Service provision

Background: The inverse care law proposing that medical services are distributed inversely to population health needs, and that this law operates more completely where medical care is most exposed to market forces, was first suggested by Tudor Hart in 1971. This paper considers whether an inverse care law can be observed for the provision of informal care as well as for medical care.

Aim: Using data from the 2001 census we sought to investigate the contemporary relevance of the inverse care law.

Older people with dementia living in the community are most likely to be cared for by other older people, predominantly spouses, who will be at increased risk of stress‐related health problems themselves. Appropriate support of such carers is crucial if carer breakdown and consequent care‐receiver admission to residential homes is to be avoided. This paper examines the experience of older carers of frail older people with dementia and examines the kind of support that is provided to such carers.

Six million informal carers provide support for aged and disabled people in the United Kingdom. Government policies suggest that primary care teams are the main support for carers. This postal survey of 300 general practitioners (GPs) and 272 district nurses (DNs) aimed to determine current practice and views on their role in supporting informal carers. In practice, GPs and DNs lack time, resources, and training to provide support, and see themselves in a reactive role only.

The aims of the study were to summarise available research evidence, to identify key gaps in existing knowledge and to identify priorities for further research in the area of services to support carers. The literature review examined and summarised evidence from published and unpublished literature (both UK and international) between 1985 and 2001 about effective and cost-effective services to support carers.

This article outlines the findings and general implications of Mental Health Foundation research into the needs of older Asians with dementia and their carers. The project was carried out in an area with an Asian majority population in North West Kent. The focus is on the identification of need and on factors which block access to care and support. There are recommendations for practitioners and commissioners about raising awareness, service development and training. 

In 2009, The Social Care Institute for Excellence introduced guidelines for practitioners to support families in which parents have mental health problems. Here, SCIE presents a case study demonstrating how the guidance could be successfully applied. 

As part of its National Strategy for Carers, the Government developed and approved in 2000 a set of fixed quality standards for local services to support carers - family and friends looking after those who are sick, disabled, vulnerable or frail. How Good is Your Service to Carers? is designed to help individuals, local groups and service organisations assess how well they meet these quality standards, which cover: information, providing a break; emotional support; support to care for and maintain the carer's own health; having a voice.

Although both family care and home support are considered essential components of home-based health-care, the experiences of family caregivers who have a relative in receipt of home support services are not well understood. Little is known about what aspects of home support services assist family caregivers or hinder them in their caregiving. This study examines family member’s experiences of the home support services received by their elderly relatives.

Personalisation is now the driving agenda for adult social care and Putting People First recognises that increasing numbers of ordinary people will be called upon to contribute to care delivered in people’s own homes. Of the UK's six million carers, 1.3 million are already caring, unpaid, for over 50 hours a week. Carers have always wanted better outcomes for the people they care for. However, with many carers suffering poverty, ill health and isolation due to unsustainably heavy caring roles, they also want and deserve better outcomes for themselves.