older person care in scotland

Outcomes in Integrated Older Person Care in Scotland: Hospital Discharge Planning

Project reference number: HLSLTC0019

Background

The Public Bodies (Joint Working) (Scotland) Act 2014 set the framework for integrating adult health and social care, to ensure a consistent provision of quality, sustainable care services for the increasing numbers of people in Scotland who need joined-up support and care. The evidence base in relation to the integration of adult health and social care is currently underdeveloped. Work to date has primarily focused on the processes of integration. The empirical work proposed here will provide invaluable insights into the processes and practices of assessment (including barriers and enablers) and outcomes for service users.

Aims

This project aims to contribute to the evidence base underpinning the integration of adult health and social care. The proposed project will explore the processes and outcomes of integration for older person care with a particular focus on discharge planning. Across the four jurisdictions of the UK, hospital discharge planning has been the focus of sustained political concern for some time. Within Scotland, the political importance and urgency of this matter has situated ‘discharge planning’ as a ‘high tariff’ concern of the ‘integration agenda’. This recognises and responds to evidence from research which as demonstrated the negative impact that delayed or premature discharge can have upon patient outcomes. Outcomes are considerably worse for older people with complex needs who have been identified as more vulnerable to the consequences of delayed discharge or premature discharge. Considerable resource allocation has been diverted towards the process of discharge in an attempt to improve both process and outcomes.

The evidence base in this area is however currently underdeveloped. Whilst the consequences of delayed and premature discharge have been understood from a quantitative / outcomes perspective, ‘deep analysis’ of the discharge planning process and the experiences of service users, carers and families is relatively absent. Accessing knowledge of this kind has been identified as particularly critical for the development of the current evidence base. The project will aim to provide a ‘deep’ understanding of the discharge process and outcomes. It will place as central the voices and experiences of service users, cares and their families and bring these into dialogue with the voices of professionals to develop a ‘deep’ understanding of these phenomena.

Methods

(1) Care pathway analysis
a. Case studies of 20 service users.
b. Two locality based sites.
c. 10 case studies per site.
(2) Ethnographic observation of discharge processes and practices.
(3) Qualitative Interviews with professionals, service users, carers and families.
(4) Secondary analysis of existing data relevant to the project aims within case study sites.
a. Analysis of patient records.
b. Case file analysis.

The study methods above are suggestive and can be adapted by the successful candidate and in collaboration with partners.

Application deadline

The application deadline for October intake is 1st of July.

Research supervisors

Candidates are encouraged to contact the following researchers for further details:

Modes of study

This project is available as a:

  • PhD: 3 years full-time or 4.5 years part-time.
  • 1 + 3 route to PhD: Undertaking MRes [1 year full-time or 2 years part-time] + PhD as above

Eligibility

Applicants will normally hold a UK honours degree 2:1 (or equivalent); or a Masters degree in a subject relevant to the research project. Equivalent professional qualifications and any appropriate research experience may be considered. A minimum English language level of IELTS score of 6.5 (or equivalent) with no element below 6.0 is required. Some research disciplines may require higher levels.

Specific requirements of the project

The successful applicant will need to demonstrate a rigorous understanding of the context of Health and Social Care Integration.

The successful applicant will be a qualified and registered health or social work professional, holding the minimum of a first degree (2:1 or above) and a relevant practice qualification. Previous experience of quantitative research methodology is desirable.