Biomedical subjects

S Layzell

Publications and source records attributed to S Layzell.

4 recordsLinked to original sources

PubMed1999

Family support in general practice.

At a time when social services are overburdened in Britain, family support in general practice offers one way to fill the gap. In the Well Family Project, a 'family support coordinator' worked within a general practice in Hackney, London. In the first eighteen months she saw 113 clients. Evaluation was by semistructured interviews with a sample of these clients and with professional workers. Comments from those interviewed indicate that the family support was valued. The general practice base was convenient and non-stigmatizing. By adopting a proactive approach, the project was able to work with clients who had previously 'slipped through the net'. Some of the professionals interviewed would have liked to provide the same help, but were unable to do so because of time and other constraints. Family support provided through general practice was well received by vulnerable families. Although there was overlap with the remit of health visitors and social workers, the protected time and the independence of the coordinator enabled clients to obtain the help they wanted. The replicability of this strategy now needs to be assessed.

Adult↗

PubMed1993

Funding policies for HIV and AIDS: time for change.

Funding for HIV and AIDS in England has been allocated to regions by a formula based on the number of cases of AIDS and HIV infection and on population size. Regions have distributed the resources directly to hospitals and community services. A survey of staff and managers in North East Thames region showed that funding arrangements have led to unsatisfactory development of services for HIV and AIDS. Firstly, because hospitals are funded according to current numbers of patients services are highly developed at the central London hospitals and underdeveloped in outer districts. Secondly, specialised community care teams have been established rather than integrating care for HIV and AIDS into generic primary care. Thirdly, the information on district of residence of infected patients is inaccurate, limiting allocation of funds according to population needs. Fourthly, prevention of infection has been given far less attention than treatment and care despite the lack of effective treatment. In future allocations for HIV and AIDS should be made to purchasers rather than directly to providers.

Acquired Immunodeficiency Syndrome↗

PubMed1993

Specialist or generic community nursing care for HIV/AIDS patients?

Improved management of HIV-related illness means that patients spend over 80% of their time in non-institutional settings. Most community-based health care in the United Kingdom is provided by primary health care teams: general practitioners and community nurses, with support from social workers. However, in many areas specialist HIV services have assumed responsibility for the care of HIV/AIDS patients, and primary health care teams have only played a marginal role. Our study examined patterns of community nursing for HIV/AIDS patients in one regional health authority, North-East Thames (NETRHA). Interviews with 77 people in seven health districts included community nurse managers, clinical nurse specialists (CNS) HIV/AIDS and palliative care nurses. The appropriateness of different nursing models was assessed, taking into account the changing epidemiological and demographic profile of the disease, the influence of dedicated HIV funding, and the effect of recent British National Health Service reforms. Three models of care have developed in NETRHA: specialist HIV teams, individual CNS HIV/AIDS acting as a resource to generic staff, and care given by generic community nurses. Our work suggests that both generic community nurses and patients benefit from specialist input, and that this should be provided using CNSs HIV/AIDS in an advisory and facilitative capacity.

Acquired Immunodeficiency Syndrome↗

PubMed1992

Community-based health services for people with HIV/AIDS: a review from a health service perspective.

Health services for people with HIV/AIDS have been mainly hospital based, but it is now recognized that much care can be provided outside hospitals. There are well documented problems in delivering care in the community to other client groups such as the elderly and the mentally ill, but there are particular difficulties with HIV/AIDS care. These stem in part from the clinical demands of AIDS-related illnesses, but also from the stigma associated with the disease. This review looks at three key areas of relevance to those planning community-based health services for people with HIV/AIDS. These are: the need for collaboration between the statutory and voluntary sectors; the need for co-ordination between providers at the point of service delivery; and whether care should be provided by generic or specialist providers. While certain universal principles apply, and are necessary to ensure a good standard of care, patterns of service delivery will inevitably vary according both to the local prevalence rates and the existing service infrastructure. There is more than one good model of care; all models must be flexible enough to deal with needs on an individual basis.

Community Health Services↗