69. The hidden work involved in providing person centred care within intermediate care services (269)

Valerie Thomas, Tutor – Health Policy, School of Health Science, Swansea University, Swansea, Wales, United Kingdom
Co author: Huw Dylan Owen
daveval.thomas@btinternet.com

Abstract:

Background:

Intermediate care is a concept familiar to many people working in health and social care in the UK. Governments have high expectations of such services to improve quality of life (QoL) for older people and to solve the system pressures within the acute hospital sector (Stevenson and Spencer 2002). Developing an evidence base of the effectiveness of a model of care that is characterised by diversity and difference in practice is problematic (Martin et.al 2004).

Aim:

The aim is to explore the perceptions of staff working in and referring to community based IC teams.

Methods:

The paper draws on results from a Doctoral study (data collection from mid 2006 to mid 2007). Methods included 2 focus groups (n=6, n=10) and observations with IC teams (n=6), face to face interviews with referrers (n=17) and an evaluation of the outcome measures. Data were coded and analysed within and across data sets to identify themes.

Results:

There is evidence of interprofessional working, confirmed by shared responsibility, coordinated rather than parallel services, understanding of other organisations and recognition and resolution of conflict areas. The teams mange to improve QoL and avoid unnecessary referrals to other parts of the health/ social care system. However, this generates work within the teams which traditional measures would not identify.

Discussion:

Evaluation is inherent in the work of nurses and other healthcare professionals and they need to be aware of the systems and structures within which they are required to work. This depth of understanding is particularly is important for intermediate care services as the heterogeneity contributes to the challenge of describing their services and measuring their effectiveness.

Conclusion:

Evidence from this project contributes to knowledge on the hidden work within person centred intermediate care for older people and will inform future planning and provision of services.

Biography:

I currently work as a tutor in health policy in the Centre for Health Economics and Policy Studies in the School of Health Science, Swansea University. Prior to joining the Centre I was staff nurse, ward manager, nurse manager and directorate manager and senior manager in the NHS and Social Services in England and Wales. I am an elected member of the Royal College of Nursing Forum for Nurses Working with Older People. I have been involved in research projects on assessment tools, older people's journeys in acute hospitals and a range of service evaluations. I am currently completing my Doctorate which explores the development of Intermediate Care.