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The purpose of this paper is to present a framework for examining variation in care coordination arrangements for older people.

A multi-method approach was adopted combining analysis of secondary data and primary data. There were two stages: the development of the framework and its constituent attributes and indicators; and its validation from two perspectives: a meeting with managers and focus groups with practitioners. It was informed by an existing generic framework; subsequent policy guidance; data from an English national survey; previous research; and international literature.

The framework comprises 19 attributes each with indicators measuring performance relating to: organisational arrangements influencing service delivery; the performance of core tasks of care coordination; and differentiation within the process to distinguish between responses to different levels of need.

Care coordination arrangements in England are characterised by diversity. This paper provides a framework for evaluating local arrangements thereby highlighting strengths and where improvements are needed. It offers a means to promote programme fidelity. As such it has utility for both service commissioners and providers.

How resources for social care are allocated to individual service users has long been a concern. There are debates regarding the priority given to certain needs in Resource Allocation Systems (RASs). The purpose of this paper is to compare the views of adults with a learning disability and Directors of Adult Social Care regarding their priorities for resource allocation with priorities arising from observed resource allocation decisions.

In a consultation workshop, 12 adults with learning disabilities were asked to rank the perceived importance of eight needs-related outcomes. Directors of Adult Social Care completed an online questionnaire concerning the distribution of resources across the same eight outcomes. Actual resource allocation data from 11 local authorities were also modelled against these outcomes. A variable importance metric (the percentage contribution of each outcome to predicting costs) was used to rank the importance of these outcomes in terms of determining actual resource allocation. Findings from these data collections were compared.

There were discrepancies between the views of adults with a learning disability, the perspectives of Directors and actual resource allocation data. Whereas adults with a learning disability perceived psychological well-being as most important, Directors and actual resource allocation data stressed the importance of activities of daily living and carer burden.

This analysis will prove useful in understanding the concerns of adults with a learning disability and whether these are adequately addressed by current RASs.