THE ESSENCE PROJECT

Support planning

Evidence

Challenging Behaviour and Learning Disabilities: Prevention and Interventions for People with Learning Disabilities Whose Behaviour Challenges [NG11]
The National Institute for Health and Care Excellence (NICE) National Institute for Health and Care Excellence, London. 2015

This guideline covers interventions and support for children, young people and adults with a learning disability and behaviour that challenges. It highlights the importance of understanding the cause of behaviour that challenges, and performing thorough assessments so that steps can be taken to help people change their behaviour and improve their quality of life. The guideline also covers support and intervention for family members or carers.

NICE has produced an easy read version for people with a learning disability.

Recommendations
This guideline includes recommendations on:

general principles of care
support and interventions for family members or carers
early identification of the emergence of behaviour that challenges
assessment
psychological and environmental interventions
medication
interventions for coexisting health problems and sleep problems
Who is it for?
Healthcare professionals, commissioners and providers in health and social care
Parents, family members or carers of children, young people and adults with a learning disability and behaviour that challenges

Related NICE guideline:
Appendix T: Health economic evidence – economic profiles Authors not listed

Community Development in Health: A Literature Review
Fisher B Health Empowerment Leverage Project, London. 2016

This literature review offers a brief background to the current state of play in the NHS and statutory services, and ideas that services more flexible, place-based services are likely to offer more effective and efficient outcomes. It then provides an overview of the nature of community development, its relationship to community health and to enhancing the responsiveness of commissioning of services. It brings together evidence which shows how communities can be supported to develop their own strengths and their own trajectories of development. It also examines the health benefits of community engagement, and identifies the limitations of some studies and where evidence that suggests poor outcomes or risks. It looks developing a business case, and what is already known of costs and benefits of community development. It finds that although it is difficult to express costs and benefits of community development in monetary terms, some effective techniques do exist. The evidence shows that community development helps to strengthen and increase social networks and therefore build up social capital. Evidence shows that they to contribute significantly to individual and to community health and resilience. Existing data also suggests that community development in health is cost-effective and provides good value for money. The review includes definitions of community development and key related concepts, including as asset-based approaches, co-production, social networks, social capital, and community capital.

Evidence to Inform the Commissioning of Social Prescribing
Centre for Reviews and Dissemination, University of York Centre for Reviews and Dissemination, York. 2015

Summarises the findings of a rapid appraisal of available evidence on the effectiveness of social prescribing. Social prescribing is a way of linking patients in primary care with sources of support within the community, and can be used to improve health and wellbeing. For the review searches were conducted on the databases: DARE, Cochrane Database of Systematic Reviews and NHS EED for relevant systematic reviews and economic evaluations. Additional searches were also carried out on MEDLINE, ASSIA, Social Policy and Practice, NICE, SCIE and NHS. Very little good quality evidence was identified. Most available evidence described evaluations of pilot projects but failed to provide sufficient detail to judge either success or value for money. The briefing calls for better evaluation of new schemes. It recommends that evaluation should be of a comparative design; examine for whom and how well a scheme works; the effect it has and its costs.

Falls Prevention: Cost-effective Commissioning
Public Health England Public Health England, London. 2018

A resource to help commissioners and communities provide cost-effective falls prevention activities.

Health Begins at Home
Family Mosaic Family Mosaic, London. 2013

This new pamphlet provides interim results at 6 months from a fascinating Family Mosaic research project being undertaken by the London School of Economics. It seeks to measure and test out the impact of their services, both as a social landlord and as a provider of housing-related care and support services, and ways in which they can improve the health and wellbeing of older residents whilst at the same time help reduce NHS costs in the areas they operate in. Initial findings suggest an annual saving of £860,000 to local health economies for the 597 participants alone. With a range of useful information and examples of prevention and reablement at work, read below.

Integrated Homes, Care and Support
Holland C, Garner I, O’Donnell J et a Extra Care Charitable Trust, Coventry. 2019

This report provides an overview of the research findings from the collaborative research project between Aston Research Centre for Healthy Ageing (ARCHA) and the ExtraCare Charitable Trust, collated by Professor Carol Holland, Centre for Ageing Research (C4AR), Lancaster University. This report extends the findings of the 2015 report, covering the period from 2012 to 2018. Throughout the report, the focus is on the benefits to residents generated through ExtraCare villages and schemes, including sustained improvements in markers of health and well-being for residents and subsequent cost implications for the NHS.

Mental Health Problems in People with Learning Disabilities: Prevention, Assessment and Management [NG54]
The National Institute for Health and Care Excellence (NICE) National Institute for Health and Care Excellence, London. 2016

This guideline covers preventing, assessing and managing mental health problems in people with learning disabilities in all settings (including health, social care, education, and forensic and criminal justice). It aims to improve assessment and support for mental health conditions, and help people with learning disabilities and their families and carers to be involved in their care.

Recommendations
This guideline includes recommendations on:

organising and delivering care
involving people in their care
prevention, including social, physical environment and occupational interventions
annual GP health checks
assessment
psychological interventions, and how to adapt these for people with learning disabilities
prescribing, monitoring and reviewing pharmacological interventions
Who is it for?
Healthcare professionals
Social care practitioners
Care workers
Education staff
Commissioners and service providers
People with learning disabilities and their families and carers

Related NICE guideline:
Appendix S: Health economic evidence –economic profiles Authors not listed

Social Prescribing and Health and Well-being
Welsh NHS Confederation Welsh NHS Confederation, Cardiff. 2017

This briefing paper sets out the important role that social prescribing has on the health and well-being of the population in Wales and highlights some of the social prescribing initiatives already in place which show how patients are benefiting from integrated, person-centred and non-medical services. The initiatives include the Valleys Steps programme which considers alternatives for seeking medical treatment for ongoing mental health issues; Gofal Community Food Co-ops, which provide opportunities for mental health patients to interact with members of the local community; and Care and Repair Cymru’s Warm Homes Prescription Scheme. It also highlights existing evidence which shows the effectiveness and cost effectiveness of social prescribing.

The economics of housing and health: The role of housing associations
Buck D, Simpson M, Ross S King's Fund, London. 2016

This report, based on work commissioned by the National Housing Federation from The King’s Fund and the New NHS Alliance, looks at the economic case for closer working between the housing and health sectors. The authors demonstrate how housing associations provide a wide range of services that produce health benefits, which can both reduce demand on the NHS and create social value.

The report concludes that there is no one piece of economic analysis that will persuade health providers or commissioners to work with or commission housing associations. However, the case studies in the report illustrate the economic benefits that housing association can provide through:

providing safe, decent homes that enhance wellbeing. This has health impacts that are valued, and can save the NHS money
alleviating the overall cost burden of illness and treatment
helping to offset and reduce costs of delivering health care to individuals
demonstrating cost-effectiveness in helping to meet the objectives of the NHS and of improving health more broadly
demonstrating the cost–benefits of their interventions in terms of the value of improvements to people’s health and savings to the NHS.
The report is one of a set of three commissioned by the National Housing Federation; the second report focuses on how housing associations can develop a business case that will be better understood by the health sector and the third explores how the health and housing sectors differ in their approach, language and terminology, roles, and use of evidence.

 Back to Organisational Framework


NIHR School for
Social Care Research