Levels of integration and specialisation within professional community teams for people with dementia.
BACKGROUND
Delivering integrated and specialist mental health services for the growing population of older people with dementia in Britain is a key concern of the present government.


OBJECTIVE
To consider the nature of current practice among multi-disciplinary and single discipline health and social care teams providing a service to people with dementia and compare the quality of service offered.


METHODS
A postal survey of professional community teams in North West England, providing services to people with dementia. Responses were analysed according to a number of standards measuring service quality, developed from research and policy documents. A response rate of 59% yielded a final sample of 52 teams.


RESULTS
Multi-disciplinary teams scored more highly than single discipline teams on many of the measures used. Single discipline teams achieved a higher score on just one measure, culturally sensitive services. Generally teams were found to provide a more integrated, targeted and person-centred service, as measured in this study, compared with earlier findings. Teams performed less well on measures of flexibility and culturally sensitive provision.


CONCLUSIONS
These findings indicate some potential gains from integration, and highlight the level of work still needed to achieve it. Further research is needed to build on the structural and process measures used in this research in order that the costs and outcomes consequent upon these practices can be measured.
Abendstern
Michele
M
PSSRU, Faculty of Medicine and Human Sciences University of Manchester, Manchester, UK. michele.abendstern@manchester.ac.uk
Reilly
Siobhan
S
Hughes
Jane
J
Venables
Dan
D
Challis
David
D
D000368:Aged; D017028:Caregivers; D003153:Community Health Services / Q000592:standards; D003430:Cross-Sectional Studies; D019033:Delivery of Health Care, Integrated / Q000592:standards*; D003704:Dementia / Q000208:ethnology / Q000451:nursing*; D004739:England; D019538:Health Care Surveys / Q000379:methods; D006297:Health Services Accessibility / Q000592:standards; D006299:Health Services for the Aged / Q000592:standards; D006801:Humans; D020380:Needs Assessment / Q000592:standards; D010347:Patient Care Planning / Q000592:standards; D010348:Patient Care Team; D018802:Patient-Centered Care / Q000592:standards; D011787:Quality of Health Care / Q000592:standards; D013038:Specialization