Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
Occupational Therapy Team, Nottingham City Council, Nottingham, UK.
Health Soc Care Community. 2022 Nov;30(6):e5560-e5569. doi: 10.1111/hsc.13980. Epub 2022 Sep 1.
International health and social care systems are experiencing unprecedented pressure and demand. 'Single-handed care' initiatives seek to identify whether all or part of a homecare package involving more than one care worker can be safely reduced to a single worker. Little is known about these initiatives across local authorities. The aim of this study was to identify, describe and explain current processes and practices for single-handed care initiatives and double-handed homecare reviews. An electronic survey link was sent to each local authority with social care responsibilities in England. The questions covered a range of areas in relation to single-handed care processes and included a combination of pre-coded and free-text responses. Responses were received from 76 (50%) local authorities. Findings were that over 12,000 reviews were reported within a year with a median of 141 (IQR 45-280) from 53 authorities that provided figures. Reviews were usually led by a local authority occupational therapist. On average, 540 min was spent per review, including conducting and organising the review, documentation, and travel. In nearly half the authorities, double handed care remained at least partially in place following at least 80% of the reviews and remained wholly in place following at least 60%. Local authorities also reported some resistance from homecare providers when implementing single-handed care. The findings have confirmed anecdotal evidence that reviews of double-handed homecare packages are common practice within local authorities. Given the amount of time taken with these reviews, and paucity of evidence on outcomes for people receiving them, further research should evaluate this.
国际卫生和社会保健系统正面临前所未有的压力和需求。“单人护理”倡议旨在确定涉及多名护理人员的家庭护理包是否可以安全地减少到一名护理人员。目前，人们对地方当局的这些倡议知之甚少。本研究的目的是确定、描述和解释单人护理倡议和双人家庭护理审查的现行流程和做法。向英格兰有社会护理责任的每个地方当局发送了电子调查链接。这些问题涵盖了与单人护理流程相关的一系列领域，包括预编码和自由文本的组合回答。来自 76 个（50%）地方当局的回复。调查结果显示，在一年内报告了超过 12000 次审查，53 个提供数字的当局中有中位数为 141（IQR 45-280）。审查通常由地方当局的职业治疗师领导。平均而言，每次审查花费 540 分钟，包括进行和组织审查、记录和旅行。在近一半的当局中，至少在 80%的审查后，双人护理仍至少部分保留，在至少 60%的审查后仍完全保留。地方当局还报告称，在实施单人护理时，家庭护理提供者存在一些抵制。调查结果证实了一个传闻，即在地方当局中，双人家庭护理包的审查是常见做法。鉴于进行这些审查所花费的时间以及关于接受这些审查的人的结果的证据不足，应进一步研究这一点。
