivations and behaviour of providers
the key features of commissioning and their consequences for market structure and outcomes;
micro-commissioning by care managers and the participative roles of service users; and
commissioning of services by users, through direct payments and individual budgets.
Direct paymentsDescription: This project carried out an evaluation of the impact of the direct payments implementation strategy in social care.Further information is available at Direct Payments Survey.
Project ID: PID273
Funder: Department of Health
Contact: Ms Vanessa Davey
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Local variability in social care across EnglandDescription: All aspects of social care provision in England are characterised by a significant degree of local variability. There is, for example, significant geographical variability in funding patterns, service eligibility criteria and service mixes. The possible explanations for such local heterogeneity are multifarious. Local differences in supply conditions, service preferences or levels and nature of need are likely to impact on what, to whom and how services are delivered. Within this context, the main aim of the study is therefore to understand which factors affect local patterns of provision, and to what extent they do so, in order to judge whether:
variability in service provision results from the influence of factors outside the control of local policy makers
whether it results from local policy decisions, and the extent to which such policies are driven by local preferences or historical trends
the impact on equity and efficiency of alternative service configurations, and in particular the impact on local social and health care service performance.
The methodology of the study is based on the econometric modelling of local authority data, placing particular emphasis on geographical and longitudinal trends. The work is being undertaken by Jose-Luis Fernandez, Julien Forder, Tom Snell and Martin Knapp.
Project ID: PID344
Funder: Department of Health
Contact: Dr José-Luis Fernández
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Innovations Forum EvaluationDescription: The evaluation accompanies the Health of Older People stream of the Innovation Forum programme, launched to improve the care and quality of life of older people and to avoid unnecessary, unplanned hospital admissions through service innovations. The nine participating councils have set a “headline” target of a 20 per cent reduction in the utilisation of hospital beds by those aged 75 and over between 2004-2007. The study will investigate to what extent and in what ways creating a single point for strategic commissioning can achieve a significant reduction in the use of unscheduled inpatient care by people aged 75 and over.
The research has three objectives:
To use the combined strengths of the evaluators and national stakeholders to ensure that the overall initiative and its individual components are evidence-based, wherever possible, thereby maximising the benefits to be obtained from applying existing knowledge.
To promote an open culture of knowledge sharing between pilot site teams, local evaluation teams and the national evaluation.
To collate, analyse and draw conclusions from data about the outputs, outcomes and consequences of the initiative overall.
The LSE team also conducted the local evaluation of four IF sites and is carrying out the quantitative data analysis and modelling of bed utilisation for the national evaluation. Staff working on this project include Kate Henderson, Derek King and Martin Knapp. Dates: 1 April 2004 and 31 March 2007.
Project ID: PID345
Funder: Kent County Council
Contact: Ms Catherine Henderson
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Wanless Social Care ReviewDescription: The main report of the Wanless Social Care Review, funded by the King’s Fund, was published in March 2006. The Review was undertaken by a project team of economists and social care specialists based at the King’s Fund in collaboration with the PSSRU at the London School of Economics.
The LSE team included Julien Forder, Jose-Luis Fernandez, Francesco Moscone with inputs from Adelina Comas and Juliette Malley.
The Review made recommendations about the service model to be used in the future. It also recommended the adoption of a partnership model of funding. Work is now being undertaken to refine these recommendations and to develop practical deliverables. In particular, the micro-simulation model developed by the Review is being extended to cover a range of specifications of the partnership model, to produce future projections, and to incorporate difference service and commissioning models. The outputs of this work include estimates of the funding required for social care, practical configurations of the arrangements for funding care (including the partnership model), and guidance about commissioning.
The work is being undertaken by Julien Forder, Jose-Luis Fernandez, Juliette Malley and Raphael Wittenberg. PublicationsWanless, D., Forder, J., Fernández, J-L., Poole, T., Beesley, L., Henwood, M. and Moscone, F. (2006) Wanless Social Care Review, Securing Good Care for Older People, Taking a Long-Term View, Report to King's Fund, King's Fund, London.
Henderson, C. (2006) Time and other inputs for high quality social care. Background paper for Wanless Social Care Review, Kings Fund, London.
Malley, J., Comas-Herrera, A., Hancock, R., Juarez-Garcia, A., King, D. and Pickard, L, (2006) Expenditure on Social Care for Older People to 2026: Projected Financial Implications of the Wanless Report, PSSRU Discussion Paper 2332, London School of Economics, London.
Project ID: PID346
Funder: King's Fund
Contact: Professor Julien Forder
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Modelling the impact of care vouchersDescription: This project aimed to evaluate the costs and benefits of rolling out care vouchers in England.
View Final Report
View Research Summary
Project ID: PID450
Funder: Westminster Advisers
Contact: Mr Tom Snell
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Care home providers' motivationsDescription: One project has focused on care home owners and managers, combining face to face interviews with surveys of providers to explore in unpredecented depth:
key aspects of current motivation, and how this is linked to their professional goals and professionalism;
changes in motivation over time, and how this connects with evolving local market environments;
the nature of operational relationships with commissioners, and how these help or hinder their functioning in local markets; and
the character of their relationships with regulators, ranging across time budget allocations, subjective experiences of inspection, and implicit or explicit recognition of their values and motivations.
Latterly, analysis of motivations has been further enhanced by examining commissioners' perceptions of provider motivations in a small sample of English local authorities. The work is being undertaken by Tihana Matosevic, Jeremy Kendall, Martin Knapp, Kate Henderson and Jose-Luis Fernandez.PublicationsMatosevic, T., Knapp, M. and Le Grand, J. (2007) Motivation and commissioning: perceived and expressed motivations of care home providers, Social Policy and Administration, forthcoming.
Matosevic, T., Knapp, M., Kendall, J., Henderson, K. and Fernandez, J. (2007) Care home providers as professionals, understanding the motivations of care home providers in England, Ageing and Society, 27, 103-126.
Forder, J., Knapp, M., Hardy, B., Kendall, J., Matosevic, T. and Ware, P. (2004) Prices, contracts and motivations: institutional arrangements in domiciliary care, Policy & Politics, 32, 2, 207-222.
Kendall, J., Matosevic, T., Forder, J., Knapp, M., Hardy, B. and Ware, P. (2003) The motivations of domiciliary care providers in England: new concepts, new findings, Journal of Social Policy,
32, 4, 489-512.
Ware, P., Matosevic, T., Hardy, B., Knapp, M., Kendall, J. and Forder, J. (2003) Commissioning care services for older people: the view from care managers, users and carers, Ageing and Society, 23, 4, 411-428.
Matosevic, T., Knapp, M., Kendall, J., Forder, J., Ware, P. and Hardy, B. (2001) Domiciliary Care Providers in the Independent Sector, PSSRU/Nuffield Institute for Health, London and Leeds.
Ware, P., Matosevic, T., Forder, J., Hardy, B., Kendall, J. and Knapp, M. (2001) Movement and change: independent sector domiciliary care providers between 1995 and 1999, Health and Social Care in the Community, 9, 6, 334-340.
Project ID: PID355
Funder: Department of Health
Contact: Dr Tihana Matosevic
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Balance of careDescription: The purpose of this project is to produce a national picture of the level and types of services that satisfy these principles. A set of planning tools based on this specification can help guide commissioning of services for older people.With increasing policy attention on outcomes, this project considers what range and balance of services is needed in the future to most cost-effectively and equitably produce desired outcomes for people. It combines measurement of outcomes and preferences for different outcomes with analysis of how services impact on these outcomes.
Building on the work of the Wanless Review of Social care, the project considers the criteria and application of cost-effectiveness principles (reflecting on how NICE employ such principles for health care)
Using the analysis the aim is to produce a national picture of the level and types of services that satisfy these principles. A set of planning tools based on this specification can help guide commissioning of services for older people. The project assesses how the commissioning function of councils and others can be further developed in using such tools, and also in terms of the incentives and motivations framework in which commissioners work
Using the micro-simulation model developed by the Wanless Review, this project also projects the future cost of array of services.
The project links with the Costs and Outcomes project at PSSRU at University of Kent. It uses Relative Needs Formula and user experience survey (UES) data.
Project ID: PID420B
Funder: Department of Health
Contact: Professor Julien Forder
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Strategic CommissioningDescription: This project aims to determine the necessary changes required to place service user choice at the heart of all decisions of service delivery amidst current policy changes designed to strengthen the role of users in commissioning care. Staff working on this project are Vanessa Davey, Gerald Wistow and Eileen Waddington. View further information
Project ID: PID419B
Funder: Joseph Rowntree Foundation
Contact: Ms Vanessa Davey
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Economic evaluation of Criminal Justice Integrated Teams (CJITs)Description: Criminal Justice Integrated Teams bring together Criminal Justice and treatment agencies with other services to direct problematic drug-using offenders out of crime and into treatment. The study aims to establish the cost implications of CJITs, by carrying out a cost-savings analysis of the scheme.
Project ID: PID372
Funder: Home Office
Contact: Dr José-Luis Fernández
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Comparative Community Care Costs AnalysisDescription: This project aimed to study the benefits of community based services as an alternative to institutions for disabled people in Europe. Further information can be found here.
Project ID: PID375
Funder: European Commission
Contact: Professor Martin Knapp
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Prevention and partnershipDescription: Various preventative measures have the potential to improve long-term outcomes for older people. This project concerns the appropriate use of ‘upstream’ services or interventions that reduce the risk of, or prevent the need for more expensive, more intensive and more invasive downstream interventions. The consequences can be measured as improvements in outcomes for older people (their independence, met needs, well-being etc.). Prevention will require successful co-ordination between sectors to promote an appropriate (e.g. cost-effective) balance of services. This project focuses on:
partnership working, most notably arrangements between councils with social services responsibilities, PCTs, provider trusts etc, but also more strategic, organisational/structural arrangements;
different incentives and performance management options that promote prevention and partnership working (e.g. by releasing savings from one sector to another);
strategic commissioning, in terms of securing the right mix and range of services;
preventative services in potentially affecting people’s future profile of need and future use of services.
This project uses statistical analyses of data at the council, PCT and ‘small area’ level (including using HES, FSS/RNF, local authority PSS and inspection data), and also existing individual-level survey data (e.g. British Household Panel Survey, the English Longitudinal Survey of Ageing). A related activity is the link with the POPPs evaluation. The work is being undertaken by Julien Forder, Jose-Luis Fernandez, Francesco Moscone and Martin Knapp.
Project ID: PID377
Funder: Department of Health
Contact: Professor Julien Forder
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Unplanned hospital admissions for older people (75+): the impact of governance and incentivesDescription: The Department of Health (NHS Service Delivery Organisation) has awarded PSSRU at the LSE (in collaboration with the Universities of Hertfordshire, Plymouth and Keele University) £300,000 to look at the impact of governance and incentives on unplanned hospital admissions of older people (75+).
The project aims to compare and critically analyse the impact of different governance models as local authorities and NHS bodies work together to reduce the utilisation of unplanned inpatient bed days for older people aged 75 and over. Phase 1 will explore models of governance, partnerships, local initiatives and incentives within nine IF sites. Phase 2 will focus on case studies in three IF sites, and a governance and incentives model will be created in Phase 3.
The study builds on a one-year research collaboration with 9 local authorities and their NHS partners under the auspices of the Innovation Forum: Improving the Future for Older People (IF). The PSSRU staff involved are Martin Knapp, Catherine Henderson and Gerald Wistow.
Project ID: PID378
Funder: NHS Service Delivery Organisation (DH)
Contact: Professor Martin Knapp
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Social economy and liberalisation of servicesDescription: The study aims to explore the impact on the performance of the social care system for older people of recent changes in the role of the state as service provider/ regulator. This question is addressed through a comparative analysis of recent policy developments in four European countries (Belgium, France, Italy and the UK). Two main questions guide the UK analysis to be carried out by Dr Jose-Luis Fernandez (LSE). Firstly, the analysis examines arguments for and against a public intervention in social care. Secondly, the study examines the relationship between the state and different types of providers, and its implications for the design of regulatory frameworks in social care.
Project ID: PID379
Funder: Universite Catholique De Louvain
Contact: Dr José-Luis Fernández
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Brighter Futures for Older People in Kent EvaluationDescription: Developing person centred services and the maintenance of health and independence in the community for older people in the community are central policy platforms.
The Brighter Futures for Older People in Kent (hereafter Brighter Futures) scheme supports older people in parts of Kent, aiming to enable them to stay independent in the community by providing them with access to a wide range of community-based services delivered by volunteers.
The study will address the following research questions:
Whether and by how much has the Brighter Futures project reduced inappropriate admissions to hospital and long-term care?
Has the range of services in the areas identified and delivered in partnership with the voluntary and community sector been developed, and to what extent are they person-centred and seamless?
Has a culture of volunteering been developed and to what extent has the quality of life of those engaged in volunteering been affected?
Have the partnerships/collaborations envisaged in the project plans resulted in improved information sharing, greater effectiveness for service users and efficiency gains?
Have social inclusion and independence been achieved?
Staff working on this project: Martin Knapp and Margaret Perkins.
Project ID: PID416
Funder: Treasury through Kent County Council
Contact: Ms Margaret Perkins
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Choice and Direct Payments for adult mental health service usersDescription: Direct payments have been seen as a central policy initiative in recent years for all service users to promote choice and independence in the way their particular social care needs are met yet various research reports specific difficulty in advancing uptake among mental health service users This exploratory seeks to investigate how, at the local level, choice and Direct Payments are being promoted and the views of care coordinators in integrated community mental health teams on meeting these objectives in their daily practice in their particular local context.
Research questions include:
what policy and service developments are taking place at the local level to meet the objectives of recent policy on choice and Direct Payments;
how do these impact on the day to day work of integrated care management teams;
what are their views on these agendas;
how do organisational arrangements and local factors affect what happens for frontline practitioners.
Project ID: PID417
Funder: Department of Health
Contact: Ms Margaret Perkins
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Compression or Expansion of Disability? Scenarios for the Wanless ReportDescription: This project was commissioned by the Wanless Review of Social Care. It reviewed trends in disease and treatment in four areas: stroke, coronary heart disease, dementia and cognitive impairment and arthritis. It then investigated how disease patterns would impact on the future levels of disability of older people over the next 20 years. Finally, it produced disability prevalence rates within age groups over the next 20 years in a form suitable to input to the PSSRU long-term care model. The project identified three main scenarios that were used in the Wanless Review. PublicationJagger C, Matthews R, Spiers N, Brayne C, Comas-Herrera A, Robinson T, Lindesay J, Croft P (2006) Compression or Expansion of Disability? Forecasting Future Disability Levels under Changing Patterns of Diseases, Background Paper to the Wanless Social Care Review, King’s Fund, London.
Project ID: PID424
Funder: King's Fund
Contact: Ms Adelina Comas-Herrera
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Accessibility to ICT Products and Services by the Elderly and People with DisabilitiesDescription: The outcomes of the study are intended to support the next important stage in the development and implementation of EU eAccessibility policy. This will be accomplished by means of providing a useful insight into “the possibilities to and appropriateness of making best use of existing EU legislation relevant to eAccessibility, adapting this legislation, and possibly proposing new legislative measures”. The purpose of this study is to provide a rigorous and practical analysis of both existing and possible new legal approaches, as well as their impact, in order to promote eAccessibility in the EU.
Project ID: PID466
Funder:
Contact:
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Assessing Needs of Care in European Nations (ANCIEN)Description: The objectives of ANCIEN are to review the LTC systems in EU member states, to assess the actual and future numbers of elderly care-dependent people in selected countries and to develop a methodology for comprehensive analysis of actual and future LTC needs and provisions across European countries, including the potential role of technology and policies on maintaining and improving quality. Performance indicators will be identified and relative performances of the different types of LTC systems assessed.
Project ID: PID467
Funder: European Commission
Contact: Ms Adelina Comas-Herrera
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MonAMI: Mainstreaming on Ambient IntelligenceDescription: This project aims to evaluate the MonAMI programme (Mainstreaming ambient technology) as it is rolled over 32 EC countries. Further Information: http://www.lse.ac.uk/collections/PSSRU/researchAndProjects/pdfs/monami.pdf (PDF)
Project ID: PID468
Funder: European Commission
Contact: Ms Jacqueline Damant
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SOCIONICALDescription: SOCIONICAL is an Information and Communication Technologies Project funded under European Seventh Framework Programme (FP7), aiming to develop Complexity Science based modelling, prediction and simulation methods for large scale socio-technical systems. Further Information: http://www.socionical.eu/index.php
Project ID: PID469
Funder:
Contact:
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European network for promoting the health of residents in psychiatric and social care institutions (HELPS)Description: The purpose of this project is to collate knowledge and identify best practice across Europe for promoting the health of residents in psychiatric and social care institutions. Further Information: http://www.lse.ac.uk/collections/PSSRU/researchAndProjects/pdfs/helps.pdf (PDF)
Project ID: PID470
Funder: European Commission
Contact: Mr David McDaid
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Changing Practice in Dementia Care in the Community: Developing and Testing Evidenced-Based Interventions, from Timely Diagnosis to End of Life (EVIDEM)Description: This programme of work comprises five projects (see http://www.evidem.org.uk/). The contribution of PSSRU at LSE is to build economic components into each of these streams of work in order to understand the cost and other resource implications of needs and responses to them, and to explore the cost-effectiveness of interventions. Further Information: http://www.lse.ac.uk/collections/PSSRU/pdf/A32832%20EVIDEM%20Leaflet_6pp%20DL_no%20crops.pdf (PDF)
Project ID: PID473
Funder: NIHR
Contact: Professor Martin Knapp
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Evaluation of a System of Structured, Pro-active Care for Chronic Depression in Primary CareDescription: LSE's component of this project aims to conduct an economic evaluation from the societal perspective, covering the service receipt and productivity losses.
Project ID: PID474
Funder: DH
Contact:
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Costs and Outcomes
There is an increasing demand for information that accurately reflects costs,quality and outcomes. This demand stretches from those involved in monitoring their own performance, be they providers or commissioners, through to those responsible for national accounts. The programme aims to develop and improve measures, investigate factors associated with variations and enhance the value of both research and routine statistical information for monitoring, evaluative and ongoing policy purposes.
Unit costs of health and social careDescription: There is a growing demand for information about the costs of community care, to serve a variety of purposes. In particular there is a need for accurate information on the unit costs of services. Although there has been a considerable amount of research which has included a costing element and other research that can inform the costing process, there is a need to establish what exactly constitutes, say, the cost of providing an hour's counselling by a social worker, or the cost of a GP consultation.A working group was established, drawn from the Personal Social Services Research Unit at the University of Kent, the Centre for the Economics of Mental Health at the Institute of Psychiatry, the Centre for Health Economics at the University of York, and the Department of Health. The programme draws on a wide range of other research and complements and builds on and assists other activities. The primary aims of the programme are threefold: to collate state of the art unit costs research; to identify important gaps in knowledge about unit costs; and to contribute to the discussion about an agreed approach to costs estimation and standard of costing which could prove of value to local and health authorities. Unit Cost reports giving detailed costs information for a wide range of health and social care workers have been published annually since 1993. The current volume is available from the PSSRU website or in printed form from the librarian at the PSSRU in Canterbury.
Project ID: PID048/C035
Funder: Department of Health
Contact: Professor Ann Netten
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An evaluation of community care arrangements for older people with dementiaDescription: Costing packages of care provided for elderly people with dementia in three local authorities in England. Main evaluation undertaken by NISW.
Project ID: PID086
Funder: National Institute for Social Work/Department of Health
Contact: Professor Ann Netten
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Extension to the 2003 Home Care User Experience SurveyDescription: Reflecting and learning from the perspective of service users is an increasingly important aspect of government policy. In order to reflect this in performance indicators relating to the quality of services, all Councils with Social Services Responsibilities (CSSRs) have been required to undertake user experience surveys (UES) since 2001-2002 on a three-year rolling basis.
The principal aims of the UES extension study were:
to add value to the User Experience Surveys for a sample of participating local authorities by enhancing comparability across dimensions not included in the four required items;
to enable authorities to compare the quality of home care provided by different providers used by their authority and that by providers used by other authorities;
to assess the questions devised by ONS for their suitability as performance indicators; and
to facilitate the further development of measurement of quality of home care services
Research Summary
Extension to the 2003 Home Care User Experience Survey, March 2004 [RS029, 4 pages, 72kb].
Publications
Netten, A., Francis, J., Jones, K. and Bebbington, A. (2004) Performance and quality: user experiences of home care services, Final report, PSSRU Discussion Paper 2104/3.
Francis, J. and Netten, A. (2003) Quality in home care: client and provider views, PSSRU Discussion Paper 2017.
Project ID: PID270
Funder: Department of Health
Contact: Professor Ann Netten
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Home Care Workers: Careers, Commitments and MotivationsDescription: The home care service is a fundamental building block of the policy to support older disabled people in their own homes. There is widespread concern about the supply and retention of home care workers and the implications of this for the quality of care provided. Planned changes to the home care commissioning arrangements in the local authority of Medway meant workforce concerns were compounded for that council. With plans to reduce the number of contracted home care agencies, particular disquiet was raised among providers that care workers would leave the home care workforce altogether out of loyalty to both their current employer and their own clients. Medway council commissioned a small-scale study to gauge the mood of the current workforce and investigate the factors that might affect people’s propensity to leave home care altogether.
Research Summary
Home Care Workers: Careers, Commitments and Motivations, March 2004 [RS028, 2 pages, 48kb].
Publications
Francis, J. and Netten, A. (2002) Homecare services in one local authority: client and provider views, PSSRU Discussion Paper 1795/3.
Francis, J. and Netten, A. (2003) Home care workers: careers, commitments and motivations, Final report, PSSRU Discussion Paper 2053.
Francis, J. and Netten, A. (2004) Raising the quality of home care: a study of service users' views, Journal of Social Policy and Administration, 38, 3, 290-305.
Project ID: PID287
Funder: Department of Health
Contact: Professor Ann Netten
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Social Care Regulation: resource use and qualityDescription:
Project ID: PID298
Funder: National Care Standards Commission
Contact: Professor Ann Netten
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Individual Budgets Evaluation Network (IBSEN)Description: Individual budgets (IBs) were piloted as a new way of providing support for older and disabled adults and people with mental health problems eligible for publicly funded social care. IBs aim to bring together all the resources from a number of different funding streams for which an individual is eligible, which can then be used flexibly according to individual priorities. The Department of Health set up IB pilot projects in 13 English local authorities, running from November 2005 to December 2007, and commissioned a national evaluation. This evaluation is the first robust UK study of the implementation and impact of personalisation approaches in social care.
See SPRU website for more publications
Project ID: PID362
Funder:
Contact:
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Outcomes, quality and costs of community equipment servicesDescription: Community equipment services have developed as an important element in keeping older and younger disabled adults independent within their own homes.
While a number of policy initiatives have highlighted some progression in community equipment service, there is still a need to improve assessments, delivery times and access to equipment. There is a dearth of research on investigating the quality, outcomes and cost of community equipment services, the relationship between them and how to measure them.
The aim of this project is to develop methods for assessing costs, quality and outcomes, to better understand the factors that constitute a quality, cost-effective service, in order to assess service performance.
Project outlineOutcomes, Quality and Costs of Community Equipment Services, June 2006 [PO64].
Project ID: PID363
Funder: Department of Health
Contact: Mr Nick Smith
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Costs and outcomes in children's social careDescription: Thirteen studies were funded under the Department of Health research initiative The Costs and Effectiveness of Services to Children in Need. They covered diverse subjects using a range of designs; from an extended health visiting service for babies to support for young people as they leave care, and from small comparative experimental studies to large cohort studies. Each study included an economic component. Some described the costs of services and others aimed to look at why the costs of services or the costs of supporting children might vary. A few brought costs and outcomes information together within a cost-effectiveness framework.
Broad findings from the initiative have been brought together in a book published under the Messages from Research series, authored by Jennifer Beecham (PSSRU) and Ian Sinclair (SWRDU, University of York). This book aims to pull together findings from this initiative, examining the way services are delivered and how resources are distributed. Particular attention is paid to the possible contributions of early intervention and better co-ordination.
Research Summaries
Summaries of each research report will soon be available at http://www.everychildmatters.gov.uk.
Publication
Beecham, J. and Sinclair, I. (2006) Costs and Outcomes in Children’s Social Care: Messages from Research, Jessica Kingsley Press, London. www.jkp.com
Project ID: PID364
Funder: Department of Health and Department for Education and Skills
Contact: Professor Jennifer Beecham
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National Evaluation of the Partnership for Older People Projects (POPP)Description: The Partnership for Older People Projects (POPP) were funded by the Department of Health to develop services for older people, aimed at promoting their health, well-being and independence and preventing or delaying their need for higher intensity or institutional care. The evaluation found that a wide range of projects resulted in improved quality of life for participants and
considerable savings, as well as better local working relationships.
See Executive Summary
Project ID: PID376
Funder:
Contact: B Windle
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Compression or Expansion of Disability? Scenarios for the Wanless ReportDescription: This project was commissioned by the Wanless Review of Social Care. It reviewed trends in disease and treatment in four areas: stroke, coronary heart disease, dementia and cognitive impairment and arthritis. It then investigated how disease patterns would impact on the future levels of disability of older people over the next 20 years. Finally, it produced disability prevalence rates within age groups over the next 20 years in a form suitable to input to the PSSRU long-term care model. The project identified three main scenarios that were used in the Wanless Review. Publications Jagger C, Matthews R, Spiers N, Brayne C, Comas-Herrera A, Robinson T, Lindesay J and Croft P (2006) Compression or Expansion of Disability? Forecasting Future Disability Levels under Changing Patterns of Diseases. Background Paper to the Wanless Social Care Review. King’s Fund: London.
Project ID: PID393
Funder:
Contact:
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User experience survey 2006-2007 for adults with physical and sensory impairments receiving support to live in their own homesDescription: The principal aims of the research are:
To explore the problem of non-response;
To develop a performance indicator that can be confidently applied to measure performance;
To add value to a sample of participating local authorities by collecting data on the quality of services delivered to adults with PSI in their areas;
To facilitate the further development of a measure of quality of services for adults with PSI;
To explore relationships between satisfaction, quality and characteristics of service users and authorities.
Project ID: PID397
Funder: Department of Health
Contact: Professor Ann Netten
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Evaluation of Somerset County Council's Partnerships for Older People projectDescription: The aims of the local evaluation are:·
To develop an approach to measuring the contribution of the ALCs to the quality of life of older people making use of the centres;
Where possible to identify the impact of services or activities generated by the ALCs including the early effects of a prevention of falls service;
To identify the comparative effectiveness of the ALCs in meeting their objectives;
To identify different approaches developed by the ALCs and the association of these approaches with the Centres’ effectiveness;
To provide an indication of the cost implications of the introduction of ALCs.Project Outline
Evaluation of the Partnerships for Older People, December 2006 [P065, 2 pages, 47kb].
Research SummaryEvaluation of Somerset’s Partnership of Older People’s Project: Interim Report, November 2007 [RS046, 2 pages, 48kb].
Project ID: PID399
Funder: Somerset County Council
Contact: Professor Ann Netten
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Extended User Experience Survey for Older People 2005-2006Description: The principal aims of the research are to:
Add value to the UES for a sample of participating local authorities by enhancing comparability across time and in dimensions of quality not included in the compulsory items;
Explore in more depth the relationship between individual characteristics and reported quality and any changes in these relationships;
Validate the measures of quality for wider use;
Enhance the value of the national data, including the use of the results for measuring the value of PSS outputs and potentially efficiency gain.Project Outline
Extended User Experience Survey for Older People 2005-06, November 2005 [P062, 2 pages, 52kb].
Project ID: PID400
Funder: Department of Health
Contact: Professor Ann Netten
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Older people's perceptions of control: the impact of services and service settings in long-term careDescription: The study aimed to: increase our understanding of how services and service settings contribute to older people's sense of control and to investigate indicators that can be used to measure this in the future; explore how service users' desire for control affects the relationship between perceived control and well-being.
The evidence was that although ECH affords residents more control over their daily lives this does not mean that they necessarily feel more in control or report higher levels of well-being. The good quality care homes in this study provided their residents with an equal sense of control over their lives, an equally high level of well-being and an equally home-like environment. Thus, although positive experiences were most certainly reported by the ECH residents, supporting the argument that it is an effective model of housing with care from a user perspective, there was no evidence to suggest that it is was leading to better outcomes for service users compared with good quality traditional care homes.
Research Summary
Control, Well-Being and the Meaning of Home in Care Homes and Extra Care Housing, July 2006 [RS038].
Project ID: PID401
Funder: Department of Health
Contact: Professor Ann Netten
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Need for social care for older peopleDescription: The aim of the study was to provide options for an improved and updated formula for the Relative Needs Formula (RNF) for allocating funds to local authorities for the support of older people. The study examined two approaches: first, individual-level analyses used information collected from samples of individuals admitted to care home or receiving home care services; second, small area analyses used information about service receipt on an area (ward-level) basis. In addition, the data collected from the surveys provide comparative information to monitor the development of services for older people over time, and contribute to the examination of other policy issues.
Publication
Darton, R., Forder, J., Bebbington, A., Netten, A., Towers, A. and Williams, J. (2006) Analysis to Support the Development of the Relative Needs Formula for Older People: Final Report, PSSRU Discussion Paper 2265/3
Project ID: PID403
Funder: Department of Health
Contact: Professor Ann Netten
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Valuing personal social services (PSS) outputs and quality changesDescription: This pilot study aimed to identify a monetary valuation for nine domains of social care outcome; to investigate factors associated with variations in these valuations and people's underlying preferences, in particular whether older people had different preferences to younger adults; to identify and to demonstrate how these might be applied to valuing variations in quality of home care for older people and to identify methodological issues that should be addressed in any further work.
Research Summary
Valuing PSS outputs and quality changes, July 2006 [RS039].
Publications
Netten, A., Forder, J. and Shapiro, J. (2006) Measuring Personal Social Services Outputs for National Accounts: Services for Older People, PSSRU Discussion Paper 2267/3.
Burge, P., Gallo, F. and Netten, A. (2006) Valuing PSS outputs and quality changes, PSSRU Discussion Paper 2356/3.
Project ID: PID398
Funder: Department of Health
Contact: Professor Ann Netten
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Home Care Reablement Services: Investigating the Longer-Term ImpactsDescription: The aims of the prospective study are:
To provide robust research evidence on the immediate and longer-term benefits of home care reablement
To identify the factors that affect the level and duration of benefits for service users of a period of reablement
To identify any impact on and savings in the use of social care and other services, that can be set against the costs of reablement services
To describe the content and costs of home care
reablement services.
The study will compare outcomes and use of services over a one-year period between people receiving home care reablement services in five local authorities with those receiving standard home care in four different localities.
Julien Forder, Karen Jones and Lesley Curtis of PSSRU at Kent are working with Hilary Arksey, Kate Baxter, Parvaneh Rabiee, and Caroline Glendinning of the Social Policy Research Unit at the University of York, who are taking the lead in the project.
Project ID: PID454
Funder: Department of Health
Contact:
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Quality Measurement Framework (QMF)Description: The Quality Measurement Framework (QMF) programme is being funded for three years by the Treasury under Invest to Save and led by the Office of National Statistics (ONS). The aim of the QMF programme is to create entirely new mechanisms for more effective and efficient measurement and monitoring of third sector provision of public services, reducing the burden on the third sector while releasing cash through more efficient use of public funds to provide public services. The purpose is to develop methodologies for measuring and assessing the value added of the relevant public services. They will constitute a framework/tool so that service commissioning authorities can assess and monitor the performance of public services delivered by third sector organisations in a way directly comparable with performance of public or private sector providers.
The work builds on previous research commissioned to feed into the Atkinson review of the measurement of government outputs and productivity for the purposes of National Accounts. This developed an approach which uses research findings and routinely collected information to identify the value of the outputs of services or interventions in terms of their potential to achieve (capacity for benefit) and the degree to which this is achieved (quality) (see PSSRU Discussion Papers 2132 and 2267).
The programme will last three years in total, starting in January 2007. The PSSRU will carry out four research projects, three projects focusing on the outputs of particular service areas as outlined below and the last project to ascertain the relative importance of the specific aspects or domains of wellbeing that these services affect.
The service projects each have three stages.
To develop the approach, methods and tools in order to measure the outcomes of services. A main analytical framework drawing on the quality of life, wellbeing and economics/psychology literature will be developed and adapted for each service setting.
To pilot the concepts and measurement tools with a small number of providers.
To refine the measurement tools and conduct a larger survey of providers to enable more robust assessment of the outcomes toolkit/framework.
Measuring and monitoring quality of outputs of care homes
The aims of this study are to develop and validate a method of measuring quality of care based on reported care standards and also a method for monitoring the dependency of residents. After the conceptual developmental stage, the project will conduct small-scale in-depth studies with 6 homes (three older adult and three for younger people with learning disabilities (PWLD)) to test the measure of quality. The pilot work will gauge how people interpret the measure and compare the results on quality and outcomes with the regulatory assessment of care homes used by CSCI. The third stage is a larger study across 100 care homes for older adults and 100 for PWLD.
Estimating the outputs of low-level interventions
Much activity in the voluntary sector is directed towards low-level interventions (such as day care, active living centres, sitting services, meal services, home improvement agencies, etc.) that the government funds through grants. Stage 1 will see the development of measurement approaches, taking into account the outcomes likely to be important to people using these services. In addition, the initial stage will consider the scope and definition of the low level services sector. As above, Stage 2 will involve fieldwork with a small number of third-sector providers and people using those services. The results will feed into a larger sample study with a more diverse group of providers. The larger sample results will be evaluated to see whether they reasonably capture the effects of services on wellbeing and quality of life, given the complexities of those concepts.
Knowledge and information project
The aim of the project is to find a way of measuring the value of information and advice services. This study will mirror the staging of those above but account for the lack of conceptual work that has hitherto been done in this area on how to capture the outcome consequences. The first stage of the work will therefore entail in-depth work with providers, service users and commissioners to investigate: what people expect of these services, what they see as the outcomes and quality, and what measurement techniques are likely to be relevant. Stage 2 will involve a small sample (3-5) of provider organisations (including the Elderly Accommodation Counsel (EAC)) which would inform a larger study of a range of advisory services (stage 3). Given the embryonic nature of work in the field the emphasis will be on establishing a feasible approach rather than refining measurement tools.
Preference study
The aim of the preference study is to ascertain the relative importance or weight people give to domains of outcome (e.g. being clean and nourished, socially participating, being in control etc.). The work will build on a pilot preference study (Burge et al 2006) and will use a range of ‘preference elicitation’ techniques (such as discrete choice, best-worst). Particular attention will be paid to phrasing and description of outcome states, and possible context/ framing effects in people’s responses. The preference study will need to accommodate the wide range of possible outcomes as exampled by the diversity of services considered above.
Outputs
The outputs of this project will include: interim and main reports, background papers and annexes on specific issues and also a toolkit for the measurement of adult social care outcomes.
Project Outline
Quality measurement framework, May 2007 [P067, 2 pages, 52kb].
Project ID: PID413
Funder: Office for National Statistics
Contact: Professor Julien Forder
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Outcomes and quality of social care services for carersDescription: Kent County Council (KCC) and the Department of Health have commissioned the PSSRU to explore the outcomes and quality of social care services and support for informal carers. Exploratory work will be conducted to identify the types of outcomes and benefits experienced by carers, and the context and process factors associated with quality. Findings from this exploratory work will be used to develop survey questions about carers’ experiences of support and services, for use by KCC. The research will include group interviews with carers and interviews with key stakeholders, and a series of one-to-one interviews with carers to test the phrasing and objectives of the survey question(naires)Project OutlineOutcomes and quality of social care services for carers, August 2007.
Project ID: PID437
Funder: Kent County Council and the Department of Health
Contact: Dr Jacquetta Holder (née Williams)
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Local Evaluation of the Kent POPP ProjectDescription: Independence through the Voluntary Action of Kent’s Elders (INVOKE) is one of nine projects in the second round of POPP. INVOKE has the following aims:
To support independence and interdependence through the creation of new forms of support: providing the extra assistance older people need when facing life-changing circumstances that could affect their long term health problems.
To put older people in personal control, providing integrated care and support through joint working across public and voluntary sectors.
To focus on prevention of ill health and promotion of wellbeing, allowing older people to be both healthy and independent.
A key purpose of the local evaluation, being conducted by Margaret Perkins, Kate Henderson and Martin Knapp, is to examine the extent to which INVOKE meets its objectives over the period from April 2007 to March 2009. The local evaluation is also assisting the national POPP evaluation, which is the responsibility of a team led from the University of Hertfordshire and including PSSRU.
Project ID: PID443
Funder: Kent County Council
Contact: Ms Margaret Perkins
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Unit Costs in Criminal Justice (UCCJ)Description: Offender Management and Sentencing (OMS) Analytical Services within the Ministry of Justice have commissioned a programme of work investigating
community and custodial interventions for offenders. Three prospective longitudinal studies are tracking large samples of offenders at different stages of the criminal justice system:
Juvenile Cohort Study (JCS)
Surveying Prisoner Crime Reduction (SPCR) study
Offender Management Community Cohort Study (OMCCS)
These studies are designed to investigate which custodial and community interventions aimed at reducing re-offending work, and for whom. In order to evaluate the cost-effectiveness of these different elements of the criminal justice service, high quality data on the costs of programmes and justice services are required. Health and social care programmes benefit from a wealth of data on costs, but there is very little similar information for the criminal justice field. Few previous attempts in the UK have been made to generate unit costs or to include detailed cost-effectiveness analyses for interventions in this area. PSSRU and the Centre for the Economics of Mental Health, Institute of Psychiatry, King’s College London have been commissioned to generate unit cost information that can be used in combination with outcome data from the cohort research studies to enable cost-benefit or cost-effectiveness evaluations to be undertaken.
The UCCJ study is divided into two phases. The first phase (completed in May 2008) focused on scoping, development of methodology for estimating unit costs and proposals for activities in phase two.
The costing approach is guided by economic theory. The aim is to estimate the long-run marginal opportunity cost to society. The general method is to follow Unit Costs of Health and Social Care (Curtis, 2007) where the bottomup approach is adopted as far as possible. The methods used to assist in identifying the costing strategies were: consultation with key individuals and departments, documentary review and identification of existing data sources, and literature review.
Phase one highlighted that due to the complex and varied nature of criminal justice interventions and the limited information available it is beyond the scope of the project to estimate unit costs for every aspect of service provision.
The focus for phase two (June 2008 to May 2010) is on generating the unit cost estimates. This phase will include the development of a unit costs spreadsheet, follow-up with the owners of source data, support for any additional studies required, advice on and design of data collection instruments and collection of detailed individual level costs.
Project ID: PID446
Funder: Home Office
Contact:
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Extended User Experience Survey of Community Equipment Services 2007/08Description:
Project ID: PID448
Funder: Department of Health
Contact: Mr Nick Smith
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Extended User Experience Survey for Older People 2008-09Description: Three-yearly user experience surveys (UES) for older people receiving home care services are required by the Department of Health and are regarded as an important part of the overall performance framework for social care. This study is a follow-up to similar studies conducted in 2002–03 and 2005–06. The 2002–03 and 2005–06 UES extension studies investigated the validity of performance indicators based on the national survey and used the items to develop measures of quality of home care. Analyses identified individual, provider and area factors associated with perceived satisfaction and quality of services and changes in perceptions of quality and satisfaction over time. The principal aims of the research are to add value to the UES for a sample of participating local authorities by enhancing comparability across time and in dimensions of quality not included in the compulsory items and investigate what explains changes in quality over time as well as the impact of factors beyond the control of the authority on PI estimates.
All CSSRs will be invited to participate in the study and participating authorities will all use the same agreed questionnaire. This is principally the questionnaire used for extended survey in 2005–06, with minor amendments that reflect the results of previous analyses and developments in our thinking.
Project ID: PID451
Funder: Department of Health
Contact: Professor Ann Netten
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Outcomes of social care for adults (OSCA)Description: There is an increasing emphasis on outcomes in the field of social care in terms of practice, policy, regulation and monitoring performance. The study builds on previous and other ongoing work on measuring outputs and outcomes of social care to generate a gold-standard preference weighted
measure of social care outcomes. This will provide the equivalent of the QALY used widely in evaluations of health care and could be used in a variety of circumstances including social care evaluations, cost-utility analyses and policy analyses.
The project comprises two phases: the first covering development and feasibility work to inform the design for a main phase where the fieldwork will collect preference data for a validated measure for both the general population and service users. In order to ensure credibility in the social care community and beyond, consultations are being undertaken with key stakeholders, including local councils that are acting as ‘critical friends’ of the project. Psychometric analysis of existing data, cognitive testing of items with service users and a survey of service users will be used to test and validate the measure. Discrete choice experiments and best–worst scaling and limited use of the time trade-off technique are being tested as approaches to identifying population and service user preferences.
The project will run from August 2008 to January 2011. An interim report on the initial work on the development of the measure and feasibility study of elicitation techniques will be available in the summer of 2009 and a report of phase 1 in late spring 2010.
The project is funded by Health Technology Assessment(HTA) NIHR and researchers at PSSRU are working with colleagues at other institutions.
Project ID: PID453
Funder: Secretary of State for Health via HTA
Contact: Professor Ann Netten
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Local Authority Carers' Experience Survey 2009Description: The PSSRU at Kent has been commissioned by the Department of Health to design a self-completion carers’ experience survey to help monitor the government’s new national strategy for carers. Local authorities will be asked to volunteer to take part and administer the survey in the autumn of 2009. The survey will be sent to adult carers of adults who have had, or been offered, a social services assessment or review in the previous year. It will focus on their experiences and views of the quality of social care services and ask them about their quality of life. Development work will build on an existing survey designed by the PSSRU for Kent County Council in 2007–08. Policymakers, stakeholders and councils will be consulted about the questions they would like to be covered and cognitive testing interviews with carers will be used to help
develop the questions.
Project ID: PID455
Funder: Department of Health
Contact:
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Quantitative modelling of long-term care costs for Green Paper analysisDescription: PSSRU at LSE and Kent have been commissioned by the
Strategy Unit and the Department of Health to carry out
modelling in connection with the forthcoming Green Paper
on care and support. The aims of the analysis are (i) to build
a set of models to replicate alternative systems for funding
publicly-funded social care and disability-related social
security benefits for adults and (ii) to describe the policy
implications of alternative proposals for reforming the
support system for adults with disabilities, and in particular
their resource and distributional consequences.
Project ID: PID458
Funder: Department of Health
Contact:
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Individual Budgets Evaluation Network (IBSEN)Description: Individual budgets (IBs) were piloted as a new way of providing support for older and disabled adults and people with mental health problems eligible for publicly funded social care. IBs aim to bring together all the resources from a number of different funding streams for which an individual is eligible, which can then be used flexibly according to individual priorities. The Department of Health set up IB pilot projects in 13 English local authorities, running from November 2005 to December 2007, and commissioned a national evaluation. This evaluation is the first robust UK study of the implementation and impact of personalisation approaches in social care.
See SPRU website for more publications
Project ID: X/PID362
Funder:
Contact:
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Personal Health Budgets Evaluation (PHBE)Description: Personalisation is an important new policy direction for health care in England. The piloting of personal health budgets (PHBs) is being viewed as one feature of this policy. However, this new way of delivering health care represents a major cultural shift within the health care service which needs to be explored before any decision of a national roll-out can be made. In 2009, the Department of Health invited 70 PCTs to become a pilot site to explore the opportunities offered by personal health budgets which will be supported by a rigorous evaluation. A multidisciplinary research team from the University of Kent, University of York and Imperial College, London are conducting the research. Further details are available at the evaluation website.
Project ID: PID475
Funder:
Contact: Dr Karen Jones
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Putting People First (PPF)Description: The Department of Health (DH) is looking to develop a new social care user experience survey (UES) for 2010/11 to be consistent with the principles and goals of Putting People First (PPF). The DH has set out a number of aspirations for the survey, as follows:
- The PPF survey should be as inclusive as possible; the same set of questions should be applicable to all adult service users, including those users living in residential settings. In the longer term this includes carers, self-funders and, and children (aged under 18 years, for transition issues) none of whom have been included in previous surveys.
- The PPF survey should focus on developing questions to fit the outcome themes of PPF, i.e. quality of life, choice and control, inclusion and contribution, health and well-being, and dignity and safety.
- A related goal is that it should be possible to link the social care PPF survey with the NHS patient survey programme.
- The PPF survey should be developed so that it works across multiple modes, including self-completion, telephone, internet, interview, Easy Read and so on.
- The aim is for an annual review of the survey to provide options develop additional questions related to evolving policy priorities.
The survey will have a number of uses. Nationally it will be used to populate national indicators: NI127 and NI128. It is also intended that it serves the needs of local areas and the Care Quality Commission. The survey should also be able to inform progress on equality of experience across different population groups such as ethnic groups and older compared with younger adults.
It is proposed that the data collected as part of the pilot stage is used to develop a proposed approach for performance measurement that reflects the aims of Putting People First and controls for exogenous sources of variation.
Project ID: PID460
Funder: Department of Health
Contact: Ms Juliette Malley
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QMF Workforce Study (ASCOT) Measuring the impact of the workforce on productivityDescription:
Project ID: PID461
Funder: Skills for Care
Contact:
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Criminal Justice
For more detailed information about research carried out by the Kent Criminal Justice Centre, click here
An evaluation of the Kent and Medway Acts 2001 - legislation intended to regulate second-hand tradersDescription:
Project ID: PID294
Funder: Home Office
Contact: Professor Ann Netten
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Unit Costs in Criminal Justice (UCCJ)Description: Offender Management and Sentencing (OMS) Analytical Services within the Ministry of Justice have commissioned a programme of work investigating community and custodial interventions for offenders. Three prospective longitudinal studies are tracking large samples of offenders at different stages of the criminal justice system:
Juvenile Cohort Study (JCS)
Surveying Prisoner Crime Reduction (SPCR) study
Offender Management Community Cohort Study (OMCCS)
These studies are designed to investigate which custodial and community interventions aimed at reducing re-offending work, and for whom. In order to evaluate the cost-effectiveness of these different elements of the criminal justice service, high quality data on the costs of programmes and justice services are required. Health and social care programmes benefit from a wealth of data on costs, but there is very little similar information for the criminal justice field. Few previous attempts in the UK have been made to generate unit costs or to include detailed cost-effectiveness analyses for interventions in this area. PSSRU and the Centre for the Economics of Mental Health, Institute of Psychiatry, King’s College London have been commissioned to generate unit cost information that can be used in combination with outcome data from the cohort research studies to enable cost-benefit or cost-effectiveness evaluations to be undertaken.
Project ID: PID412
Funder: Home Office
Contact:
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Dementia Care Information at Manchester
Dementia Information - FactsheetsDescription: These factsheets are designed for busy health and social care professionals and summarise key literature for a number of dementia care related topics. These were produced for the North West Dementia Centre which is part of PSSRU at Manchester. The factsheets may be downloaded in Adobe Acrobat PDF format.Downloadable FactsheetsAlzheimers Disease
Creutzfeldt-Jakob Disease
Dementia
Oral Care
Pain in Dementia
Activities in Care Homes
Vascular Dementia
Frontotemporal Dementia
Medical Disorders in Older People with Dementia
Differential Diagnosis of Dementia
Project ID: PID356
Funder: Novartis Pharmaceuticals
Contact: Professor David Challis
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Dementia Information - Mental Health in Old Age BulletinsDescription: These bulletins provide a summary of topical and important areas of treatment and care of mental health problems in older people, particularly in relation to dementia. The production of the bulletins was funded by Novartis Pharmaceuticals. These are downloadable in Adobe Acrobat PDF format below.Downloadable Mental Health in Old Age BulletinsMental Health in Old Age Bulletin 1
Mental Health in Old Age Bulletin 2
Mental Health in Old Age Bulletin 3
Mental Health in Old Age Bulletin 4
Mental Health in Old Age Bulletin 5
Mental Health in Old Age Bulletin 6
Mental Health in Old Age Bulletin 7
Mental Health in Old Age Bulletin 8
Mental Health in Old Age Bulletin 9
Mental Health in Old Age Bulletin 10
Mental Health in Old Age Bulletin 11
Mental Health in Old Age Bulletin 12
Mental Health in Old Age Bulletin 13
Mental Health in Old Age Bulletin 14
Mental Health in Old Age Bulletin 15
Mental Health in Old Age Bulletin 16
Project ID: PID361
Funder: Novartis Pharmaceuticals
Contact: Professor David Challis
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Housing and Care: Care Homes and their Alternatives
The programme builds on and broadens the work carried out on the Roles, Quality and Cost of Care Homes programme, which focused on the characteristics of care homes, including funding, costs and quality of care and on the characteristics of residents, including their admission and health outcomes. This programme has also included a series of investigations into the causes, process and consequences of home closures. We are currently completing our work on home closures and on expected length of stay. Future work will focus on the development and impact of forms of housing and care other than care homes.
Currently, the main focus of the programme is on alternative settings to care homes, particularly extra care housing, the characteristics of these settings and how they affect older people in need of care and support. Preliminary work involved a scoping project, which tracked the development of extra care housing, and the research team is now conducting an evaluation of schemes supported by the Department of Health’s Extra Care Housing Fund.
The programme of work includes:
Survey of Admissions to Residential Care and Nursing HomesDescription: The aim of the survey was to provide a picture of the use of residential care and nursing homes, in order to feed into discussion about the Standard Spending Assessment (SSA) formulae for allocating funds to local authorities for the support of elderly people. This study was linked to the complementary cross-sectional study, focusing on the characteristics of homes and their residents and the costs of homes.
Project Outline
Survey of Admissions to Residential Care and Nursing Homes for Elderly People, October 1995 [P019].
Publications
Bebbington, A., Brown, P., Darton, R. and Netten, A. (1996) Survey of admissions to residential care. SSA report, PSSRU Discussion Paper 1217/3.
Bebbington, A., Darton, R. and Netten, A. (1997) Lifetime risk of entering residential or nursing home care in England, PSSRU Discussion Paper 1230/3.
Forder, J. and Netten, A. (2000) The price of placements in residential and nursing home care: the effects of contracts and competition, Health Economics, 9, 7, 643-657.
Bebbington, A., Darton, R., Bartholomew, R. and Netten, A. (2000) Survey of Admissions to Residential and Nursing Care. Final report of the 42 month follow-up, PSSRU Discussion Paper 1675.
Bebbington, A., Darton, R. and Netten, A. (2001) Care Homes for Older People: Volume 2. Admissions, Needs and Outcomes. The 1995/96
National Longitudinal Survey of Publicly-Funded Admissions, PSSRU, University of Kent (ISBN 1-902671-25-2). (Available to buy. See books etc. under PSSRU publications section of the website.)
Netten, A., Darton, R., Bebbington, A. and Brown, P. (2001) Residential or nursing home care? The appropriateness of placement decisions, Ageing and Society, 21, 1, 3-23.
Project ID: PID167
Funder: Department of Health
Contact: Mr Robin Darton
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Cross-Sectional Survey of Care Homes for Elderly PeopleDescription: The cross-sectional survey took place in the autumn of 1996. To facilitate comparisons with the longitudinal survey it was conducted in 21
authorities, 17 of which were in the longitudinal survey; 673 homes participated. Information collected about the characteristics of homes included the occupancy
level, care policies, costs and an assessment of the social climate. Information collected about the residents included level of dependency, cognitive characteristics,
source of admission, fees paid and source of funding.
Research Summary
1996 Survey of Care Homes for Elderly People, December 1998 [P035a/RS006].
Publications
Netten, A., Bebbington, A., Darton, R., Forder, J. and Miles, K. (1998) 1996 Survey of Care Homes for Elderly People. Final report, PSSRU Discussion Paper 1423/2.
Netten, A., Bebbington, A., Darton, R. and Forder, J. (2001) Care Homes for Older People: Volume 1. Facilities, Residents and Costs (ISBN
1-902671-24-4) (Available to buy. See books etc. under PSSRU publications section of the website.)
Netten, A., Darton, R., Bebbington, A., Forder, J., Brown, P. and Mummery, K. (2001) Residential and nursing home care of elderly people with cognitive impairment:
prevalence, mortality and costs, Aging and Mental Health, 5, 1, 14-22.
Darton, R., Netten, A. and Forder, J. (2003) The cost implications of the changing population and characteristics of care homes, International Journal of Geriatric
Psychiatry, 18, 3, 236-243.
Project ID: PID169
Funder: Department of Health
Contact: Mr Robin Darton
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Study of Self-Funded Admissions to Care HomesDescription: A survey of admissions to care homes was carried out between July 1999 and March 2000, covering admissions during a 14 month period from January 1999. Information was collected about 921 residents admitted to 292 homes. The aim was to explore the circumstances of admission among self-funded residents and to compare their characteristics with those of publicly-funded residents. The dataset has been deposited with the UK Data Archive.
Summary of Findings
Self-Funded Admissions to Care Homes, March 2002 [RS022]. Publications
Netten, A., Darton, R. and Curtis, L. (2002) Self-Funded Admissions to Care Homes. Department of Work and Pensions Research Report No. 159, Corporate Document Services, Leeds (ISBN 1 84123 420 6). Available on the Department for Work and Pensions website:
http://www.dwp.gov.uk/asd/asd5/rrep159.pdf.
Netten, A. and Darton, R. (2003) The effect of financial incentives and access to services on self-funded admissions to long-term care, Journal of Social Policy and Administration, 37, 5, 483-497.
Project ID: PID198
Funder: Department for Work and Pensions
Contact: Mr Robin Darton
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The Rates, Causes and Consequences of Care Home ClosureDescription: The aims of the project were to identify:
The rates of home closure of all types of home nationally and the consequences for supply;
The types and characteristics of homes that are closing;
The combinations of circumstances that lead to home closure.
Data collection included: a survey of all Registration and Inspection Units in England in 2001 to establish rates of closure and local demand and supply issues; a telephone survey of a sample of Registration and Inspection Units to establish the status of homes surveyed in 1996; interviews with owners/managers of recently closed independent care homes about the causes of closure.
Research Summaries
Closures of Care Homes for Older People, Summary of Findings, No. 1, February 2002 [RS021].
Publications
Netten, A., Darton, R. and Williams, J. (2002) The rate, causes and consequences of home closures, PSSRU Discussion Paper 1741/2.
Williams, J., Netten, A., Hardy, B., Matosevic, T. and Ware, P. (2002) Care home closures: the provider perspective, PSSRU Discussion Paper 1753/2.
Netten, A., Darton, R. and Williams, J. (2003) Nursing home closures: effects on capacity and reasons for closure, Age and Ageing, 32, 3, 332-337.
Darton, R. (2004) What types of home are closing? The characteristics of homes which closed between 1996 and 2001, Health and Social Care in the Community, 12, 3, 254-264.
Netten, A., Williams, J. and Darton, R. (2005) Care-home closures in England: causes and implications, Ageing and Society, 25, 3, 319-338.
Project ID: PID269
Funder: Department of Health
Contact: Professor Ann Netten
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Scoping the development of extra care housingDescription: The project aimed to establish the amount of extra care housing provision. Objectives include: (a) the collection of accurate descriptive information about the quantity and nature of extra care housing; (b) understanding of the local context of extra care housing developments; (c) identification of factors that facilitate or limit development; (d) comparison of the growth of extra care housing with the supply of other forms of housing and care over time, such as care homes; and (e) a better understanding of the impact of extra care housing on patterns of services.
Key findings were:
There is still relatively little extra care housing
There has been little public/private partnership
Government funding has been key to developments to date
Developments are including intermediate care
Most of the identified developments offered rented accommodation, so ECH is not necessarily succeeding in increasing the choice and diversity of housing options for older owner-occupiers considering downsizing.
Project OutlineBenchmarking Extra Care Housing for Older People, June 2005 [P061].
Research Summary
Scoping Extra Care Housing for Older People, December 2006 [RS042, 2 pages, 55kb].
Project ID: PID334
Funder: Department of Health
Contact: Professor Ann Netten
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Closures of homes for older people: policies and perspectives on managing the closure processDescription: The aims were: to identify the prevalence and content of council closure protocols; to investigate the process and consequences of home closure from the perspective of those involved, including residents, their relatives and carers, care home staff and social services department staff; and to identiify recommendations for good practice.
Research Summaries
Closures of Care Homes for Older People, Summary of Findings, No. 2, Local authority guidelines, October 2003 [RS026].
Closures of Care Homes for Older People, Summary of Findings, No. 3, Relatives' and residents' views, October 2003 [RS027].
Closures of Care Homes for Older People, Summary of Findings, No. 4, Care managers' experiences and views, July 2005 [RS032].
Publications
Williams, J. and Netten, A. (2003) Guidelines for the closure of care homes for older people: prevalence and content of local government protocols, PSSRU Discussion Paper 1861/2.
Williams, J., Netten, A. and Ware, P. (2003) The closure of care homes for older people: relatives' and residents' experiences and views of the closure process, PSSRU Discussion Paper 2012/3.
Williams, J. and Netten, A. (2005) English local authority powers, responsibilities and guidelines for managing the care home closure process, British Journal of Social Work, 35, 6, 921-936.
Williams, J., Netten, A. and Ware, P. (2006) Managing the care home closure process: care managers experiences and views, British Journal of Social Work, advance access published on May 24 2006.
Project ID: PID395
Funder: Department of Health
Contact: Dr Jacquetta Holder (née Williams)
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Evaluation of the Extra Care Housing InitiativeDescription: Evaluating the Extra Care Housing Initiative is an opportunity to collect research evidence about the process and impact of new approaches to providing accommodation and care for older people. The aims are to evaluate and learn from the extra care schemes from their initial implementation to following older people’s experiences and health in the longer term. The objectives are to identify:
The models and characteristics of extra care housing schemes, their advantages and disadvantages;
Circumstances and factors that influence the feasibility and success of the schemes;
Views, experiences and characteristics of the people who live in the schemes;
Views, experiences and characteristics of care and support staff;
The impact of design characteristics on the success of the schemes;
The role of and interaction with the local community;
Cost-effectiveness of different models;
Long-term outcomes for individuals, such as their health and quality of life;
The role and potential of such schemes in the overall provision of care for older people (including residential care, and day and domiciliary care).
Project Outline
Evaluation of Extra Care Housing Initiative, September 2006 [P058, 2 pages, 55kb].
Research Summary
Evaluation of the Extra Care Housing Funding Initiative: Summary of Initial Findings, January 2008 [RS047, 4 pages, 85kb].
Other Publications
Housing and Care for Older People Newsletter 1, October 2006 [2 pages, 91kb]
Housing and Care for Older People Newsletter 2, January 2008 [2 pages, 90kb]
Darton, R. and Muncer, A. (2005) Alternative housing and care arrangements: the evidence, in B. Roe and R. Beech (eds) Intermediate and Continuing Care: Policy and Practice, Blackwell Publishing, Oxford.
Darton, R., Bäumker, T., Callaghan, L., Holder, J., Netten, A. and Towers, A. (May 2008) Evaluation of the Extra Care Housing Funding Initiative: Initial Report, PSSRU Discussion Paper 2506/2 [pdf, 647KB]
A full list of publications from the evaluation is available here.
Project ID: PID402
Funder: Department of Health
Contact: Professor Ann Netten
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Social well-being in extra care housingDescription: An important consequence of moving into a care setting is that older people’s levels of activity and social well being are particularly reliant on that community. An evaluation of innovative Extra care housing (ECH) schemes funded under a Department of Health initiative is being undertaken as part of PSSRU’s long-term funded programme of work. The bids include a variety of proposals for addressing activity and community participation including user led approaches and the provision of facilities such as gyms. This study would focus on the initial opening period when new communities are being formed. The aims of the project are to identify for newly opened innovative schemes:
ECH residents’ expectations and experiences of a variety of approaches to developing social activities
The relative effectiveness of these in fostering individual social well being and a supportive and encouraging social climate
Project ID: PID406
Funder: Joseph Rowntree Foundation
Contact: Professor Ann Netten
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Design evaluation of older people's extra care housing: development of an assessment tool based on the Sheffield Care Environment Assessment MatrixDescription: Extra care housing is an evolving building type and there is considerable variation in provision. Evaluations of recent schemes indicate that the design of the physical environment is a major concern of building residents, but as yet there is very little research evidence to guide the design of extra care housing. Hence there is a need to identify aspects of buildings that promote the well-being of users. In order to achieve this, researchers from the School of Architecture, the Sheffield Institute for Studies in Ageing and the School of Health and Related Research, University of Sheffield, in partnership with the Personal Social Services Research Unit, University of Kent, aim to produce a new and valid tool (EVOLVE) that can be used for the evaluation and assessment of extra care housing design. It will build on an existing evaluation tool, the Sheffield Care Environment Assessment Matrix (SCEAM) which was developed in the Design in Caring Environments (DICE) project funded by the Engineering and Physical Sciences Research Council EQUAL programme, to assess the extent to which residential care buildings meet the needs of building users.
Project OutlineDesign evaluation of older people’s extra care housing, November 2007.
Project ID: PID419A
Funder: EPSRC
Contact: Professor Ann Netten
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Care home residents' expectations and experiencesDescription: The study will examine the differences between older people's expectations and experiences of living in a care home setting.
The study aims to:
Compare the expectations and experiences of residents living in care homes for older people;
Examine people's reasons for moving into care homes, and their perceptions and beliefs about living in care homes, and compare these with their experience of living in care homes for a period of three months;
Compare the experiences of residents who moved into care homes with those of individuals who moved into extra care housiing;
Identify the characteristics of residents for whom care home provision is a positive choice;
Provide evidence for the future development of the care home sector.Project Outline
Care Home Residents' and Relatives' Expectations and Experiences, January 2008 [P068a, 2 pages, 56kb].
Project ID: PID420A
Funder: Department of Health
Contact: Mr Robin Darton
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Evaluation of the Rowanberries Extra Care Housing Scheme in BradfordDescription: There is a systematic lack of evidence about the cost consequences of extra care housing. This study provides an opportunity to investigate costs to all stakeholders before and after residents move into extra care housing, and in the process develop a methodology for collecting comprehensive cost data. Rowanberries in Bradford opened in April 2007 and is a 46-unit joint project between social services and MHA. The principal aim of the study, funded by the Joseph Rowntree Foundation, is to assess the comparative cost to the resident before and after their move to extra care housing, and to achieve as true a comparison as possible.
Project OutlineEvaluation of the Rowanberries Extra Care Housing Scheme in Bradford, October 2007 [P071].
Project ID: PID418
Funder: Joseph Rowntree Foundation
Contact: Professor Ann Netten
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Evaluation of the Extra Care Housing Scheme at Pocklington Place, BirminghamDescription: Thomas Pocklington Trust provides housing, care and support for people with sight loss in the UK, and funds a programme of research on the prevention, cure and alleviation of blindness. In January 2008 the Trust opened its first extra care scheme in Birmingham, believed to be the first extra care scheme aimed specifically at providing housing for people with sight loss. A second scheme, in Plymouth, opened in June 2009. The Trust has commissioned the PSSRU to extend the evaluation of schemes supported by the Extra Care Housing Fund to include the Birmingham scheme and, subsequently, the Plymouth scheme.
The objectives of the study in Pocklington Place are to:
Compare the views, experiences and characteristics of the residents with those of the residents in the 19 schemes in the main evaluation
Identify the specific needs and circumstances of residents with sight loss
Examine the outcomes for residents, in terms of their health and quality of life
Examine staffing and care arrangements, and the services provided to residents
Identify the impact of sight loss on the costs of extra care housing
Examine the costs of providing care for people with sight loss in different settings
Examine design issues for people with sight loss living in extra care
The project will run from February to December 2009
Project ID: PID456
Funder: Thomas Pocklington Trust
Contact:
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Admission Risk to Care Homes (ARCH)Description:
Project ID: PID457
Funder: Kent County Council
Contact:
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Extension to the 2003 Home Care User Experience SurveyDescription: Reflecting and learning from the perspective of service users is an increasingly important aspect of government policy. In order to reflect this in performance indicators relating to the quality of services, all Councils with Social Services Responsibilities (CSSRs) have been required to undertake user experience surveys (UES) since 2001-2002 on a three-year rolling basis.
The principal aims of the UES extension study were:
to add value to the User Experience Surveys for a sample of participating local authorities by enhancing comparability across dimensions not included in the four required items;
to enable authorities to compare the quality of home care provided by different providers used by their authority and that by providers used by other authorities;
to assess the questions devised by ONS for their suitability as performance indicators; and
to facilitate the further development of measurement of quality of home care services
Research Summary
Extension to the 2003 Home Care User Experience Survey, March 2004 [RS029, 4 pages, 72kb].
Publications
Netten, A., Francis, J., Jones, K. and Bebbington, A. (2004) Performance and quality: user experiences of home care services, Final report, PSSRU Discussion Paper 2104/3.
Francis, J. and Netten, A. (2003) Quality in home care: client and provider views, PSSRU Discussion Paper 2017.
Project ID: X/PID270
Funder: Department of Health
Contact: Professor Ann Netten
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Evaluation of the Extra Care Housing Scheme at Pocklington Rise, PlymouthDescription: Thomas Pocklington Trust provides housing, care and support for people with sight loss in the UK, and funds a programme of research on the prevention, cure and alleviation of blindness. The Trust opened its first extra care scheme, Pocklington Place, in Birmingham in January 2008, to replace an existing sheltered housing development nearby. In June 2009 the Trust opened a second scheme in Plymouth, Pocklington Rise, on the site of a sheltered housing development and a former care home.The Trust has commissioned the PSSRU to extend the evaluation of schemes supported by the Extra Care Housing Fund to include the Birmingham and the Plymouth schemes.
The main PSSRU evaluation aims to examine the development of the schemes from their implementation, and to follow residents’ experiences and health over time. The PSSRU evaluation provides a framework for the collection of comparable information from the two Thomas Pocklington schemes, and by including the Thomas Pocklington schemes it is hoped to raise the profile of sight loss and highlight the role of housing in supporting people with sight loss.
The objectives of the study in Pocklington Rise are to:
Compare the views, experiences and characteristics of the residents with those of the residents in the 19 schemes in the main evaluation and in Pocklington Place
Identify the specific needs and circumstances of residents with sight loss
Examine the outcomes for residents, in terms of their health and quality of life
Examine staffing and care arrangements, and the services provided to residents
Identify the impact of sight loss on the costs of extra care housing
Examine the costs of providing care for people with sight loss in different settings
Examine design issues for people with sight loss living in extra care
The project will run from April 2009 to June 2011.
Project ID: PID459
Funder: Thomas Pocklington Trust
Contact:
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Long-Term Care Finance
The overall aims of the LTCF programme are to make projections of likely demand for long-term care for older people and associated expenditure to 2041 under different scenarios. The scenarios relate to changes in external drivers of demand, such as demographic pressures, and to potential changes in patterns of care or policies. A specific objective is to assess the likely impact of different policies and approaches to funding long-term care for older people on the balance of expenditure between sectors.
Work to date has been widely used by national and local policy-makers.
Long-term care demand and finance for elderly peopleDescription: Construction of models for projection of numbers of elderly people in need of help with tasks of daily living to 2030, demands for formal care, costs to public funds under various policy assumptions; and prediction of the consequences of alternative packages of financing mechanisms.
Project ID: PID150
Funder: PSSRU main programme funded by Department of Health
Contact: Mr Raphael Wittenberg
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Long-term care projections projectDescription: This project is concerned with projections of demand for long-term care for older people in England to 2041 and associated public and private expenditure under different assumptions about key factors affecting demand. The aims are to make projections to 2041 of four kinds: first, estimated numbers of older people with different levels of disability by age group, gender and household type; second, estimated volumes of long-term care services demanded; third, estimated expenditure on long-term care services by funding source, that is, by whether it is publicly- or privately-funded; and fourth estimated social care workforce caring for older people The project has involved the construction of a cell-based computer model to make these projections, the development of scenarios on trends in the key drivers of demand for long-term care and the production of projections under variant assumptions and scenarios. A wide range of formal health and social services and disability benefits are covered and informal care is considered. Projections have been produced under different assumptions about trends in life expectancy, disability rates, real unit costs, availability of informal care and patterns of formal care. Projections have also been made of future expenditure under different funding systems. The project has generated projections and analyses for the Department of Health, the Royal Commission on Long-Term Care, HM Treasury and the Wanless Health Trends and Social Care Reviews.
Project ID: PID262
Funder: Department of Health
Contact: Mr Raphael Wittenberg
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Paying for long-term careDescription: This project was concerned with projecting expenditure on long term care services for older people under a wide range of options for reforming the current system. View Research Summary View Final Report
Project ID: PID267
Funder: Nuffield Foundation
Contact: Ms Adelina Comas-Herrera
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Local projections of long-term careDescription: This project estimated numbers of older people with different levels of dependency, estimated volumes of long-term care services demanded and estimated expenditure on long-term care services. Publications
Comas-Herrera, A., Wittenberg, R., King, D. and Pickard, L.M. (2004) Projections of demand for long-term care in Norfolk to 2016, PSSRU Discussion Paper 2146.
King, D., Wittenberg, R., Comas-Herrera, A. and Pickard, L.M. (2004) Projections of demand for long-term care in Worcestershire to 2011, PSSRU Discussion Paper 2144.
Project ID: PID280
Funder: Individual local authorities
Contact: Ms Adelina Comas-Herrera
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Work with ECOFIN (Economic and Financial Affairs Directorate General of the European Commission)Description: This work involved provision of advice to ECOFIN (Economic and Financial Affairs Directorate General of the European Commission) on making projections of public expenditure on long-term care for the European member states. Members of the Long-Term Care Finance Team provided advice to ECOFIN for their first set of projections of public expenditure on long-term care and conducted a comparative study for the EU of projected expenditure on long-term care for older people in four European countries. ECOFIN has requested further advice on methodologies for their next set of projections. Adelina Comas spent two weeks at ECOFIN in Autumn 2004 and two weeks in Autumn 2005 as a visiting research fellow. Staff working on these European projections included Adelina Comas-Herrera, Linda Pickard and Raphael Wittenberg. PublicationComas-Herrera, A., Wittenberg, R. and Pickard, L. (2005) Making projections of public expenditure on long-term care for the European member states, Methodological proposal for discussion, PSSRU Discussion Paper 2254.
Project ID: PID323
Funder: ECOFIN
Contact: Ms Adelina Comas-Herrera
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Cognitive Impairment StudyDescription: This project was concerned with the exploration of scenarios about the future prevalence of cognitive impairment in older people and their impact on long-term care expenditure. The aim of the study was to explore scenarios about the future prevalence of cognitive impairment in older people through the views of experts working on the development of treatments for dementia. The cost implications of these scenarios would then be investigated using an updated version of the PSSRU Cognitive Impairment Model, which makes projections of future demand for long-term care services and of associated expenditure, based on alternative scenarios about trends in the drivers of demand.
Staff working on this project included Adelina Comas-Herrera, Martin Knapp, Raphael Wittenberg and Sara Northey from LSE, and Alastair Burns and Guk-Hee Suh from University of Manchester.
Project ID: PID324
Funder: Alzheimer's Research Trust
Contact: Ms Adelina Comas-Herrera
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Long-term care projections for WalesDescription: This study was concerned with projected demand for a range of long-term care services for older people in Wales to 2030. The aim of the study was to produce projections of the impact of demographic pressures on demand for long-term care services for older people in Wales to 2030. Projections were produced for Wales as a whole and for each Local Authority in Wales, under different assumptions about trends in dependency and different scenarios about the future balance between residential and home-based care. The study involved the construction of a Welsh version of the long-term care projections model developed for England. Staff working on this project include Adelina Comas-Herrera and Raphael Wittenberg.
PublicationComas-Herrera, A., Casado, D., Wittenberg, R., King, D. and Pickard, L. (2005)
Projections of Demand for Long-Term Care for Older People in Wales to 2030, by Local Authority, Report to the Welsh Assembly.
Project ID: PID318
Funder: National Assembly for Wales (NAW)
Contact: Ms Adelina Comas-Herrera
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Disability in 2020: Population projections, policy trends and potential future scenariosDescription: This project was concerned with projections on the possible ‘state of affairs’ concerning disabled people in the year 2020. View Final Report
Project ID: PID319
Funder: Disability Rights Commission
Contact: Ms Adelina Comas-Herrera
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Projected financial implications of the Wanless ReportDescription: This study prepared projections of the financial implications of the Wanless Review of Social Care.View Final Report
Project ID: PID380
Funder:
Contact: Professor Martin Knapp
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Modelling Needs and Resources of Older People to 2030Description: A study on Modelling Needs and Resources of Older People to 2030 in collaboration with researchers at the University of Essex, University of Leicester, London School of Hygiene and Tropical Medicine, London School of Economics and Pensions Policy Institute, this three-year study, led by Professor Mike Murphy (LSE), is expected to start in January 2007.
The project will use simulation models to project up to 2030 the numbers, family circumstances, income, pensions, savings, disability and care needs (formal and informal) of older people, the key determinants of their resources and needs. Special attention will be given to the inter-relationships between care needs (and their determinants) and economic resources in later life, and to the affordability, and distribution of costs and benefits. For the first time, long-term care and pensions policy reform options may be analysed together – including co-payments systems for long-term care and proposals in the Government White Paper on pension reform. Project website.
Project ID: PID391
Funder: ESRC
Contact: Ms Juliette Malley
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Long-term Care projections Project: Future Supply of Informal Care and EmploymentDescription: This project aims to make projections of the future supply of informal care and link these projections to the future supply of the long-term care workforce. The research is part of the Long-Term Care Projections programme.This research takes forward earlier work on trends in demand for informal care for older people. There are two parts to the research on the future supply of informal care and employment. The first part is concerned with the future supply of informal care to 2041, particularly care provided to older people by their adult children. The research is examining a number of potential scenarios around the future supply of informal care by children, including scenarios around a continuing reduction in co-residence of older people with their children and around the impact of changes in the availability of carers arising from socio-demographic trends. The second part of the research uses long-term care projections for informal care and for the workforce to look at the extent to which a decline in informal care by working age carers might contribute towards meeting the demands of the long-term care workforce. PublicationsPickard, L., Wittenberg, R., Comas, A., King, D. and Malley, J. (2007) Care by spouses and care by children: Projections of informal care for older people in England to 2031, Social Policy and Society, 6, 3, 353-366.
Pickard, L., Wittenberg, R., Comas-Herrera, A., Davies, B. and Darton, R. (2000) Relying on informal care in the new century? Informal care for elderly people in England to 2031, Ageing and Society, 20, 745-772.
Project ID: PID425
Funder: Department of Health
Contact: Dr Linda Pickard
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Unpaid Care and the FamilyDescription: This project produced a chapter by Linda Pickard on unpaid care and the family for the ONS Multi-Source Topic Report (MSTR) on the Family.View Unpaid Care and the Family, in ONS MSTR Volume on the Family here.
Project ID: PID426
Funder: ONS
Contact: Dr Linda Pickard
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Modelling Needs and Resources of Older People to 2030: Informal (Unpaid ) Care research at PSSRUDescription: This project aims to project up to 2030 the numbers, family circumstances, income, pensions savings, disability and care needs (formal and informal) of older people, the key determinants of their resources and needs.This research on informal (unpaid) care at PSSRU is part of the ESRC-funded New Dynamics of Ageing (NDA) project, Modelling Needs and Resources of Older People to 2030 (described under Long-Term Care Finance). The research on informal care at PSSRU will primarily undertake analyses of receipt of informal care by older people with functional disabilities, mainly using the English Longitudinal Study of Ageing (ELSA), with the aim of producing projections of trends in informal care and projections of long-term care expenditure under a range of scenarios on trends in informal care. Research Team: Linda Pickard, Raphael Wittenberg, Adelina Comas-Hererra, Derek King, Juliette Malley.
Project ID: PID427
Funder: ESRC
Contact: Dr Linda Pickard
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The Effectiveness and cost-effectiveness of Services for Informal Carers of Older People: Research OutlineDescription: This piece of work entailed the production of an update and summary of the review on the effectiveness and cost –effectiveness of services for informal carers of older people. View Outline(PDF).
Project ID: PID428
Funder: RiPfA
Contact: Dr Linda Pickard
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The Effectiveness of and Cost-Effectiveness of Support and Services to Informal Carers of Older PeopleDescription: This project aimed to review the literature on the effectiveness and cost-effectiveness of support and services to informal carers of older people in England and Wales. View Final Report
Project ID: PID429
Funder: Audit Commission
Contact: Dr Linda Pickard
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Caring for Older People and EmploymentDescription: This project aimed to review the literature on caring for older people and employment, with a particular focus on the public sector. View Final Report
Project ID: PID430
Funder: Audit Commission
Contact: Dr Linda Pickard
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Is Ageing Changing? Health, Healthy Life and Cognition across GenerationsDescription: The study builds on the design and infrastructure of the successful MRC Cognitive Function and Ageing Study collaborative (CFAS). New cohorts in Cambridgeshire, Newcastle and Nottingham will provide new data on generational and geographical differences in new cohorts including people in institutions. The aims of the study include estimation of the current and future cost of dementia and of long-term care for older people. The study will be conducted by researchers from the Universities of Cambridge, Edinburgh, Exeter, Leicester, Newcastle, Nottingham and the PSSRU at the London School of Economics.
Project ID: PID444
Funder: MRC
Contact: Mr Raphael Wittenberg
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Care Questions Study (main)Description: The purpose of this study is to develop clear and robust questions for use in social surveys and economic evaluations about receipt of care and support services by older people; payment for social care for older people; receipt of unpaid, informal care by older people; and provision of unpaid, informal care. Further Information: http://www.lse.ac.uk/collections/PSSRU/researchAndProjects/CQS/Carequestionstudy.htm
Project ID: PID471
Funder: DH and Nuffield Foundation
Contact: Mr Raphael Wittenberg
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BUPA AnalyseDescription: The PSSRU Long-Term Care Finance team at LSE, led by Raphael Wittenberg, undertook analyses for BUPA looking at key elements in the future demand and supply of long-term care in England
Project ID: PID472
Funder: BUPA
Contact: Mr Raphael Wittenberg
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Mental Health Economics and Policy
The programme comprises research on mental health policy and practice, drawing particularly but not exclusively on economic approaches and associated empirical methods. Work covers the full age range and all mental disorders, and includes research on intellectual disabilities. Much of the work is conducted outside the UK.
Twelve years on: outcomes and costs of community care for people with learning disabilities and mental health problemsDescription: The study examined the long-term outcomes and costs of community care for around 200 people with intellectual disabilities and 150 people with mental health problems who left long-stay hospital in the mid 1980s.
Project ID: PID354
Funder: Department of Health
Contact: Professor Martin Knapp
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Secure units: long-term outcomes and costsDescription: This project is an economic evaluation of forensic psychiatric services based on data for over 1000 people with mental health problems discharged from medium secure units, looking particularly at length of stay, costs and comparative efficiency. This work is being carried out by Martin Knapp, Andrew Healey and Maria Raikou (LSE Health), and is linked to Professor Jeremy Coid (Bart’s), and will feed into a report to the Department of Health in late 2006.
Project ID: PID249
Funder: Department of Health
Contact: Professor Martin Knapp
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Social exclusion, mental health and social policy: a systematic reviewDescription: Individuals with mental health problems are believed to be at increased risk of social exclusion. This project reviewed all relevant empirical evidence to establish what is known about the relationship between mental health and social exclusion and the factors that mediate the impacts. This extensive review assessed both qualitative and quantitative evidence. Further work will now focus on particular aspects of social exclusion. This work was conducted by Claire Curran, David McDaid and Martin Knapp, and also by Tania Burchardt (Centre for the Analysis of Social Exclusion, LSE).Publication
Curran, C., Burchardt, T., Knapp, M., McDaid, D. and Li, B. (2006) Challenges in multi-disciplinary systematic reviewing, improving the evidence base for social exclusion and mental health policy, Social Policy and Administration, 41, 3, 289-312.
Project ID: PID281
Funder: The Gatsby Foundation
Contact: Mr David McDaid
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The Mental Health Economics European Network (MHEEN)Description: The Network aimed to promote and protect public health in Europe by analysing information and knowledge in the economics and financing of mental health. View Project Outline.
Project ID: PID282
Funder: European Commission
Contact: Mr David McDaid
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EQOLISEDescription: EQOLISE (Enhancing the Quality of Life and Independence of persons disabled by severe mental illness through Supported Employment) was a 3-year project led by a team at St George’s Medical School. The intervention is based on a US model for supported employment for those with severe mental health problems that recommends the ‘place and support’ of people with mental health problems rather than the more traditional ‘support and place’ of sheltered employment. The LSE carried out the economic evaluation of the supported employment approach compared to standard arrangements in six European countries, and were also responsible for assessing the impact that each of the six countries’ welfare and employment systems have on the employment outcomes for people with mental health problems.
The PSSRU team comprises Martin Knapp, Adelina Comas-Herrera and formerly Claire Curran, working with Anita Patel (CEMH, Institute of Psychiatry), and linked to the St. George’s/Oxford team led by Jocelyn Catty and Tom Burns (now Oxford). Further information is available here.
Project ID: PID283
Funder: European Commission
Contact: Professor Martin Knapp
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GENDEPDescription: GENDEP (Genome-Based Therapeutic Drugs for Depression) is looking at genetic-based approaches for prescribing anti-depressants. This cross-national study is looking at people with depression in eight countries. The PSSRU team (Claire Curran and Martin Knapp) is carrying out an economic evaluation and looking at the employment data collected, as well as examining more broadly the economic consequences of genetics-based approaches in this area.Further information available here.
Project ID: PID284
Funder: European Commission
Contact: Professor Martin Knapp
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Mental health and developing countriesDescription: Various short-term projects have been carried out looking at aspects of mental health economics and policy in low- and middle-income countries. These projects have looked at the financing of mental health care services in developing countries as part of a Country Profile project led by Rachel Jenkins (Institute of Psychiatry), there is ongoing work looking at the role of NGOs in the financing of mental health care services in developing countries. An International Mental Health Economics conference was organised in 2003, funded by the UK Department for International Development, when many of these issues were considered, and there is hope to repeat this. There are also opportunities to evaluate different mental health policies emerging. Papers have been written on barriers to better mental health care, equity, and financing. A new component is economic advice to a major DFID-funded programme on mental health and poverty in Africa led by the University of Cape Town. Claire Curran, Dave McDaid and Martin Knapp are working in this area.PublicationsDixon, A., McDaid, D., Knapp, M. and Curran, C. (2006) Financing mental health, equity and efficiency concerns for low and middle income countries, Health Policy and Planning, 21, 171-182.
Knapp, M., Funk, M., Curran, C., Prince, M., Gibbs, M. and McDaid, D. (2006) Mental health in low- and middle-income countries, economic barriers to better practice and policy, Health Policy and Planning, 21, 157-170.
ID21 Health Research Highlight (2006) Barriers to Better Mental Health Practice and Policy.
Project ID: PID285
Funder: DfID and various others
Contact: Ms Claire Curran
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Opti-WorkDescription: The Opti-Work (Optmising Strategies for Integrating People with Disabilities into Work) project sets out to develop and disseminate a conceptual framework consisting of a number of analytic tools, and cross-national comparative reports, to assist in:
Formulating EU policy;
Calculating the socio-economic impact of those policies; and
Making recommendations for innovative strategies to enhance the labour market integration of citizens with disabilities.
The analytic tools will be applied to existing strategies and methods aimed at integrating people with disabilities into the labour market to identify good practice and system inefficiencies, as a means of informing future system planning and implementation.
Opti-Work is a 36-month project being undertaken by partners from the Netherlands, Ireland, the United Kingdom, Finland, Greece and Belgium. Partners from these countries are being supported in their activities by National Contact Centres in fifteen European countries, which fall under the auspices of the the European Platform for Rehabilitation.
More information available here.
Project ID: PID347
Funder: European Commission
Contact: Mr David McDaid
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Review of evidence on the use of QALYs in studies of people with schizophreniaDescription: This work (involving Roshni Mangalore and Martin Knapp) has reviewed evidence on the use of QALYs (Quality Adjusted Life Years) in studies of people with schizophrenia, and - where relevant - for mental health more broadly.
Project ID: PID313
Funder: Eli Lilly & Co Ltd
Contact: Dr Roshni Mangalore
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Cost of illness of schizophrenia for the UK (England)Description: Schizophrenia is associated with financial and social burden for people with the illness, their families and the wider society. This work estimated prevalence-based costs associated with schizophrenia for the year 2004/05, for England. Costs for subgroups of people with schizophrenia were also identified, distinguishing groups by place of residence. PublicationsMangalore, R. and Knapp, M. (2006) Cost of schizophrenia in England, PSSRU Discussion Paper 2376.
Mangalore, R. and Knapp, M. (2007) Cost of schizophrenia in England, Journal of Mental Health Policy and Economics, 10, 23-41.
Project ID: PID314
Funder: Eli Lilly & Co Ltd
Contact: Dr Roshni Mangalore
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The Brodersen Gift: social exclusion and mental healthDescription: The aim of this work is to explore the inter-relationship between dimensions of social exclusion and mental health. The project will build upon the results of previous PSSRU work (funded by the Gatsby Foundation) conduct a user consultation session explore data looking at the extent of social exclusion experienced by people with mental health problems and propose what can be done to address problems identified through appropriate social and public policy action.
This project has been funded by a donation by Mr and Mrs Christian Brodersen (Alumni of the London School of Economics and Political Science) as part of The Campaign for LSE, and is a joint venture by the LSE branch of PSSRU and the Centre for Social Exclusion, London School of Economics and Political Science.
Project ID: PID349
Funder: Mr and Mrs Christian Brodersen, Alumni LSE
Contact: Professor Martin Knapp
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Evaluation of the first phase of Choose LifeDescription: The purpose of this study was to evaluate the first phase of 'Choose Life' the national strategy and action plan to prevent suicide in Scotland. View Final Report
Project ID: PID348
Funder: Scottish Executive Health Department
Contact: Mr David McDaid
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Medication adherenceDescription: This study by Derek King and Martin Knapp explored whether changes in service use and cost patterns are associated with the degree to which people with schizophrenia take the medications that they are prescribed. Links were found between non-adherence and higher costs. Further research is ongoing to determine the impact of non-adherence over time. Another aim is to consider the impact of changes in treatment patterns on patient satisfaction and the association between antipsychotic use and the onset of diabetes. Publication
Knapp, M., King, D., Pugner, K, and Lapuerta, P. (2004) Medication non-adherence: associations with resource use and costs for people taking antipsychotics, British Journal of Psychiatry, 84, 509-516.
Project ID: PID350
Funder: Department of Health
Contact: Dr Derek King
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Trends and medication choice in antipsychotic prescribingDescription: This project lby Derek King and Martin Knapp looked at how antipsychotic medications are prescribed to people with schizophrenia and schizoaffective disorders. The study sought to determine what factors impact on the prescribing of the newer class of antipsychotics ('atypicals') relative to the older class of drugs ('typicals'), drawing on data from the General Practice Research Database (1993-1999). These data suggest that factors other that those related to need may impact on whether or not an individual receives an atypical antipsychotic. One important factor is age: on average, a 35 year old individual is 15% less likely to be prescribed an atypical compared to someone aged 30, and likewise, a 40 year old is 15% less likely to be prescribed an atypical as a 35 year old (and so on). One of the key conclusions is that much careful evaluation is required on how different factors influence choice of medication; this is particularly relevant in light of guidance from NICE recommending that atypicals be more widely prescribed. Findings from the study were recently published in the Journal of Mental Health (King and Knapp 2006).Research Summary
Patterns of, and factors associated with, atypical and typical antipsychotic prescribing by general practitioners in the UK during the 1990s, May 2007 [RS043, 2 pages, 51kb]
Publications
King, D. and Knapp, M. (2006) Patterns of, and factors associated with, atypical and typical antipsychotic prescribing by general practitioners in the UK during the 1990s, Journal of Mental Health, 15, 3, 269-278.
Knapp, M., Kanavos, P., King, D. and Yesudian, H.M. (2005) Economic issues in access to medications: schizophrenia treatment in England, International Journal of Law and Psychiatry, 28, 514-531.
Project ID: PID351
Funder: Department of Health
Contact: Dr Derek King
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Adulthood economic consequences of antisocial behaviour in childhood and adolescenceDescription: Using data from the Cambridge Study in Delinquent Development (CSDD), this study will examine the degree to which child and adolescent antisocial behaviour impacts on adult labour market participation and health and social care costs. The CSDD is a prospective longitudinal study of a cohort of boys in a working class area of South London, first studied at the age of 8 in 1961/62. The data to be studied here is based on the most recent interviews of the CSDD subjects at the age of 48. This analysis being undertaken by Derek King and Martin Knapp, jointly with David Farrington (Cambridge), builds on work published by Healey et al (2004) based on earlier interviews of the CSDD subjects. Publication
Healey, A., Knapp, M. and Farrington, D.P. (2004) Adult labour market implications of antisocial behaviour in childhood and adolescence: findings from a UK longitudinal study, Applied Economics, 36, 93-105.
Project ID: PID352
Funder: Department of Health
Contact: Dr Derek King
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The Socio-Economic Burden of Depression (SEBoD) InitiativeDescription: The Socio-Economic Burden of Depression (SEBoD) Initiative aims to reduce the social, cultural, economic and regulatory barriers to early diagnosis and treatment of depression in the Asian region through education and destigmatization of depressive disorders. In the first phase of its programme, the Initiative is collecting evidence about depressive disorders in Asia to determine how they could be treated. This is being followed by regional and national action programmes designed to deal with depression.
SEBoD includes the following activities:
In-depth research studies on social and economic burdens and depression epidemiology in the Asia-Pacific region. Training primary care physicians and healthcare workers to improve recognition, diagnosis and treatment of depression. Public education programmes to destigmatize depression and encourage people to seek treatment. Proactive education of policy makers to combat the economic impact of untreated depression.
The SEBoD Initiative was launched with the help of an unrestricted grant from Wyeth. Other funding is currently being sought. The Initiative is headed by Professor Norman Sartorius, with the economics research coordinated by Professor Teh-Wei Hu (University of California, Berkeley) and Professor Martin Knapp (LSE).
Publication Reducing the Socio-Economic Burden of Depression Report, 2002. Contact: Donald Scales, dfs@globalmedicalprograms.com.
Project ID: PID360
Funder:
Contact: Professor Martin Knapp
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Mental health and low and middle income countriesDescription: Various short-term projects have been carried out looking at aspects of mental health economics and policy in low- and middle-income countries. A new component is economic advice to a major DFID-funded programme on mental health and poverty in parts of Africa led by the University of Cape Town. Martin Knapp and David McDaid are working in this area. PublicationsDixon, A., McDaid, D., Knapp, M. and Curran, C. (2006) Financing mental health, equity and efficiency concerns for low and middle income countries, Health Policy and Planning, 21, 171-182.
Knapp, M., Funk, M., Curran, C., Prince, M., Gibbs and McDaid, D. (2006) Mental health in low- and middle-income countries, economic barriers to better practice and policy, Health Policy and Planning, 21, 157-170.
Project ID: PID387
Funder: Department for International Development
Contact: Mr David McDaid
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APOLLODescription: The Apollo project coordinated by University of Athens and funded by the European Commission is a 3 year multi-country multi-partner project looking at strategies and best practice to reduce the health and social-economic costs and consequences of injuries both accidental and self inflicted. David McDaid (LSE) is working on this project. Further information available here.
Project ID: PID381
Funder: European Commission
Contact: Mr David McDaid
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CANEDescription: An evaluation has been conducted of the impact on user outcomes and costs of providing staff with information from a comprehensive needs assessment of care home residents with dementia. The main project is led by Martin Orrell (UCL), with PSSRU (Martin Knapp and Catherine Henderson) responsible for the economic evaluation.
Project ID: PID382
Funder:
Contact: Professor Martin Knapp
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Dementia UKDescription: This project aimed to get up-to-date estimates of the prevalence and costs of dementia, and patterns of service provision across the UK. View Final Report
Project ID: PID383
Funder: Alzheimer’s Society
Contact: Professor Martin Knapp
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European collaboration on dementiaDescription: This is a 3-year project led by Alzheimer Europe and funded by the European Commission. The aim of the project is to develop a European network in the area of dementia to jointly develop consensual indicators and to develop an ongoing dialogue to identify ways of developing synergies and a closer collaboration at the EU level. The project will also look at the socio-economic costs of dementia in Europe and the availability of support services across countries, with contributions from David McDaid (PSSRU). Further information is available here.
Project ID: PID385
Funder: European Commission
Contact: Mr David McDaid
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Implementing Mental Health Promotion Action (IMHPA)Description: IMHPA is a network of partners across 20 European countries and led from the Ministry of Health in Catalonia with funding from the European Commission. The network aims to develop and disseminate evidence-based mental health promotion and mental disorder prevention strategies across Europe and to facilitate their integration into countries' policies, programmes and health care professionals' daily clinical work. The PSSRU component is led by David McDaid. Further information is available here.
Project ID: PID386
Funder: European Commission
Contact: Mr David McDaid
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Equity and mental healthDescription: The reduction of health inequalities is a major policy goal in the UK. While there is general recognition of the disadvantaged position of people with mental health problems, the extent of inequality, particularly the association with socio-economic characteristics, has not been widely studied. There is need to demonstrate more effectively the relevance of different equity principles to mental health policy and practice by developing standardised methods for empirical analysis of equity, so as to examine the distribution of psychiatric morbidity and use of services by income, socio-economic group, ethnicity, gender and residence, and, of course, to examine how equity can be promoted. This has been the objective of ongoing work by Roshni Mangalore and Martin Knapp. Publication
Mangalore, R. and Knapp, M. (2006) Equity in mental health, Epidemiologia e Psichiatria Sociale, 15, 4, 260-266.
Project ID: PID388
Funder:
Contact: Professor Martin Knapp
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Spatial patternsDescription: Recent years have witnessed growing interest in the geography of mental health, with particular emphasis on spatial concentration of needs. The object of some of our research is the study of spatial variations in mental health expenditure: to provide theoretical foundations and empirical evidence of underlying spatial patterns of mental health spending in England. This work by Francesco Moscone will contribute to discussions of the factors that influence local spending levels. PublicationsMoscone, F., Knapp, M. and Tosetti, E. (2007) Mental health expenditure in England: a spatial panel approach, Journal of Health Economics, 26, 842-864.
Moscone, F., Tosetti, E. and Knapp, M. (2007) SUR model with spatial effects: an application to mental health expenditure, Health Economics Letters, 11, 2, 3-9.
Costa Font, J. and Moscone, F. (2006) Inter-territorial interaction of regional health expenditure in Spain: A spatial panel approach, presented at the International conference of Spatial Econometrics and Statistics.
Moscone, F., Tosetti, E. and Fernández, J-L. (2006) Cholera in the City: a Spatio-Temporal Study, PSSRU Discussion Paper 2352, Personal Social Services Research Unit, University of Kent at Canterbury.
Moscone, F. and Knapp, M. (2005), Exploring the spatial pattern of mental health expenditure, Journal of Mental Health Policy and Economics, 8, 205-217.
Project ID: PID389
Funder:
Contact: Professor Martin Knapp
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Mental Health to 2026Description: The King’s Fund have commissioned a piece of work from the Centre for the Economics of Mental Health, Institute of Psychiatry, King’s College London, to estimate mental health expenditure over the next 20 years. PSSRU staff at LSE will be contributing. The specific aims of the study will be: to estimate the number of people in England with specific mental disorders over the 20-year period between 2007 and 2026; to examine the evidence on rates of treated prevalence in order to make projections of trends in contact rates over the same period; to define typical service packages for people with these disorders based on current service configurations, including impacts outside the NHS (for example on social care services, employers, education services, criminal justice services and the social security system); to estimate the expenditure on these services over the 20-year period; to estimate the outcomes in terms of QALY gains that might be achieved from providing more appropriate, evidence-based services; to change key parameters in the model to take account of possible technological advances in mental health care treatment and provision; and to discuss the policy implications of these predicted expenditure needs. This study will be finished in autumn 2007.
Project ID: PID392
Funder: King's Fund
Contact: Professor Martin Knapp
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Dementia: International ComparisonsDescription: The project undertook a review of the evidence. View Summary Report
Project ID: PID408
Funder: National Audit Office
Contact: Professor Martin Knapp
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Housing services for people with mental health problemsDescription: Housing services for people with mental health problems have been the focus of several governmental initiatives. Their provision has been increasing significantly and absorbs large amounts of public funding. Nevertheless, little is known about what users are in different types of housing services, for how long they are in the projects, what the aims of care are, and what costs different types of services generate. This information is essential for evaluating existing housing services and planning future housing support for these vulnerable people. The project, proposes to conduct a stock taking survey to establish the characteristics of users and services in England. The survey aims to identify what models of housing services are provided for people with mental health problems in England and to establish the characteristics of the users of the different models including the costs of their care.
The survey will be conducted over a 14-month period. Socio-demographic and clinical data, characteristics of current care provision and costs will be assessed for each user in the sample. The findings will provide a comprehensive picture and a basic comparative evaluation of different types of services, and be the basis for more specific research studies in the future. It will also provide evidence for what information should be routinely collected to monitor and evaluate housing services for people with mental health problems.
PSSRU will be responsible for costing of service use and data analysis in general, using various statistical and econometric methods.
This work is being led by Dr Stephen Priebe of Queen Mary College, University of London. The LSE team comprises Professor Martin Knapp and Roshni Mangalore.
Project ID: PID415
Funder: Department of Health
Contact: Dr Roshni Mangalore
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Economics of early intervention services: Scoping studyDescription: This exploratory project is looking at what data might be available to allow the building of economic models of early intervention for psychosis. It is particularly focussed on the possibilities for further work in relation to young people, offenders, people from Black and Minority Ethnic groups, rural areas and suicide. One further aspect is to look at the cost of lost opportunities.
This project follows on from work undertaken by Paul McCrone and Martin Knapp – working with Sujith Dhanisiri (CEMH) - to produce a general model which estimated the economic impact of early intervention services. The findings from that work will shortly be submitted to a journal for publication. This new, small scoping study is therefore exploring what further work might be possible for specific groups of people and in relation to some specific issues.
Project ID: PID423B
Funder: Department of Health
Contact: Dr Roshni Mangalore
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Economics and mental health: cost-effectiveness evidence review and economic implications of stigmaDescription: This project aimed to review of evidence on the cost-effectiveness of specific interventions in mental health care and produce a model to assess the economic impact of initiatives aimed at reducing stigma and discrimination experienced by people with mental health issues.Given resource constraints in the NHS, it is imperative to have an understanding of the economic implications of needs (in this case mental health needs) and the various options available to address them. This project comprised two activities: a review of evidence on the cost-effectiveness of specific interventions in mental health care (in particular ‘talking’ therapies, early intervention initiatives and employment schemes); and development of a model to assess the economic impact of initiatives aimed at reducing stigma and discrimination experienced by people with mental health issues. Project team: Martin Knapp, Mary Henri, Paul McCrone (KCL). The final report will be launched by Rethink shortly.
Project ID: PID432
Funder: Rethink
Contact: Professor Martin Knapp
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Health and social care needs of young adults 18-25 with long-term neurological conditions on transition to adult services and the costs of service provisionDescription: The focus of this short-term piece of work is to look at services used by people aged 18-25 with neurological conditions, and in particular to investigate the costs of services received from health, social care, education and other services as provided by the statutory sector or by voluntary and private organisations.The National Service Framework for Long-Term Conditions (NSF for LTNC) lays down standards of care that those with long term neurological conditions can expect from services, for example, early recognition, specialist and community rehabilitation, vocational rehabilitation, equipment and accommodation, and personal care and support, but there has been very little work to date on the costs attached to the services that are required to enable young adults with these conditions to live as independently as possible.
Research questions include:
What is the prevalence of selected neurological conditions in young people aged 18-25 years?
What services and supports do young people with these conditions currently use?
What other unmet needs for health and social care support do these young people have?
What are the costs of current and ‘ideal’ health and social care support packages for identified groups of young people?
What are the total costs of health and social care support packages for young people with neurological conditions? Research team: Jeni Beecham (KCL), Martin Knapp, Margaret Perkins and Tom Snell.
Project ID: PID433
Funder: Department of Health
Contact: Ms Margaret Perkins
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Maintaining good health for older people with dementia who suffer a neck of femur fractureDescription: The purpose of this project was to develop a cell-based macrosimulation model which analyses the cost of delayed discharge in people with dementia who suffer a neck of femur fracture. View Final Report View Research Summary
Project ID: PID434
Funder: National Audit Office
Contact: Ms Catherine Henderson
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Child and adolescent mental health in enlarged EU: Development of effective policies and practices (CAMHEE)Description: This project aims to analyze the existing national mental health policies in the field of child and adolescents mental health and consequentially to provide EU with policy and action recommendations.Led by State Mental Health Center, Lithuania, the project aims to trigger positive changes in EU Member States and candidate countries in the field of child and adolescent mental health (CAMH) actions and practices. To achieve this, the project has four main objectives:
To create a network of partners within the European Union to encourage adoption and implementation of modern effective public health approaches.
To develop guidelines and recommendations for national and municipal (regional) policies in participating countries in the field of CAMH based on evidence obtained through the independent analysis of country situations, including the analysis of context, resources, processes and outcomes.
To initiate and support activities in new and applicant member states in the field of CAMH, with special focus on implementation of effective and evidence-based policies and practices based on involvement and participations of children, families and communities.
On the basis of information, share experience by networking, to advise the European Union and member states on mental health promotion (MHP) and mental disorder prevention (MDP) among children and adolescents, with special focus on management of changes needed in new member states to move from inherited patterns of institutionalization and medicalization to modern public health approaches based on involvement of children, youth, parents and communities.
Further information available at CAMHEE,
Project ID: PID435
Funder: European Commission
Contact: Mr David McDaid
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Developing the evidence base for mental health promotion and prevention in Europe: A database of programmes and the production of guidelines for policy and practice (DataPREV)Description: This is a multi-country 6th Framework European project led by Radboud University, Nijmegen, Netherlands.
Gathering and building on research and evidence across settings and relevant sectors, DATAPREV aims to add value to EU and country policies by deepening the understanding and enhancing the scientific base for MHP and MDP. DATAPREV will develop a standardised online information system collecting available MHP and MDP practice for infants, children, working and elder populations, describing and synthesising the evidence base, describing programme outcomes for increased cognitive and emotional development, reduced mental ill health, decreased psychiatric symptoms and disorders, and improved positive mental health.
DATAPREV will outline some of the potential social and economic outcomes such as increased educational attainment and improved performance and reduced absenteeism within the labour force. DATAPREV will also support policy making at both a European and national level by making available information in an accessible and concise format on available research and practice. Guidelines will be developed and training provided for effective approaches for facilitating the use of evidence in the decision making process.
It is crucial to convey in a meaningful fashion information not only on what interventions work, what gains may be achieved, and in what settings, but also to elicit what resources and structures are required for implementation. improve understanding effective interventions, improving existing implementation. Such information in integral to making the case for a greater level of investment in effective MHP and MDP interventions across Europe. The LSE is leading on work to look on the socio-economic impact of prevention and promotion programmes.
Project ID: PID436
Funder: European Commission
Contact: Mr David McDaid
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Economic Analysis based on STAR trialDescription: The Schizophrenia Trial of Aripiprazole (STAR), is a 26-week naturalistic study comparing aripiprazole with standard of care (SoC) (treatment with one of olanzapine, risperidone or quetiapine) for people with schizophrenia who are being treated in community health or hospital-based outpatient settings, and for whom a switch in atypical antipsychotic medication was deemed necessary by the treating physician. Although most attention in treatment decisions is rightly given to symptomatic response, adverse events and quality of life, it is also widely recognized that decisions must be made in cognizance of their economic consequences. A short study is underway, conducted by Derek King and Martin Knapp - with support from Renee Romeo (CEMH) - looking at service use, accommodation and employment data collected in STAR, and subsequently involving a cost-effectiveness analysis.
Project ID: PID439
Funder: Bristol Myers Squibb
Contact: Dr Derek King
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Development of a Social Inclusion Index to capture subjective and objective life domainsDescription: This multi-centre project is led by the Department of Applied Social Science at the University of Swansea. LSE input is from David McDaid and Martin Knapp, together with Tania Burchardt at the LSE’s Centre for the Analysis of Social Exclusion. The overall aim of the proposed study is to develop an indicator of social inclusion for use in routine outcome measurement, both in general settings and in mental health services and in mental health service research, that reflects the views of people with mental health problems, their carers and professionals in the field and, which is reliable, sensitive and valid.
Project ID: PID441
Funder: UK National Institute for Health Research Health Technology Assessment Methodology Programme
Contact: Mr David McDaid
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Support at Home - Interventions to Enhance Life in Dementia (SHIELD)Description: This 60 month project is being led by Professor Martin Orrell at UCL. The aim of this applied research programme is to prevent excess disability, promote social inclusion, improve health outcomes, and enhance the quality of life for people with dementia and their carers. The aim will be achieved by a rigorous 5 year programme of psychosocial research building on existing work by the applicant team; in cognitive stimulation, reminiscence work, and carer support, and also by a new initiative developing intensive home support to manage crises at home, and prevent admission to hospital for people with dementia. Professor Martin Knapp is providing health economics expertise.
Project ID: PID442
Funder: NIHR
Contact: Professor Martin Knapp
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A randomised controlled study to meet the needs of older people with dementia in residential careDescription: The Audit Commission has highlighted shortcomings in the care of older people with dementia in residential or nursing home care and recommended that specialist mental health professionals provide this expertise to residents. This study seeks to provide an evaluative framework to maximise the effectiveness of their input. It is designed to assess the met and unmet health and social care needs of older people with dementia resident in care homes. The study is being undertaken in three areas in the UK: London and the south-east, Bangor and Manchester, with the lead researcher based at University College, London.The write up of the study is in progress but early findings indicate that the intervention reduced needs at follow up, suggesting that a planned routine assessment and care planning process for care homes could offer a way to improve quality of care. PublicationsHancock, G.A., Woods, B., Challis, D. and Orrell, M. (2006) The needs of older people with dementia in residential care, International Journal of Geriatric Psychiatry, 21, 43-49.
Orrell, M., Hancock, G., Hoe, J., Woods, B., Livingston, G. and Challis, D. (2007) A cluster randomised controlled trial to reduce the unmet needs of people with dementia living in residential care, International Journal of Geriatric Psychiatry, 22, 1127-1134.
Project ID: X/PID251
Funder: The Wellcome Trust
Contact: Professor David Challis
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Choice and Direct Payments for adult mental health service usersDescription: Direct payments have been seen as a central policy initiative in recent years for all service users to promote choice and independence in the way their particular social care needs are met yet various research reports specific difficulty in advancing uptake among mental health service users This exploratory seeks to investigate how, at the local level, choice and Direct Payments are being promoted and the views of care coordinators in integrated community mental health teams on meeting these objectives in their daily practice in their particular local context.
Research questions include:
what policy and service developments are taking place at the local level to meet the objectives of recent policy on choice and Direct Payments;
how do these impact on the day to day work of integrated care management teams;
what are their views on these agendas;
how do organisational arrangements and local factors affect what happens for frontline practitioners.
Project ID: X/PID417
Funder: Department of Health
Contact: Ms Margaret Perkins
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Non-Programme Projects at LSE
SHSGIDescription: The European Commission, DG Employment, Social Affairs and Equal Opportunities, designated a consortium led by the European Centre for Social Welfare Policy and Research (Vienna, Austria) to develop the project The situation of social and health services of general interest in the European Union. PSSRU at LSE were commissioned to contribute a report examining the state-of-the-art of long-term care in general and particularly with respect to modernisation issues and the development of quality initiatives in the United Kingdom. Staff working on the report included Vanessa Davey, Catherine Henderson, Juliette Malley, Tihana Matosevic and Raphael Wittenberg. Further information available here.
Project ID: PID407
Funder: European Commission via European Centre for Social Welfare Policy and Research
Contact: Mr Raphael Wittenberg
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MonAMI: Mainstreaming on Ambient IntelligenceDescription: The purpose of this project is to evaluate the MonAMI programme (Mainstreaming ambient technology) as it is rolled over 32 EC countries.Many Europeans are at risk of being excluded from the information society and its benefits. Two large and growing groups in this position are older and disabled people. These people are often left behind as information and communication technologies develop. Yet previous European projects have shown that technological augmentation of the living space can help alleviate the problems of daily living, improve quality of life and reduce the need for institutional and other care. The European Commission has awarded €9 million to a consortium to select and evaluate collections of services in the areas of comfort applications, communication/information, health, safety and security. The project – MonAMI - will build, test and deploy these services and evaluate whether they can be cost-effectively brought through the future mainstream ambient intelligence technologies. The PSSRU at LSE is responsible for the evaluation of the MonAMI programme as it is rolled out in a number of European countries. Further information is available at MonAMI. Staff working on this project are Martin Knapp, Jackie Damant and Maggie Ellis.
Project ID: PID421A
Funder: European Commission
Contact: Ms Jacqueline Damant
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The economic impact of crisis resolution teamsDescription: The purpose of this work was to model the economic costs of CRHT teams over a period of five years with the model being representative of CRHTs across the country. View Final Report
Project ID: PID431
Funder: National Audit Office
Contact: Professor Martin Knapp
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Assessing the economic impact of health visiting in post-natal depressionDescription: The aim of this study is to examine the economic costs and economic consequences of health visiting in supporting women with post-natal depression. A model is being built from available evidence, current statistics and (as needed) expert opinion to represent care and related pathways and to chart economic impacts over time. Particular attention is being paid to the development of children, and the consequences for them and society over a number of years. The work is being undertaken by Pon-Pon Yeh and Martin Knapp, in collaboration with the Community Practitioners’ and Health Visitors’ Association.
Project ID: PID438
Funder: Unison
Contact: Ms Pon-Pon Yeh
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Services for children and young people
Focusing on children and young people who have additional needs and who use specialist services alongside universal supports, this programme brings an economic perspective to studies of cross-agency service provision and use of services. It has its roots in the earlier Economics of Social Care programme but reflects the broader vision found in the Change for Children policy agenda. Current research includes exploring support for disabled children, mental health services, adoption services, specialist foster care, and the interfaces between health, education and social care. Strong links are maintained with the Mental Health Economics and Policy programme and the Centre for the Economics of Mental Health at the Institute of Psychiatry, London.
A multicentre randomised trial of the outcome, acceptability and cost-effectiveness of family therapy and multi-family day treatment compared with inpatient care and outpatient family therapy for adolescent anorexia nervosaDescription: Led by the Institute of Psychiatry at King's College London, this study aims to examine the outcome, cost-effectiveness and acceptability of brief multiple family day treatment (MFDT) compared to two types of standard treatment (inpatient care, outpatient family therapy) in two parallel, integrated randomised controlled trials in adolescents with anorexia nervosa.
Project ID: PID462
Funder: PPP Healthcare
Contact: Professor Jennifer Beecham
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Access to child and adolescent mental health servicesDescription: Promoting the mental health and psychological well-being of children and young people is the ninth of eleven standards in the National Service Framework for Children. Part of the vision is to see that all children under 18 years with mental health problems have access to mental health care provided by staff with an appropriate range of skills and competencies. In this project we built on work already undertaken with adult mental health services to explore two issues; the potential for access through availability of services, and the actual access made as indicated by utilisation rates of child and adolescent mental health services (CAMHS).
Project ID: PID367
Funder: Department of Health
Contact: Professor Jennifer Beecham
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Education services for young people living away from homeDescription: The educational achievement of looked after children remains one of the primary concerns of both central and local government. An exploratory study, completed in 2002 looked at ways of comparing care and education supports for children living in EBD schools, children’s homes and foster care. An analytic framework was developed that included social care, special education and economic perspectives.
This work was taken forward in the current evaluation funded under the Department of Health Quality Protects research initiative. The main research questions are
What is the quality of care provided for different group of ‘difficult to manage’ adolescents living in foster care, children’s homes and residential schools for children with emotional and behavioural problems (EBD)?
What are the educational and wider outcomes for children in these groups?
What are the costs of the care and education services used and how do these relate to outcomes?
How do the public and independent sectors compare?
This study is undertaken in collaboration with researchers at the Department of Applied Social Studies, University of Bedfordshire.
The research will be completed in 2006.
Publications
Berridge, D., Beecham, J., Brodie, I., Cole, T., Daniels, H., Knapp, M. and MacNeill, V. (2003) Services for troubled adolescents: exploring user variation, Child and Family Social Work, 8, 269-279.
Berridge, D., Beecham, J., Brodie, I., Cole, T., Dnaiels, H., Knapp, M. and MacNeill, V. (2002) Costs and Consequences of Services for Troubled Adolescents: An Exploratory, Analytic Study, University of Luton.
Project ID: PID368
Funder: Department of Health
Contact: Professor Jennifer Beecham
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Multi-agency support for disabled young peopleDescription: Recent policy documents have stressed the need for child-centred, co-ordinated, multi-agency care packages to be in place to support disabled children and young people, and their families. However, there is little evidence to show how children and families currently use services across agencies and at what cost.
The aim is to identify and collate recent research findings and data on the way disabled children and their families use services allowing the following activities:
exploration of the ways in which disabled children and their families are supported by multi-agency packages of care;
estimation of the costs of supporting children who have different types of disability, needs or levels of severity;
exploration of the associations between the costs of support and needs.
Project ID: PID365
Funder: Department of Health
Contact: Professor Jennifer Beecham
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Health, social care and education interfaceDescription: Provision of integrated services is a central component of the policy to improve access to a range of supports for children and families. This project identified these ‘interface’ services and explored the ways in which they are provided, to whom and at what cost.
Project ID: PID366
Funder: Department of Health
Contact: Professor Jennifer Beecham
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An investigation of linking and matching in adoptionDescription: Little is known about what makes a good match in adoption or how much it might cost. A national survey will provide a broad picture of linking and matching practices. Innovative as well as more routine approaches will be examined in more detail through a catch-up prospective study of 150 children from 5-10 adoption agencies in the public and voluntary sectors. Sixty of these children will be followed-up for six months into their placement. The survey and detailed study will be accompanied by careful estimation of the costs and an exploration of why these might vary. Guidance on matching will be developed for social workers and policy-makers based on the findings from the study.
This study is undertaken in collaboration with researchers at the School for Policy Studies, University at Bristol.
The study will continue until May 2009.
Project ID: PID369
Funder: Department for Education and Skills
Contact: Professor Jennifer Beecham
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An exploration of different models of key worker services for disabled children and their families: effectiveness and costsDescription: Research has shown that families of disabled children who have a key worker benefit from this service and recent policy initiatives emphasis the importance of such provision. Alongside the recent expansion of these services (30 were found in a recent national survey) has come a proliferation of models of service delivery. This study, undertaken with researchers at the Social Policy Research Unit, University of York aimed to identify which characteristics of key worker services were associated with better outcomes for disabled children and their families, and at what cost.
Publications
Sloper, T., Greco, V., Beecham, J. and Webb, R. (2006) Key worker services for disabled children: what characteristics of service lead to better outcomes for children and families, Child: Health, Care and Development, 32, 2, 147-157.
Greco, V., Sloper, T., Webb, R. and Beecham, J. (2006) Key worker services for disabled children: the views of staff, Health and Social Care in the Community, 14, 6, 445-452.
Greco, V., Sloper, T., Webb, R. and Beecham, J. (2006) Key worker services for disabled children: the views of parents, Children & Society, 21, 3, 162-174.
Greco, V., Sloper, P. Webb, R. and Beecham, J. (2005) An Exploration of Different Models of Multi-Agency Partnerships in Key Workers Services for Disabled Children: Effectiveness and Costs, DfES Research Report 656, Department for Education and Skills Publications, Nottingham. Available at http://www.dfes.gov.uk/research/data/uploadfiles/RR656.pdf
Project ID: PID370
Funder: Department of Health, Department for Education and Skills, HM Treasury, and Welsh Assembly Government
Contact: Professor Jennifer Beecham
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Secondary analysis of the Children in Need Survey 2001Description: As part of the drive to improve the level of knowledge about children supported by social services a new statistical collection for children’s social care services was developed, the Children in Need (CIN) Survey. This one-week Survey, first collected in 2000, brings together information on children, their needs for services, the social services’ responses, and the costs. The 2001 CIN Survey provides data on 363,389 children who were ‘on the books’ of 144 English children’s departments that year (CIN2001; DfES, 2002). The characteristics of children were recorded on the database (age, gender, ethnic group membership, etc) alongside one of nine broad pre-set ‘needs’ categories such as abuse and neglect, disability, or parental ill-health. Over the one-week period all SSD services and staff recorded how much support they had provided for each child. Thus the ‘care package’ for any child in the dataset included social services-funded days in the various placements, receipt of grants or one-off payments, and use of group work or individual sessions with social services’ staff.
The PSSRU was asked by the Department of Health to produce topic-specific analyses from these data, focusing on exploring variations between councils. The analyses cover four ‘process’ related issues - funding and income, active case rates, case longevity and staff time use - and three relating to particular groups of children - disabled children, those from ethnic minority background, children with autism, and child asylum seekers.
Copies of these short reports, including a short departmental commentary, can be found at http://www.dfes.gov.uk/qualityprotects/work_pro/analysis1.shtml.
Project ID: PID371
Funder: Department of Health
Contact: Professor Jennifer Beecham
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Models of multi-agency services for transition to adult services for disabled young people and those with complex health needs: impact and costsDescription: This study is undertaken in collaboration with researchers at the Social Policy Research Unit, University of York. There is considerable evidence from research that, for most young people with disabilities or complex health needs, the process of transition from child to adult services is problematic. Current policy developments and the growth of multi-agency working may lead to improvements in this situation. However, there is little research which can identify the components of models of good practice in transition services or the costs of such services. This research will address both these issues in order to inform good practice in services for disabled young people and their families at transition.
Project ID: PID414
Funder: Department of Health
Contact: Professor Jennifer Beecham
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Transition to adult services and adulthood for young people with autistic spectrum disordersDescription:
Project ID: PID476
Funder: Department of Health via University of York
Contact: Professor Jennifer Beecham
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Evaluation of the Costs and Cost-Effectiveness of Interventions carried out on behalf of the National Academy for Parenting PractitionersDescription: The National Academy for Parenting Practitioners works directly with parenting practitioners to provide them with the high quality skills and knowledge they need to enable parents to deal with day to day challenges and give their children the best possible start in life. The Academy’s aim is to improve the quality of support that is made available to practitioners and in turn parents through research, training and information. PSSRU at LSE, led by Dr Jeni Beecham, will undertake the cost effectiveness evaluation components within the NAPP research programme. This will make it possible to determine their cost-effectiveness on a per child and on a per team basis and to identify cost savings in the short and longer term. Broader questions to be addressed include whether it is more cost-effective to intervene early in a preventive way, or later on once problems have developed; whether fewer public services are used after intervention; and which interventions are not good value. Project Outline: http://www.lse.ac.uk/collections/PSSRU/pdf/NAPP.doc (Doc)
Project ID: PID463
Funder: National Academy for Parenting Practitioners
Contact: Professor Jennifer Beecham
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Evaluation of Supported Housing Pilot for Teenage Parents (SHPTP)Description: Teenage parents come disproportionately from disadvantaged backgrounds, and a substantial body of evidence documents poor outcomes for both teenage mothers and their children, including poor housing outcomes, poor economic well-being, poor emotional health and well-being, and poor child health outcomes. This evaluation focuses on the Supported Housing Pilot for Teenage Parents (SHPTP). This study is led by Prof Martin Knapp and Dr Jeni Beecham.
Project ID: PID464
Funder: DCSF
Contact: Professor Jennifer Beecham
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Long Term Consequences of Anti-Social Behaviour in ChildhoodDescription: The Cambridge Study in Delinquent Development (CSDD) is a longitudinal study that has followed a cohort of approximately 400 boys from the age of 8. They were most recently interviewed at age 48. This study is exploring the connections between behavioural and emotional problems in childhood and adult service use, service use costs and employment outcomes.
Project ID: PID465
Funder:
Contact: Professor Martin Knapp
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