Choice, appropriateness and adequacy of care for older people: utilising patients and professionals views to identify future service improvements.


  • Emma Stanmore Lecturer in Nursing, School of Nursing, Midwifery and Social Work, University of Manchester, UK



Objectives: To explore the views of older patients and professionals on their experience of Intermediate Care Services and to utilise these views in future service improvements.Background: Intermediate care services have grown rapidly over the last ten years. Yet, it appears from the literature that despite the push for user involvement in the development of services, sparse attention has been given to the views of older people. Design: Qualitative, semi-structured interviews were undertaken, using theory triangulation of patients’ and professionals’ views.Subjects and setting: Twenty six focused interviews, each of 1 hour duration were carried out with patients and professionals from one Primary Care Trust in the Northwest of England. Participants were recruited from a total of 8 General Practices.Results: This paper reports on the themes associated with choice and appropriateness and adequacy of care.Conclusions: From the findings of the study, recommendations were implemented to ensure that the views of the participants were taken into account. Service changes included the funding of a specialist nurse to provide training in nursing homes to ensure continuity of care from hospital, to raise standards and to ensure a rehabilitative approach was employed. Generic rehabilitative support workers were also trained to enhance home care and provide rehabilitation at home. This study demonstrates the relevance of evaluating older peoples’ and professionals’ views within intermediate care to improve practice and to ensure that services are person-centred, rather than service-focused.


. Andrews, J., Manthorpe, J. & Watson R. (2004). Involving older people in intermediate care. Journal of Advanced Nursing 46 (3), 303-310.

. Petch. A. (2003). Intermediate Care: What do we know about older people’s experiences? York: Joseph Rowntree Foundation.

. Kaambwa, B., Bryan, S., Barton, P., Parker, H., Martin, G., Hewitt, G., Parker, S. & Wilson, A. (2008). Costs and health outcomes of intermediate care: results from five UK case study sites. Health & Social Care in the Community 16, 573-581.

. Department of Health. (2009). Intermediate Care – Halfway Home. London: Department of Health.

. Department of Health. (2002). National Service Framework for Older People Supporting Implementation Intermediate Care: Moving Forward. London: Department of Health.

. Department of Health. (2001). The National Service Framework for Older People. London: Department of Health.

. Department of Health. (2001). Shaping the Future NHS: Long Term Planning for hospitals and related services. London: Department of Health.

. Ebrahim, S. (2001). Proposals for Intermediate Care are Reinventing Workhouse Wards. British Medical Journal 323, 337-338.

. Cornes, M.L. & Clough, R. (2001). The Continuum of Care: older people’s experience of intermediate care. Education and Ageing 16, 179-202.

. Bowling, A. (2002). Research Methods in Health (2nd ed.). Maidenhead: Open University Press.

. Silverman, D. (2000). Doing Qualitative Research, A Practical handbook. London: Sage Publications.

. Pickard, S. & Glendinning, C. (2002). Caring for a relative with Dementia; the perceptions of carers and CPNs. Quality in Ageing 2, 3-11.

. Department of Health. (2001). Involving Patients and the Public in Healthcare – A Discussion Document. London: Department of Health.

. The Standing Nursing and Midwifery Advisory Committee. (2001). Caring for Older People: A Nursing Priority. London: Department of Health.

. Stanmore, E. & Waterman, H. (2007). Crossing professional and organizational boundaries: the implementation of generic rehabilitation assistants within three organizations in the northwest of England. Disability & Rehabilitation 29 (9), 751-759.





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