What does the future hold for intermediate care?

Abstract

Intermediate care (IC) is seen as a key element in government policy to reduce hospital waiting lists, it was developed to promote independence for older people by developing a range of integrated health and social care services fully networked into local hospital, community Health, social services and primary care services. It was specifically designed around the needs of older people to facilitate hospital discharges and prevent admissions in other words; it is a bridge between home and hospital. In some localities older people with mental health problems or varying degrees of cognitive impairment including dementia are deliberately being excluded from intermediate care. This is based on the assumption that older people with dementia cannot benefit from rehabilitation. The UK has an ageing population as a result of declines both in fertility rates and in the mortality rate. The older people population growth combined with the prevalence of dementia increasing with age has implications for local authorities, and to meet the challenges of an ageing society, and address the needs of all older people there needs to be a rethink in intermediate care service delivery. This study looks at planning and forecasting models that can be used to predict service demand and plan for future the future of IC. A total of seven authorities including Liverpool City Council (LCC) participated in this research. Interviews and surveys explored current service provision to determine what if any specialist intermediate care was available for older people with a diagnosis of dementia. It then went on to establish what if any planning and forecasting systems were being used by the authorities to assist in meeting the challenges of an ageing society. Results drawn from the data analysis showed that even among top performing authorities the approach to forecasting and forward planning is not very sophisticated, only a couple of authorities seem to be taking an objective, quantitative and systematic approach to determine future requirements in older peoples services.