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1 – 10 of 561Valentina Iemmi, Martin Knapp, Caroline Reid, Catherine Sholl, Monique Ferdinand, Ariane Buescher and Marija Trachtenberg
Positive behavioural support has been considered as a valuable alternative to residential care for children and adolescents with learning disabilities and behaviour that…
Abstract
Purpose
Positive behavioural support has been considered as a valuable alternative to residential care for children and adolescents with learning disabilities and behaviour that challenges. While recent evidence suggests it has a positive impact on behaviour and carer ability to cope, there is little evidence of its economic costs or benefits. The paper aims to discuss this issue.
Design/methodology/approach
An exploratory cross-sectional study was conducted to evaluate the cost of providing positive behavioural support to ten children and adolescents with learning disabilities and behaviour that challenges living in the community in Ealing, West London. Comparison was also made with the cost estimate of possible alternative support packages for children and adolescents with learning disabilities and behaviour that challenges in the UK, as obtained through a Delphi exercise.
Findings
Total cost of services per child was £1,454 per week for young people supported short-term, and £1,402 supported long-term. Children and adolescents were making use of a range of social care, education and health services. Over the full sample, half of the total cost was accounted for by education services. The Delphi exercise estimated the weekly cost of residential-based care as more expensive than the cost of community-based care for children and adolescents with learning disabilities and behaviour that challenges. At the end of the ITSBS, all ten children and adolescents initially at risk of imminent residential placement were living in the community with less service-intensive and less expensive support. This suggests that avoiding residential-based care could reduce costs in the long term.
Originality/value
Positive behavioural support has potential to support people with learning disabilities and behaviour that challenges in the community, leading to potential cost advantages. However, this is a small study and more robust research is needed.
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Rachael Frost, Kate Walters, Jane Wilcock, Louise Robinson, Karen Harrison Dening, Martin Knapp, Louise Allan and Greta Rait
Post-diagnostic dementia care is often fragmented in the United Kingdom, with great variation in provision. Recent policies suggest moving towards better community-based care for…
Abstract
Purpose
Post-diagnostic dementia care is often fragmented in the United Kingdom, with great variation in provision. Recent policies suggest moving towards better community-based care for dementia; however, little is known on how this care is delivered. This study aimed to map the post-diagnostic dementia support provided in England a decade after the introduction of a National Dementia Strategy.
Design/methodology/approach
A mixed-methods e-survey (open Nov 2018–Mar 2019) of dementia commissioners in England recruited through mailing lists of relevant organisations was conducted. The authors descriptively summarised quantitative data and carried out thematic analysis of open-ended survey responses.
Findings
52 completed responses were received, which covered 82 commissioning bodies, with representation from each region in England. Respondents reported great variation in the types of services provided. Information, caregiver assessments and dementia navigation were commonly reported and usually delivered by the voluntary sector or local authorities. Integrated pathways of care were seen as important to avoid overlap or gaps in service coverage. Despite an increasingly diverse population, few areas reported providing dementia health services specifically for BME populations. Over half of providers planned to change services further within five years.
Practical implications
There is a need for greater availability of and consistency in services in post-diagnostic dementia care across England.
Originality/value
Post-diagnostic dementia care remains fragmented and provided by a wide range of providers in England.
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It has proved useful in studies of the personal social services, and in other areas of social policy, to make a distinction between final and intermediate outputs. Final outputs…
Abstract
It has proved useful in studies of the personal social services, and in other areas of social policy, to make a distinction between final and intermediate outputs. Final outputs measure changes in individual client well‐being compared with changes in well‐being in the absence of a caring intervention. In other words, final outputs measure the degree of success of a service or a care unit in meeting its client‐level policy objectives, where due consideration is paid to client states had care not been available. In contrast, intermediate outputs are operationally defined in terms of the care services themselves rather than the effects of these services on clients.
Martin R.J. Knapp, Sarah Curtis and Ernestini Giziakis
The present range and character of child‐care services in Britain have evolved erratically over a long period of time. Structured by a succession of Acts of Parliament, shaped and…
Abstract
The present range and character of child‐care services in Britain have evolved erratically over a long period of time. Structured by a succession of Acts of Parliament, shaped and re‐shaped by the changing pattern of social values, needs and expectations, current provision is both complex and comprehensive. Statutory and voluntary bodies now provide preventive services, shelter and treatment for both the deprived and the delinquent, for the able‐bodied and the handicapped, for infants and for adolescents. Often this care will be provided in the child's own home or in a foster home, but at any one time roughly 40 per cent of the 120,000 children and young persons that are today the responsibility of local authorities will be resident in a children's home.
Paul Cambridge, John Carpenter, Jennifer Beecham, Angela Hallam, Martin Knapp, Rachel Forrester‐Jones and Alison Tate
This paper reports on the key findings of a study into the outcomes and costs of community care for a large cohort of people with learning disabilities, supported in 12 study…
Abstract
This paper reports on the key findings of a study into the outcomes and costs of community care for a large cohort of people with learning disabilities, supported in 12 study sites across England, who left various long‐stay hospital 12 years ago as part of a centrally monitored and evaluated government policy initiative on deinstitutionalisation. It represents the last follow‐up of a raft of linked longitudinal evaluations, conducted at four time points over a twelve‐year period. The paper identifies the findings from the last follow‐up and interprets and presents them as summary observations and trends in relation to the findings in learning disability, briefly reviewing them in relation to wider evidence on deinstitutionalisation and community care in England.
The rapid growth in the British public sector since the turn of the century, and particularly since the end of the last war, has been most noticeably experienced in the social…
Abstract
The rapid growth in the British public sector since the turn of the century, and particularly since the end of the last war, has been most noticeably experienced in the social services. By 1974, expenditure on the health, welfare, education, housing, and income maintenance services accounted for almost half of total expenditure, having grown at an average rate of exactly ten per cent per annum since 1951. Unfortunately, this growth has not been accompanied by an increased awareness of the need for socio‐economic monitoring and analysis of service provision. Only since the oil crisis of 1973, as cutback has followed cutback, and as central and local government administrators have been faced with the problem of increasing, or at least maintaining, output levels whilst input supplies have steadily fallen, has attention been focused upon efficiency and effectiveness.
This register of current research in social economics has been compiled by the International Institute of Social Economics. The register does not claim to be comprehensive but is…
Abstract
This register of current research in social economics has been compiled by the International Institute of Social Economics. The register does not claim to be comprehensive but is merely an aid for research workers and institutions interested in social economics. The register will be updated and made more comprehensive in the future but this is largely dependent on the inflow of information from researchers in social economics. In order to facilitate this process a standardised form is to be found on the last page of this register. Completed forms, with attached sheets as necessary, should be returned to the compiler: Dr Barrie O. Pettman, Director, International Institute of Social Economics, Enholmes Hall, Patrington, Hull, N. Humberside, England, HU12 OPR. Any other comments on the register will also be welcome.
Claire Curran, Martin Knapp and Jennifer Beecham
This paper brings together findings from current research into mental health and employment from an economic perspective. The economic impact of reduced employment and…
Abstract
This paper brings together findings from current research into mental health and employment from an economic perspective. The economic impact of reduced employment and productivity for people with mental health problems is described from both individual and societal viewpoints. Interventions reported to have an impact on employment are considered, looking at both clinical interventions that have reported employment outcomes and interventions that have as their primary target the improvement of employment outcomes. The paper also describes the impact of common mental health problems on employment and productivity and reports the findings of some studies in this area. However, the quantity and quality of economic information in this area are limited.
The objective of this paper is to focus on the evolution of development economics, both as an academic discipline and as a subject taught at both undergraduate and postgraduate…
Abstract
The objective of this paper is to focus on the evolution of development economics, both as an academic discipline and as a subject taught at both undergraduate and postgraduate levels, at the University of Manchester, from approximately the early‐1950s onwards. It is not a history or survey of development economics per se but concentrates rather on the richness and variety of the contributions made by a number of eminent economists while they were in the Department of Economics (since 1993, the School of Economic Studies), to both the development of theory and to empirical analysis and to policy prescription, and to the teaching of development economics. Only a limited account is given of the work of these economists once they were no longer in Manchester.
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Eric Emerson, Janet Robertson, Nicky Gregory, Chris Hatton, Sophia Kessissoglou, Angela Hallam, Martin Knapp, Krister Järbrink, Ann Netten and Patricia Walsh
This paper provides an overview of the main results of a Department of Health‐funded research project which investigated the quality and costs of residential supports for people…
Abstract
This paper provides an overview of the main results of a Department of Health‐funded research project which investigated the quality and costs of residential supports for people with learning disabilities. The main findings were that the adjusted costs of community‐based supports were higher than residential campuses and village communities; within community‐based provision there were no statistically significant differences between the adjusted costs of supported living, small group homes and group homes for 4‐6 people; community‐based provision and village communities offered better care than residential campuses; there appeared to be distinct benefits associated with community‐based provision and village communities; within community‐based provision there were benefits associated with smaller size and supported living arrangements.