HC Deb 28 March 1983 vol 40 cc36-7W
Mr. Alfred Morris

asked the Secretary of State for Social Services if he will list in the Official Report any subsequent research on the cost-effectiveness of different packages of care undertaken since those recorded in the third report from the Social Services Committee, Session 1979–80.

Mr. Geoffrey Finsberg

Recent findings of such studies supported by the Department include the following. Details of continuing research projects are given in the Department's annual Handbooks of Research and Development, copies of which are in the Library.

Subject Aspect of cost-effectiveness covered* Principal researchers(S) Summary of findings
1. Balance of care approach to the joint planning of resources in health and personal social services in East Sussex and Wiltshire HvPSS IvD Arthur Anderson and Co. in association with operational research service of DHSS Attempts to provide decision makers with a basis for deciding about the trade-off between different types of care within financial constraints. A main finding is the confirmation of the need to shift away from institutional care towards community care. Dramatic shifts towards community-based care can be achieved, however, only if substantial changes in operational policy and practice are implemented. These were outlined.
2. Kent community care project IvD HvPSS Personal social services research unit, university of Kent The cost of packages of care tailored to the needs of individual elderly people living in the community, but who might otherwise be living in residential accommodation. The research indicates that the packages of care being provided are similar in cost or slightly cheaper than either residential provision or conventional domiciliary provision. In addition clients of the scheme lived longer and were happier and safer in their own homes than comparable elderly people not receiving the scheme.
3. Report of a study on community care 1981 includes: long-term care of the elderly: (Annex B) considerations of cost effectiveness. IvD DHSS officials Little identifiable shift in the balance of care for those on margin between institutional and community-based care. Close health, PSS, voluntary and informal care collaboration is essential. Resource shifts are needed if more care to be provided in the community.
4. The Coventry home help scheme IvD Coventry SSD Ms Latto This study increased the role of home helps to include personal care and improved the methods of assessing clients and the number of home helps available. The study did not look at cost per se but looked at the alterations in resources needed to help support elderly people within their own homes when they had the benefit of the home help scheme. In general terms the findings showed a considerable increase in the need for relatively cheap resources such as mobile meals, day centre places, aids and adaptations and a decrease in expensive ones such as residential placements, district nurses and health visitors.
5. Comparison of the potential advantages and disadvantages of using community psychiatric nurses to follow up and care for patients suffering from chronic neurosis, a clinical area traditionally served by out-patient psychiatry. IvD E. Paykel S. Mangen J. Griffiths (St. George's medical school, Tooting) A. Burchell P. V. Mancini (DHSS) In a randomised controlled prospective trial, two groups of patients, one receiving care from community psychiatric nurses, the other traditional out-patient psychiatrist managements, were followed up over a period of 18 months. Data on clinical and social outcomes together with the costs falling upon the HPSS and the patient and his family were collected. The study revealed that clinical and social outcomes were comparable; consumer satisfaction was significantly greater among those receiving nursing care; and the costs of the two forms of care were not significantly different over an 18 month period.
* Health versus Personal Social Services (HvPSS).

Institutional versus Domiciliary Care (IvD).