title: Models of inter professional working for older people living at home: a survey and review of the local strategies of English health and social care statutory organisations.
abstract: BACKGROUND
  Most services provided by health and social care organisations for older people living at home rely on interprofessional working (IPW). Although there is research investigating what supports and inhibits how professionals work together, less is known about how different service models deliver care to older people and how effectiveness is measured. The aim of this study was to describe how IPW for older people living at home is delivered, enacted and evaluated in England.
  
  
  METHODS
  An online survey of health and social care managers across England directly involved in providing services to older people, and a review of local strategies for older people services produced by primary care organisations and local government adult services organisations in England.
  
  
  RESULTS
  The online survey achieved a 31% response rate and search strategies identified 50 local strategies that addressed IPW for older people living at home across health and social care organisations. IPW definitions varied, but there was an internal consistency of language informed by budgeting and organisation specific definitions of IPW. Community Services for Older People, Intermediate Care and Re-enablement (rehabilitation) Teams were the services most frequently identified as involving IPW. Other IPW services identified were problem or disease specific and reflected issues highlighted in local strategies. There was limited agreement about what interventions or strategies supported the process of IPW. Older people and their carers were not reported to be involved in the evaluation of the services they received and it was unclear how organisations and managers judged the effectiveness of IPW, particularly for services that had an open-ended commitment to the care of older people.
  
  
  CONCLUSIONS
  Health and social care organisations and their managers recognise the value and importance of IPW. There is a theoretical literature on what supports IPW and what it can achieve. The need for precision may not be so necessary for the terms used to describe IPW. However, there is a need for shared identification of both user/patient outcomes that arise from IPW and greater understanding of what kind of model of IPW achieves what kind of outcomes for older people living at home.
authors.affiliation: Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, AL10 9AB, UK. c.goodman@herts.ac.uk
authors.forename: Claire
authors.initials: C
authors.lastname: Goodman
authors.forename: Vari
authors.initials: V
authors.lastname: Drennan
authors.forename: Fiona
authors.initials: F
authors.lastname: Scheibl
authors.forename: Dhrushita
authors.initials: D
authors.lastname: Shah
authors.forename: Jill
authors.initials: J
authors.lastname: Manthorpe
authors.forename: Heather
authors.initials: H
authors.lastname: Gage
authors.forename: Steve
authors.initials: S
authors.lastname: Iliffe
mesh_terms: D000288:Administrative Personnel / Q000523:psychology*; D000328:Adult; D000368:Aged; D003153:Community Health Services / Q000458:organization & administration* / Q000592:standards; D004739:England; D019538:Health Care Surveys; D006299:Health Services for the Aged / Q000592:standards*; D006699:Home Care Services; D006801:Humans; D057187:Independent Living; D007400:Interprofessional Relations; D017146:Models, Organizational; D009313:National Health Programs; D010348:Patient Care Team / Q000458:organization & administration; D011320:Primary Health Care / Q000458:organization & administration; D036301:Qualitative Research; D012947:Social Work / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D000078329:Workforce