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22/10 HSDR Adult Social Care Needs Assessment and Care Planning - commissioning brief


19 January 2022


1.0 - January 2022


Closing date: 1pm on 19 July 2022


The Health and Social Care Delivery Research (HSDR) Programme is calling for research to evaluate the effectiveness, implementation, and impact of social care needs assessment and care planning (as referred by Ombudsman) in England, Wales, and Northern Ireland. The Programme wants to fund research which will support improvements in timely, appropriate, holistic, and transparent social care needs assessments and care planning, which in turn will lead to improved support for those needing social care services. The programme is therefore, interested in receiving applications for cross-UK studies including natural experiments, aiming to produce generalisable and actionable findings. The main aim of this call is to deliver an evaluation of implementation, variation of practice and experiences of social care needs assessments and care planning. The experiences element relates to people who use these assessments such as people with disability, long-term illness, or mental health as well as the experiences of people who support those who use these assessments such as their friends, family, and carers.

Research to understand the application of eligibility criteria and impact on people with different care needs was identified as one of the top ten priorities in the 2018 James Lind Alliance (JLA) Priority Setting Partnership (PSP) on Adult Social Work. Further uncertainties raised by HSDR stakeholders concerned the reliability and validity of instruments used to determine social as opposed to health care needs.

Identified research need

Little is known about how assessments to determine a person’s eligibility for social care are being undertaken, what variations exists between local authorities and how this is impacting on access and outcomes for people in need of support. Charitable and non-profit organisations and individuals who draw on social care services, have noted variation in practice when assessments are undertaken both at local authority and practitioner level, long waiting times to access services, and levels of unmet need leading to increased use of secondary services (Unmet Needs, Improper Social Care Assessment for Older People in England)

A meta-analysis by Spiers et al suggests that adequate access to social care at home or in care homes has the potential to reduce demand on secondary health services amongst older adults. However, little evidence exists on the impact of availability of social care on primary care workload and activities.

Research in this area has the potential to optimise the quality and consistency of social care needs assessments and care planning across the UK. This will affect the experience of service users using these assessments and care planning including their support network, and health and care professionals delivering these assessments. Social care needs assessments and care planning approaches tailored to individual needs (rather than adoption of a standardised “one size fits all” approach) are likely to have a positive health impact and therefore will likely be beneficial to other parts of the health and care system.

Areas of interest

The HSDR Programme is likely to fund more than one study in this area, taking account of the following broad areas of uncertainty identified by stakeholders including social care practitioners, service leaders and those using care services. Research looking into experiences of self-funders and those funded by the local authority are both within the scope of this call.

Social care needs assessment practices and assessment tools

  • Improving the delivery of care needs assessment and care planning across the UK, reducing variations in access to assessment and improving consistency in decision-making
  • Comparison of costs and outcomes of care needs assessments and care plans undertaken by different local authorities including different geographies and localities such as rural and urban provision of assessments.
  • Reliability, validity and use of care needs assessment tools and models of strengths-based and holistic approaches to care needs assessments and care planning.
  • How needs assessment and care planning data are used and how they might support population needs at system or population level. How the data are used for planning and targeting services.

 Social workers and other professionals

  • Understanding the scope and role of social workers and other professionals involved in care needs assessments and care planning and the appropriate skill mix in assessment teams.
  • An exploration of how individual needs for social care change over time, optimal review intervals and what might prompt a revision of the care and support plan.
  • Evaluation of innovative approaches to reducing the length of care needs assessments, improving decision-making by social workers and others, and making assessment and care planning processes more transparent.
  • Understanding the interplay between processes for assessing needs and assessing means and their impact on individuals using care and support.
  • Approaches to joint assessment processes including relationships and interdependencies between social care and other types of assessments such as those under Mental Capacity Act and Mental Health Act.

 Experiences of individuals using care and support and their carers/families

  • Exploring the impact of provision of social care and support on families and carers, including use of other services such as emergency hospital admissions and wider wellbeing of the individual receiving care.
  • Approaches used during assessment to improve an individual’s support network (friends, family, neighbours), and their strengths, abilities, and knowledge.
  • Implications of handling finance and resource issues during the needs assessment and care planning process, including related areas such as eligibility for continuing health care.
  • Experiences of people with care and support needs and their carers of participating in assessment and care planning, including the level of input they have to the assessment and care planning process and the impact these have on uptake and access to services including any negative impact for individuals identified has having disability or impairment.
  • Evaluation of differences in accessing care assessments and receiving services, how care needs assessments and care planning process can be tailored to allow equitable access, especially for individuals with more complex needs from underserved communities.

There are no set methods or designs for research in this area, but research might take the form of longitudinal studies, using observational methods to track people in receipt of care, as well as case study methods. There is also likely to be a need to employ quantitative methods with a robust plan of analysis, synthesising all findings to provide a coherent output which will be actionable and generalisable.

Equality, diversity, and inclusion in research

The NIHR is committed to actively and openly supporting and promoting equality, diversity, and inclusion (EDI). All NIHR applications need to demonstrate they have met the requirements of the Equality Act (2010) by embedding EDI throughout the research proposal, ensuring there is no discrimination across the following domains:

  • age
  • disability
  • race, including colour, nationality, ethnic or national origin
  • religion or belief
  • sex
  • sexual orientation
  • gender reassignment
  • being married or in a civil partnership
  • being pregnant or on maternity leave.

Applicants are expected to pay attention to populations in locations with greatest need, socioeconomic disadvantage, which have disproportionately less access to health and social care services and are of an under researched area.

General guidance

The NIHR Health and Social Care Delivery Research programme supports applied research with the aim of improving health and social care services across the UK. It is open to any methodology, or combination of methods, appropriate to answer the proposed research question(s), and this must be fully explained and justified.

To enhance the success of a proposal a clear theory of change and pathway to impact with links into the NHS and social care is required. It is useful to consider in your study design how outcomes can be scaled up to maximise impact and value for money across the NHS and social care – the focus is on applied research with tangible impact on systems to improve the quality, accessibility and organisation of health and social care services. This also includes stakeholder engagement and the development of processes, tools, and guidelines to strengthen workforce capacity Further general information about the Health and Social Care Delivery Research Programme can be found there.

Research proposals should be co-produced with national organisations and professional bodies, health and social care service professionals, and individuals with lived experiences. Links with health and social care planners, commissioners and professional bodies is encouraged to facilitate the impact and scaling up of research findings to benefit the wider health and social care system. Applicants should consult the NIHR INVOLVE guidance on co-producing research.

The COVID-19 pandemic is having a significant impact across health and social care. As this research might be conducted during the COVID-19 response and recovery stage, the research should consider how the impact of COVID-19 response and recovery could affect how the proposed research will be conducted. Mitigating steps need to be set out to demonstrated deliverability and feasibility of the proposed work.