Priority 3 from the Setting priorities for social care research in Wales project

UNCERTAINTY: How can social care and health services, including the voluntary sector, work together more effectively to meet the needs of older people? (Priority 2)
Overall ranking	3
JLA question ID	0102/3
Explanatory note	Older people and carers wondered how hospitals and social care services could work together so that people are safe at home when discharged from hospital and/or there is better provision of intermediate rehab. Practitioners wanted more effective joint working across all sectors so that all the needs of older people could be better met – and everyone providing care for an older person would be talking to each other and know if their needs were being met. It is all interconnected - for example if someone’s home is cold – their health condition might get worse.
Evidence	Gonçalves‐Bradley DC, Lannin NA, Clemson LM, Cameron ID, Shepperd S. Discharge planning from hospital. Cochrane Database of Systematic Reviews 2016, Issue 1. Art. No.: CD000313. DOI: 10.1002/14651858.CD000313.pub5. ~ Briggs AM, Valentijn PP, Thiyagarajan JA, et al. Elements of integrated care approaches for older people: a review of reviews. BMJ Open 2018;8:e021194. doi: 10.1136/bmjopen-2017-021194 ~ Liljas AEM, Brattström F, Burström B, Schön P, Agerholm J. Impact of Integrated Care on Patient-Related Outcomes Among Older People – A Systematic Review. International Journal of Integrated Care. 2019;19(3):6. DOI: http://doi.org/10.5334/ijic.4632 ~
Health Research Classification System category	Generic health relevance

Extra information provided by this project
Original uncertainty examples	How social care can in many ways lead the way and inform health care. Instead of the other way around which is a presumption held by many. ~ How the citizen's outcomes can be met effectively through care provision and other community services ~ How can the different legislations [health and social care] marry up to provide appropriate support and enable older people meet their health and wellbieng and personal outcomes. ~ Greater integration of services between Health and Social Care ~ the provision of rehab beds in the community ( in care homes for example), offered the opportunity for my mother to optimise her abilities before returning home. This included intensive physio and OT support to bridge the gap between a long-term hospital stay and home. However these resources are limited
Submitted by	6 x carers, 9 x practitioners

Extra information provided by this project

Original uncertainty examples

How social care can in many ways lead the way and inform health care. Instead of the other way around which is a presumption held by many. ~ How the citizen's outcomes can be met effectively through care provision and other community services ~ How can the different legislations [health and social care] marry up to provide appropriate support and enable older people meet their health and wellbieng and personal outcomes. ~ Greater integration of services between Health and Social Care ~ the provision of rehab beds in the community ( in care homes for example), offered the opportunity for my mother to optimise her abilities before returning home. This included intensive physio and OT support to bridge the gap between a long-term hospital stay and home. However these resources are limited

Submitted by

6 x carers, 9 x practitioners

Project information
Project unique ID	0102
Project name	Setting priorities for social care research in Wales
Total number of uncertainties identified by this project.	35 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop	16 & 17 September 2020