The organization, form and function of intermediate care services and systems in England: results from a national survey

This paper reports the results of a postal survey of intermediate care co-ordinators (ICCs) on the organization and delivery of intermediate care services for older people in England, conducted between November 2003 and May 2004. Questionnaires, which covered a range of issues with a variety of quantitative, ‘tick-box’ and open-ended questions, were returned by 106 respondents, representing just over 35% of primary care trusts (PCTs). We discuss the role of ICCs, the integration of local systems of intermediate care provision, and the form, function and model of delivery of services described by respondents. Using descriptive and statistical analysis of the responses, we highlight in particular the relationship between provision of admission avoidance and supported discharge, the availability of 24-hour care, and the locations in which care is provided, and relate our findings to the emerging evidence base for intermediate care, guidance on implementation from central government, and debate in the literature. Whilst the expansion and integration of intermediate care appear to be continuing apace, much provision seems concentrated in supported discharge services rather than acute admission avoidance, and particularly in residential forms of post-acute intermediate care. Supported discharge services tend to be found in residential settings, while admission avoidance provision tends to be non-residential in nature. Twenty-four hour care in non-residential settings is not available in several responding PCTs. These findings raise questions about the relationship between the implementation of intermediate care and the evidence for and aims of the policy as part of NHS modernization, and the extent to which intermediate care represents a genuinely novel approach to the care and rehabilitation of older people.

Libraries and open access: the implications of open-access publishing and dissemination for libraries in higher education institutions

This chapter discusses the consequences of open-access (OA) publishing and dissemination for libraries in higher education institutions (HEIs). Key questions (which are addressed in this chapter) include: 1. How might OA help information provision? 2. What changes to library services will arise from OA developments (particularly if OA becomes widespread)? 3. How do these changes fit in with wider changes affecting the future role of libraries? 4. How can libraries and librarians help to address key practical issues associated with the implementation of OA (particularly transition issues)? This chapter will look at OA from the perspective of HE libraries and will make four key points: 1. Open access has the potential to bring benefits to the research community in particular and society in general by improving information provision. 2. If there is widespread open access to research content, there will be less need for library-based activity at the institution level, and more need for information management activity at the supra-institutional or national level. 3. Institutional libraries will, however, continue to have an important role to play in areas such as managing purchased or licensed content, curating institutional digital assets, and providing support in the use of content for teaching and research. 4. Libraries are well-placed to work with stakeholders within their institutions and beyond to help resolve current challenges associated with the implementation of OA policies and practices.