Older individuals are more likely to become ill with long term conditions, to have multiple diseases (multi-morbidity), to have disabilities associated with illnesses and to be admitted to hospital. Timely diagnosis, involvement in decision making and a co-ordinated health social care response, as well as involvement of individuals is crucial for both the wellbeing and independence of the patient and the cost-efficiency of health and social care services.
Providing care for individuals struggling at home or in care homes with a variety of physical and mental health problems is challenging for organisations and practitioners in the context of guidelines and teams based around individual diseases. Furthermore it is hard for individuals with disability and multi-morbidity to take charge of their own health and social care.
Timely diagnosis of long term conditions such as dementia and more acute conditions potentially leading to admission is a critical component of health care. Diagnosis is no longer the preserve of doctors and we need to explore how individuals, carers and other professionals as well as technology can assist in more timely diagnosis that makes a difference.
The University is uniquely placed in the southwest, with schools for many health and social care professionals, to become a centre for of excellence for the development of and study of integrated care. Building on several high quality projects we will work with our partners in the third sector and health and social care to develop innovative responses to the challenges of reducing the frustrations, wastage and avoidable admissions associated with poorly integrated care; and also ensure that a person centres approach - valuing individualised goals, self-care and involvement in decision making - is central to our work. Key approaches will include shared and ongoing individualised goals and plans, liaison and communication, co-location, sharing information.
Diagnosis and care
Timely diagnosis and integrated care for older people
