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CGA in Primary Care Settings: Involving Social Services </div> </h1> <span property="dc:title" content="9. CGA in Primary Care Settings: Involving Social Services" class="rdf-meta element-hidden"></span><span property="sioc:num_replies" content="0" datatype="xsd:integer" class="rdf-meta element-hidden"></span> <div class="resource-header-details"> <div class="card-resource-type-i"> <div class="card-resource-type"> Good practice guide </div> <div class="resource-type-i-icon">i</div> <div class="resource-type-info-arrow"></div> </div> <div class="resource-type-info"><div class="resource-type-info-text">Good practices guides focus on providing information on a clinical topic.</div></div> </div> <div class="node-header-details"> <div class="card-authors-wrapper"><div class="label">Authors:</div><div class="author-details">British Geriatrics Society</div></div> <div class="card-topics-wrapper"><div class="label">Topics:</div><a href="/taxonomy/term/2935">Comprehensive Geriatric Assessment (CGA) in community settings</a></div> <div class="node-header-dates"> <div class="card-date-wrapper"><div class="label">Date Published:</div><div class="card-date"> <span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2019-01-28T00:00:00+00:00">28 January 2019</span> </div> </div> <div class="card-date-updated"> <div class="label">Last updated: </div> <span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2019-01-28T00:10:00+00:00">28 January 2019</span> </div> </div> </div> </div> <div class="view view-sections view-id-sections view-display-id-main view-dom-id-46ac6c867674a92bbeb1c29a3074f5aa"> <div class="view-content view-content-main"> <div class="views-row views-row-1 views-row-odd views-row-first views-row-last section-row palette-default "> <div class="section-inner"> <div class="card-body"> <p>A comprehensive assessment needs to consider the impact of social factors on the health and wellbeing of individuals and vice versa. The connections between their social circumstances, improved health outcomes and a sense of wellbeing may not be visible to the individual, nor to the professionals unless there is a full picture and joint development of the care and support needs, considering all the interdependencies and the wishes of the individual. </p> <p>Closer integrated working with Health and Social Care would enable information sharing - saving time and reducing the consequences of poor communication. Putting the patients and their informal carers at the centre of this assessment and allowing sharing of the information with any health and social care professional with whom they come into contact should be supported. This would create a truly patient-centred resource and stop the repetition of information-giving that is a frequent source of discontent amongst patients and their carers.</p> <p>Readers need to be mindful of the differences in the legislative frameworks supporting health and social care delivery across the 4 countries of the UK when reading this page. These have similar aims but key differences. Their application and levels of integration can influence the ease with which the delivery of a single assessment can be achieved. More information can be found about these frameworks below.</p> <p>Regardless of the legislative framework there is a general consensus of what good practice in supporting people with frailty should look like. </p> <p>With new duties being placed on health and social care, the development of integrated working with shared information systems and processes is essential. This may also require that professionals not only share information but trust colleagues' information and undertake some of each other's parts of the assessment where this makes sense. </p> <p>The health and social care legislation differs in the four nations of the UK:</p> <h2 class="sidebar-nav">Wales</h2> <p>The <a href="http://www.legislation.gov.uk/anaw/2014/4/pdfs/anaw_20140004_en.pdf" rel="nofollow">Social Services and Well-being (Wales) Act 2014</a> contains some distinct differences in duties around assessment and information. </p> <h2 class="sidebar-nav">Northern Ireland</h2> <p>Northern Ireland are making changes to their health and social care system under a programme called <a href="http://www.transformingyourcare.hscni.net/" rel="nofollow">Transforming your care</a>.</p> <h2 class="sidebar-nav">Scotland</h2> <p><a href="http://www.gov.scot/Topics/Health/Policy/Adult-Health-SocialCare-Integration/About-the-Bill" rel="nofollow">Public Bodies (Joint Working) (Scotland) Act 2014</a></p> <ul> <li>Nationally agreed outcomes, which will apply across health and social care, and for which NHS Boards and Local Authorities will be held jointly accountable</li> <li>A requirement on NHS Boards and Local Authorities to integrate health and social care budgets</li> <li>A requirement on Partnerships to strengthen the role of clinicians and care professionals, along with the third and independent sectors, in the planning and delivery of services</li> <li>Partnerships will be jointly accountable to Ministers, Local Authorities, NHS Board Chairs and the public for delivering the nationally agreed outcomes.</li> </ul> <h2 class="sidebar-nav">England</h2> <p>The Care Act 2014 (England) places a statutory duty on local authorities to:</p> <ul> <li>Carry out an assessment of anyone who appears to require care and support, regardless of their likely eligibility for state-funded care.</li> <li>Focus the assessment on the person’s needs and how they impact on their wellbeing, and the outcomes they want to achieve.</li> <li>Involve the person in the assessment and, where appropriate, their carer or someone else they nominate.</li> <li>Provide access to an independent advocate to support the person’s involvement in the assessment if required</li> <li>Consider other things besides care services that can contribute to the desired outcomes (e.g. preventive services, community support).</li> </ul> <p>Use the new national minimum threshold to judge eligibility for publicly funded care and support. </p> <h2 class="sidebar-nav">Further Reading</h2> <p>See <a href="https://www.nice.org.uk/guidance/ng22" rel="nofollow">NICE guidance</a> regarding social care needs for older people with one or more long term conditions.</p> </div> <div class="card-view-4"> <div class="view view-attachment view-id-attachment view-display-id-main view-dom-id-8869ea6946b2eb18ae4a27788952cdae"> </div> </div> </div> </div> </div> </div> </article> </div> <div class="content-additional"> 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class="view view-sections view-id-sections view-display-id-sidebar view-dom-id-8bb0ab6617794f8488138b3ccc54758b"> <div class="view-content view-content-main"> <div class="views-row views-row-1 views-row-odd views-row-first side-row "> <div class="section-inner"> <div class="card-title"> <h2 class="field-content">Section 1: CGA in Primary Care</h2> </div> <div class="side-row-wrapper"> <div class="card-body"> <p><a href="/resources/1-cga-in-primary-care-settings-introduction">Introduction</a><br /> <a href="/resources/2-cga-in-primary-care-settings-the-elements-of-the-cga-process">The elements of CGA</a>:<br /> - <a href="/resources/3-cga-in-primary-care-settings-physical-assessment">Physical assessment</a><br /> - <a href="/resources/4-cga-in-primary-care-settings-functional-and-social-assessment">Functional, social and environmental assessment</a><br /> - <a href="/resources/5-cga-in-primary-care-settings-psychological-components">Psychological components</a><br /> - <a href="/resources/6-cga-in-primary-care-settings-medication-review">Medication review</a><br /> - <a href="/resources/7-cga-in-primary-care-settings-creating-a-problem-list">Creating a problem list</a><br /> <a href="/resources/8-cga-in-primary-care-settings-care-and-support-planning">Care and support planning</a><br /> <strong>Involving Social Services (you are here)</strong></p> </div> </div> </div> </div> <div class="views-row views-row-2 views-row-even views-row-last side-row "> <div class="section-inner"> <div class="card-title"> <h2 class="field-content">Section 2: Specific Presentations</h2> </div> <div class="side-row-wrapper"> <div class="card-body"> <p><a href="/resources/10-cga-in-primary-care-settings-patients-presenting-with-mobility-and-balance-issues">Mobility and balance</a><br /> <a href="/resources/11-cga-in-primary-care-settings-bone-health">Bone health</a><br /> <a href="/resources/12-cga-in-primary-care-settings-patients-at-risk-of-falls-and-fractures">Falls</a><br /> <a href="/resources/13-cga-in-primary-care-settings-patients-presenting-with-depression">Depression</a><br /> <a href="/resources/14-cga-in-primary-care-settings-patients-presenting-with-confusion-and-delirium">Confusion/delirium</a><br /> <a href="/resources/15-cga-in-primary-care-settings-mental-capacity-issues">Mental capacity</a><br /> <a href="/resources/16-cga-in-primary-care-settings-patients-presenting-with-urinary-incontinence">Urinary incontinence</a><br /> <a href="/resources/17-cga-in-primary-care-settings-weight-loss-and-nutrition-issues">Weight loss and nutrition</a><br /> <a href="/resources/18-cga-in-primary-care-settings-end-of-life-care-issues">End of life care</a></p> </div> </div> </div> </div> </div> </div> </section> </div> </aside> </div> </main> <section class="postscript-first"> <div class="postscript_first"> <section class="block block-views postscript-section-row-block"> <h2 class="block-title">Other resources in this series</h2> <div class="view view-resource-series view-id-resource_series view-display-id-block section-row row-max-4 view-card-default-palette view-dom-id-f8a1f7aa05e4bc746fd9fe78bf6989f0"> <div class="view-content view-content-main"> <div class="views-row views-row-1 views-row-odd views-row-first"> <a class="card resource-card" href="/cgatoolkit"><div class="card-text"><div class="card-content"> <div class="card-title"> <h3>1. CGA in Primary Care Settings: Introduction</h3> </div> <div class="card-date-display-override"> <span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2019-01-28T00:00:00+00:00">28 Jan 2019</span> </div> <div class="card-summary"> <div class="card-summary-wrapper"> <div class="card-summary"> An introduction to CGA in primary care settings. This toolkit was developed by the British Geriatrics Society and has been endorsed by the ANCD for Older People and Integrated Person-Centred Care and by the Council of British Geriatrics Society, Scotland. </div> </div> </div> </div><div class="card-footer"> <div class="card-resource-series"> In a series </div> <div class="card-resource-type"> Good practice guide </div> </div></div></a> </div> <div class="views-row views-row-2 views-row-even"> <a class="card resource-card" href="/resources/2-cga-in-primary-care-settings-the-elements-of-the-cga-process"><div class="card-text"><div class="card-content"> <div class="card-title"> <h3>2. CGA in Primary Care Settings: The elements of the CGA process</h3> </div> <div class="card-date-display-override"> <span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2019-01-28T00:00:00+00:00">28 Jan 2019</span> </div> <div class="card-summary"> <div class="card-summary-wrapper"> <div class="card-summary"> An overview of how Comprehensive Geriatric Assessment (CGA) is done in the primary care setting, and what to consider when conducting the assessment. </div> </div> </div> </div><div class="card-footer"> <div class="card-resource-series"> In a series </div> <div class="card-resource-type"> Good practice guide </div> </div></div></a> </div> <div class="views-row views-row-3 views-row-odd"> <a class="card resource-card" href="/resources/3-cga-in-primary-care-settings-physical-assessment"><div class="card-text"><div class="card-content"> <div class="card-title"> <h3>3. CGA in Primary Care Settings: Physical Assessment </h3> </div> <div class="card-date-display-override"> <span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2019-01-28T00:00:00+00:00">28 Jan 2019</span> </div> <div class="card-summary"> <div class="card-summary-wrapper"> <div class="card-summary"> Examination of older patients incorporates all the typical aspects of clinical examination, although there are some general considerations and emphases that should be borne in mind, and specific examinations that may be more relevant in older people. </div> </div> </div> </div><div class="card-footer"> <div class="card-resource-series"> In a series </div> <div class="card-resource-type"> Good practice guide </div> </div></div></a> </div> <div class="views-row views-row-4 views-row-even views-row-last"> <a class="card resource-card" href="/resources/4-cga-in-primary-care-settings-functional-and-social-assessment"><div class="card-text"><div class="card-content"> <div class="card-title"> <h3>4. CGA in Primary Care Settings: Functional and social assessment</h3> </div> <div class="card-date-display-override"> <span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2019-01-28T00:00:00+00:00">28 Jan 2019</span> </div> <div class="card-summary"> <div class="card-summary-wrapper"> <div class="card-summary"> Functional assessment examines factors like mobility and daily living activities, and social assessment looks at social circumstances. Asking what the older person does and what environment they live in adds context to any Comprehensive Geriatric Assessment. </div> </div> </div> </div><div class="card-footer"> <div class="card-resource-series"> In a series </div> <div class="card-resource-type"> Good practice guide </div> </div></div></a> </div> </div> <div class="view-footer"> <div class="card-feed-link"><a href="/resources/resource-series/comprehensive-geriatric-assessment-toolkit-for-primary-care-practitioners">See all resources in this series</a></div> </div> </div> </section> <section class="block block-views postscript-section-row-block"> <h2 class="block-title">You may also be interested in</h2> <div class="view view-resource-series view-id-resource_series view-display-id-related_auto_manual view-dom-id-4342a360ba3f341241ae91c5c5e57835"> <div class="view-content view-content-main"> <div class="views-row views-row-1 views-row-odd views-row-first views-row-last"> <div class="card-views-conditional"> <div class="view view-resource-series view-id-resource_series view-display-id-related section-row row-max-4 view-card-default-palette view-dom-id-fcbbcfbf22179340ccd8d96bfe228397"> <div class="view-content view-content-main"> <div class="views-row views-row-1 views-row-odd views-row-first"> <a class="card resource-card" href="/resources/7-cga-in-primary-care-settings-creating-a-problem-list"><div class="card-text"><div class="card-content"> <div class="card-title"> <h3>7. CGA in Primary Care Settings: Creating a problem list</h3> </div> <div class="card-date-display-override"> <span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2019-01-28T00:00:00+00:00">28 Jan 2019</span> </div> <div class="card-summary"> <div class="card-summary-wrapper"> <div class="card-summary"> Creating a problem list as part of Comprehensive Geriatric Assessment can help identify all the issues to consider and will be helpful in drawing up a care plan. </div> </div> </div> </div><div class="card-footer"> <div class="card-resource-series"> In a series </div> <div class="card-resource-type"> Good practice guide </div> </div></div></a> </div> <div class="views-row views-row-2 views-row-even"> <a class="card resource-card" href="/resources/5-cga-in-primary-care-settings-psychological-components"><div class="card-text"><div class="card-content"> <div class="card-title"> <h3>5. CGA in Primary Care Settings: Psychological components</h3> </div> <div class="card-date-display-override"> <span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2019-01-28T00:00:00+00:00">28 Jan 2019</span> </div> <div class="card-summary"> <div class="card-summary-wrapper"> <div class="card-summary"> Depression among the over-65s is often under-recognised, so CGA is not complete without assessing mental health. The assessment conversation also offers an opportunity to identify cognitive dysfunction which may be a sign of dementia or delirium. </div> </div> </div> </div><div class="card-footer"> <div class="card-resource-series"> In a series </div> <div class="card-resource-type"> Good practice guide </div> </div></div></a> </div> <div class="views-row views-row-3 views-row-odd"> <a class="card resource-card" href="/resources/6-cga-in-primary-care-settings-medication-review"><div class="card-text"><div class="card-content"> <div class="card-title"> <h3>6. CGA in Primary Care Settings: Medication review</h3> </div> <div class="card-date-display-override"> <span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2019-01-28T00:00:00+00:00">28 Jan 2019</span> </div> <div class="card-summary"> <div class="card-summary-wrapper"> <div class="card-summary"> Medication review is a core component of CGA. Older patients can have indications for multiple medications, some of which may be based on sound evidence, but others may do more harm than good. The evidence base for guideline based prescribing may not be so relevant to frail older people. </div> </div> </div> </div><div class="card-footer"> <div class="card-resource-series"> In a series </div> <div class="card-resource-type"> Good practice guide </div> </div></div></a> </div> <div class="views-row views-row-4 views-row-even views-row-last"> <a class="card resource-card" href="/resources/8-cga-in-primary-care-settings-care-and-support-planning"><div class="card-text"><div class="card-content"> <div class="card-title"> <h3>8. CGA in Primary Care Settings: Care and support planning</h3> </div> <div class="card-date-display-override"> <span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2019-01-28T00:00:00+00:00">28 Jan 2019</span> </div> <div class="card-summary"> <div class="card-summary-wrapper"> <div class="card-summary"> A reference guide to care and support planning within Comprehensive Geriatric Assessment for primary care and community clinicians, including the recommended components and tips for creating a care plan. </div> </div> </div> </div><div class="card-footer"> <div class="card-resource-series"> In a series </div> <div class="card-resource-type"> Good practice guide </div> </div></div></a> </div> </div> </div> </div> </div> </div> </div> </section> </div> </section> <footer id="site-footer" role="contentinfo"> <section class="footer-first"> <div class="outer-wrapper"> <section class="block block-views"> <div class="view view-footer-sections view-id-footer_sections view-display-id-orgs view-display-grid view-dom-id-f8b841879f1734af42984c3d3cee75be"> <div class="view-header"> <script> if(jQuery('#Main.CRM_Contribute_Form_Contribution_Main').length > 0){ jQuery('#Main.CRM_Contribute_Form_Contribution_Main').on('submit',function(e){ setTimeout(function(){ e.preventDefault(); 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