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Title: Reshaping care for frail older people in Scotland : an outcomes-focused evaluation of telehealthcare services in Falkirk
Author: MacNamara, Gail Fraser
Awarding Body: Glasgow Caledonian University
Current Institution: Glasgow Caledonian University
Date of Award: 2012
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An increase in longevity has had a major impact on demographics in Scotland with the need to shift the balance and reshape care, specifically for older people. The aim of transforming services has been a priority for the Scottish Government following the publication of major health and social care policy documents (2005-2011). This research study aims to highlight how care has been reshaped at a local level in Falkirk, Central Scotland. There is a gap in the knowledge base regarding the impact of telehealthcare and complementary services in transforming service delivery at a local level. The aim of this study is to evaluate a specific service implemented at a local level to reshape care (the assessment and delivery of telehealthcare solutions to frail older people who are community dwellers in the Falkirk area of Scotland) in order to formulate recommendations at a local and government level regarding effective implementation of telehealthcare services in Scotland. The challenge to drive forward the policy agenda (e.g. anticipatory, proactive care services that encourage a self-managed approach to care) are highlighted in this empirical work. The challenge encompasses partnership working, unplanned hospital admission/readmission, delayed discharge, intermediate care, rehabilitation and reablement, the management of falls and the capacity of the workforce to manage transformational change. A purposive sample of multiple stakeholders (e.g. ten frail older people who are telehealthcare users. ten of their informal carers, six assessors and two technology providers) participated in the research study. Findings from the empirical work highlight that the prevention of falls and telehealthcare solutions allow frail older people to meet their defined outcomes and remain living independently in their own home, while reducing unplanned admissions to acute hospital services and speeding up the hospital discharge process. Other findings reveal that frail older people and their informal carers achieve peace of mind and reduced levels of anxiety once a telehealthcare service is in place and that this is a priority for both parties. Thus telehealthcare solutions are having a positive influence and are playing a part in changing service delivery and helping to reshape care in Falkirk. Recommendations are made to further develop/improve the implementation of te1ehealthcare services at both a local and Scottish Government level (e.g. improvement of the assessment process for telehealthcare, a need for more public awareness of the rapidly developing telehealthcare service, a culture change regarding self-managed care and the adoption of technology across health, social care aod in the public arena). Long-term strategic planoing is required at a local level to sustain and develop telehealthcare services, with strong leadership in place to guide and control the next steps as new technologies advance at a rapid rate. Finally, the impact the Professional Doctorate has had on the researcher's professional practice is discussed. The knowledge gained during the period of study and research has enhanced the researcher's contribution to the redesign of Falkirk Council Care & Support at Home Services and new Change Fund projects that will help to reshape care for frail older people.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Prof.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available