Tessa Trappes‐Lomax and Annie Hawton
This paper aims to report verbatim the voices of older people describing their experiences of rehabilitation services in community hospitals and local authority short‐term…
Abstract
Purpose
This paper aims to report verbatim the voices of older people describing their experiences of rehabilitation services in community hospitals and local authority short‐term residential units followed by “usual care” services at home. It aims to contribute directly to the implementation of the DH Section 256 “reablement guidance”.
Design/methodology/approach
The paper is a qualitative study, based on semi‐structured face‐to‐face interviews in 2002/3, with 42 participants (mean age 81.4 years) using interpretative phenomenological analysis (IPA).
Findings
Four main themes emerged from users' comments: the complexity of rehabilitative need, the influence of the setting, the role of the staff and the availability of reablement support back at home.
Research limitations/implications
Qualitative studies have limited generalisability, but these findings are consistent both with other studies of user experience and with earlier related evidence about assessment, institutionalisation and psychological factors.
Practical implications
The findings clearly demonstrate changing rehabilitative needs along the care pathway, with implications for commissioners and providers of reablement services. The findings bring a user perspective to current debates about the integration of services and the use of pooled budgets.
Originality/value
Effective reablement is critically dependent on service users' co‐operation and motivation. It therefore needs to be highly responsive to their needs and views. This study offers specific user views about their experiences in different settings and at different stages of reablement, together with their ideas for how it might work better. The data are analysed within a single framework, offering an example of the type of local evaluation currently sought by the Department of Health.
Details
Keywords
In response to elevated local self-harm and suicide rates, and the lack of a dedicated pathway for children and young people (CYP) who self-harm, a rapid response pathway united…
Abstract
Purpose
In response to elevated local self-harm and suicide rates, and the lack of a dedicated pathway for children and young people (CYP) who self-harm, a rapid response pathway united to reduce self-harm (RUSH) was developed and implemented within Norwich (Norfolk, England). This public health case study aims to describe the pathway model and share its outcomes, learnings, and reflections over the pilot year.
Design/methodology/approach
RUSH was a community-based pilot pathway aiming to support CYP, 11–18 years old, engaging in or at risk of engaging in repeated self-harm and subsequently at risk of repeated attendance at local emergency departments. From May 2020 to April 2021, RUSH supported 61 CYP using funding from NHS England and Improvement.
Findings
This case study shares the pathway’s outcomes, through a mixed-method evaluation. Results indicate statistically significant reductions in self-harm frequency (p = 0.01) and anxiety and depression symptomatology (p < 0.001); a statistically significant increase in progress towards goals (p < 0.001); and a general downward trend in re-attendance at local emergency departments following RUSH. Findings also illustrate high service user satisfaction. Framework analysis of focus group data highlights positive experiences with hope for recommissioning from a staff perspective.
Originality/value
This study will be valuable for services looking to develop and implement a similar service provision, in response to the need to tackle self-harm rates as a broader approach to suicide prevention. In light of the NHS long-term plan (2019), it also serves as an example of how to develop and use a strategic co-production group, and work collaboratively with the voluntary, community and social enterprise sectors.