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

Abstract

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.