Scope
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 the Ombudsman) in England, Wales, and Northern Ireland. The HSDR 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. More recently, NICE guideline [NG216] – Social work with adults experiencing complex needs published in 2022, identified the need to establish the effectiveness of different approaches to assessment for individuals with complex care and support needs, including barriers and facilitators to delivering these.
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 . 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 and care planning 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 as having disability or impairment
- evaluation of differences in accessing care assessments and receiving services, how care needs assessment and care planning processes 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
The NIHR is committed to actively and openly supporting and promoting equality, diversity and inclusion (EDI). All NIHR research proposals need to demonstrate that they have met the requirements of the Equality Act (2010) by embedding EDI throughout their research study, ensuring that 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; and being pregnant or on maternity leave. Applicants are expected to pay attention to populations that have been underserved, to conduct research in locations where the need is greatest, and to promote the inclusion of diverse participants.
General guidance
The HSDR Programme supports applied research with the aim of improving both health and social care services across the nation and is open to any appropriate methodological approaches to answer the proposed research question(s); the approach must be fully explained and justified. In order to enhance the success of a research proposal, a clear theory of change and pathway to impact, with links into the NHS and social care services delivery, is suggested. It is useful to consider in the research study design how outcomes could be scaled up to maximise impact and value for money across the NHS and social care services – the focus is on applied research with tangible impacts that improve the quality and organisation of health and social care services. This includes stakeholder engagement and the development of processes, tools and guidelines to strengthen workforce capacity.
Research proposals should be co-produced with national organisations, professional bodies, health and social care service professionals, and service users. Links with health and social care planners and professional bodies are required to ensure impact and scaling up of research findings to benefit the wider health and social care system.
The COVID-19 pandemic is having a significant impact across the health and social care system. As this research may be conducted during the COVID-19 response and recovery period, applicants should consider how the impact of the COVID-19 response and recovery may affect the deliverability of their research.