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A comparative overview of health and social care policy for older people in England and Scotland, United Kingdom (UK)

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posted on 2024-01-09, 15:46 authored by N Aujla, H Frost, B Guthrie, B Hanratty, E Kaner, A O'Donnell, ME Ogden, HG Pain, SD Shenkin, SW Mercer
Background: Responsibility for health and social care was devolved to Scotland in 1999 with evidence of diverging policy and organisation of care compared to England. This paper provides a comparative overview of major health and social care policies in England and Scotland published between 2011 and 2023 relating to the care of older people. Methods: We searched United Kingdom (UK) and Scotland government websites for macro-level policy documents between 2011 and 2023 relating to the health and social care of older people (aged 65+). Data were extracted and emergent themes were summarised according to Donabedian's structure-process-outcome model. Results: We reviewed 27 policies in England and 28 in Scotland. Four main policy themes emerged that were common to both countries. Two related to the structure of care: integration of care and adult social care reform. Two related to service delivery/processes of care: prevention and supported self-management and improving mental health care. Cross-cutting themes included person-centred care, addressing health inequalities, promoting use of technology, and improving outcomes. Conclusion: Despite differences in the structure of care, including more competition, financial incentivization, and consumer-based care in England compared to Scotland, there are similarities in policy vision around delivery/processes of care (e.g. person-centred care) and performance and patient outcomes. Lack of UK-wide health and social care datasets hinders evaluation of policies and comparison of outcomes between both countries.

Funding

NIHR Applied Research Collaboration - North East and North Cumbria (ARC NENC)

National Institute for Health Research

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Citation

Navneet Aujla, Helen Frost, Bruce Guthrie, Barbara Hanratty, Eileen Kaner, Amy O'Donnell, Margaret E. Ogden, Helen G. Pain, Susan D. Shenkin, Stewart W. Mercer, A comparative overview of health and social care policy for older people in England and Scotland, United Kingdom (UK), Health Policy,Volume 132, 2023,104814, ISSN 0168-8510, https://doi.org/10.1016/j.healthpol.2023.104814.

Author affiliation

School of Psychology and Vision Sciences, University of Leicester

Version

  • VoR (Version of Record)

Published in

Health Policy

Volume

132

Pagination

104814

Publisher

Elsevier BV

issn

0168-8510

eissn

1872-6054

Acceptance date

2023-04-03

Copyright date

2023

Available date

2024-01-09

Spatial coverage

Ireland

Language

eng

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