Who knows best? Understanding older people’s experience of emergency hospital admission

glasby-littlechildJon Glasby and Rosemary Littlechild

An extended version of this post was originally published on 4 October 2016 in the Policy Briefing section of Discover Society which is provided in collaboration with the journal Policy & Politics. The original post is available at http://discoversociety.org/2016/10/04/policy-briefing-who-knows-best-understanding-older-peoples-experience-of-emergency-hospital-admission/.

Every year, the NHS experiences more than 2 million unplanned hospital admissions for people over 65 (accounting for 68 per cent of hospital emergency bed days and the use of more than 51,000 acute beds at any one time).  With an ageing population and a challenging financial context, such pressures show no sign of abating – and the NHS is having to find ways of reducing emergency hospital admissions (in situations where care can be provided as effectively elsewhere).  Often, the assumption in policy and media debates seems to be that potentially large numbers of older people are admitted to hospital without really needing the services provided there, but because there is nowhere else for them to go or because other services are not operating effectively.    Continue reading

Tightrope walking: The future of political science

MFlinders-new-smallMatthew Flinders

This blog post was originally published on the OUPblog on 2 October 2016. The original post can be accessed at:  http://blog.oup.com/2016/10/future-political-science-impact-phase/

Imagine standing at the edge of a precipice. A combination of forces are pushing at your back, biting at your heels and generally forcing you to step into an unknown space. A long thin tightrope without any apparent ending stretches out in front of you and appears to offer your only lifeline. Doing nothing and standing still is not an option. You lift up your left foot and gingerly step out….

Such dramatic prose is rarely associated with the study of politics but it strikes me that the notion of being forced to walk a tightrope is strangely apt at the present time. Having spent the last three weeks travelling around Western Europe and contributing to debates and discussions about the future of political science it seems that, from Manchester to Milan, and from Prague to Porto, the discipline finds itself on the cusp of a distinctive new phase in its history.

Let us, for the sake of simplicity, refer to this as ‘the impact phase’ and define it as being marked by the imposition of external requirements to demonstrate the relevance and direct effects of scholarship beyond the lecture theatre and seminar room. What my recent travels have revealed is that although ‘the impact phase’ has emerged very rapidly and aggressively in the United Kingdom, it is emerging— albeit in a softer, less instrumental, ‘impact-lite’ version — as a key issue in a host of countries. Moreover, those countries are well aware of the UK’s historical role as a testing ground for New Public Management inspired reforms within higher education that frequently ripple-out across the world. Continue reading

Individualised disability funding in Australia and England – different design, same challenges

needham-and-dickinsonCatherine Needham, University of Birmingham and Helen Dickinson, University of Melbourne

In July 2016, the full national roll out began of Australia’s National Disability Insurance Scheme (NDIS).

This scheme, which has been piloted in several localities in the last three years, constitutes a major new investment in disability services in Australia. We have been undertaking research and writing on the implementation of NDIS and comparing it to our earlier research on personalisation and a critique of individual budgets and personalisation in English social care services. Continue reading

The Immorality of Innovation – the Tale of Social Impact Bonds

meghan-joy-john-shieldsMeghan Joy and Dr. John Shields

In a post sub-prime mortgage induced financial crisis, another financial tool that risks increasing precarity for those most vulnerable is becoming increasingly popular in a political climate of austerity.

 

Social Impact Bonds (SIBs) are a social policy tool that claims to solve complex policy problems, such as homelessness, unemployment, and recidivism, through the scientific methods of financial modelling. Actively supported by several governments worldwide – there are currently 54 projects in 13 countries – SIBs provide a mechanism to turn the risky behaviours of vulnerable individuals into a form of profit making for private impact investors. SIB projects target population groups, such as the homeless, troubled youth, and obese, whose problems result in costly use of emergency-oriented public services such as shelters, prisons, and hospitals. In this way, SIBs are positioned as preventative, allowing future savings on costly public programs. These savings, also known as impacts, outcomes, or results are measured for their social value created (Dowling & Harvie, 2014). The SIB instrument places a current price on anticipated social value based on the assessed future risk that participants will not be reformed. Risks become a reward as investors bet on the extent to which vulnerable people will be transformed.

Continue reading