We intended to gather management information into a single format that could inform and improve our performance across the partnership, bringing together health and social care information, to allow managers to work together to bring about change and re shape care in the area. We also developed and applied service user and carer questionnaires using the Talking Points approach.
Carer burn-out or extreme fatigue has often been anecdotally cited by carers themselves as the lead cause for the cared-for being moved on to institutional hospital care, often viewed as an avoidable hospital admission.
This can often lead to poor personal outcomes for both the cared-for and the carer. Tackling this in a preventative manner has allowed carers to retain their physical and mental well-being, supporting them in the longer term in their caring role.
Orkney Health and Care (OHAC) has been under development as an integrated health and social care partnership since November 2010. A restructure process has been undertaken to establish an integrated generic management structure, supported by a professional structure. Staff within teams have been integrated and new joined up ways of working are in place. An evaluation of the process and outcomes to date was undertaken in late 2013, with facilitation by the Scottish Social Services Council and NHS Education Scotland leadership development Action Learning Programme.
The early identification of carers in order to provide information and support before the caring role begins to have a negative impact on the health and wellbeing of the carer.
The aim was to identify carers at the point of hospital discharge, and to provide information and support to the carers of older people in Falkirk at this vital time at the start of their caring journey or when their caring role was changing.