Care management in social and primary health care: The gateshead community care scheme

This book provides an evaluation of the Gateshead Community Care Scheme which was devised as an alternative to residential and hospital care for frail elderly people. An important feature of the scheme was the decentralization of control of resources to individual social workers acting as care managers, with defined caseloads and expenditure limits to ensure accountability. The initial social social care scheme was subsequently extended to provide both health and social care to clients from a large general practice based in a health centre. The social care team was enlarged to include a nurse care manager and part-time doctor and physiotherapist. The study examines the operation of care management in both settings, the use of devolved budgets and services developed, the outcomes for clients and carers and the costs of care. Admissions to residential care were reduced and the elderly people who received the scheme's support experienced a better quality of care and greater well-being when compared with elderly people receiving the usual range of services. This was achieved at no greater cost. The characteristics of those for whom the scheme was most appropriate are described. In addition, the pattern of development of the scheme as it was incorporated into the mainstream of the Social Services and after the implementation of the NHS and Community Care Act are examined. Final, the implications for the development of care management are considered