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Purpose: This project/development paper outlines the development of an algorithm-based predictive model in England (the King's Fund's PARR tool) that uses routine data to identify people at risk of re-admission to hospital. It examines how the model, when linked with data collected from general practices, can and has been used as a method for organizing integrated care services in the home environment to vulnerable at-risk individuals. Context: The use of a 'combined predictive model' in the development of a community matrons intervention in Croydon PCT (a local health economy in South London, UK) to show how integrated health and social care services may respond quickly to meet the needs of at-risk patients. Data sources: Systematic literature review using international studies to summarise and assess the principal approaches to predicting risk within the health arena. Development of risk algorithm using routine data and assessment of the accuracy of the PARR software tool and Combined Predictive Model to identify patients most at risk of future emergency re-admission to hospital. Case description: Croydon PCT has been using the Combined Predictive Model in its virtual wards project whereby people identified by the model as having a very high risk of future hospitalisation are put on a 'virtual ward'. These people are provided with preventive care in their own homes by a multi-disciplinary team who use the systems, timetable and staffing of a hospital ward but without the physical building. Admission to the virtual ward is determined solely by the output of the Combined Predictive Model. Patients' risk scores are monitored over time and can be used to prompt the virtual ward staff to discharge patients when appropriate--and offer admission to a patient at higher risk. Conclusions: The improving accuracy of predictive risk modeling enables 'at-risk' individuals and populations to be identified prior to an emergency admission or acute episode. Health care systems, through integrated and multi-professional interventions, can potentially reduce hospitalisation rates and improve dependency. Discussion: Predictive risk modeling has great potential as a tool to enable the development of pro-active integrated care to vulnerable patients. However, the tool requires accurate and up-to-date public health and service utilisation data whilst the system needs to overcome professional and institutional boundaries to enable the necessary integrated care response. [ABSTRACT FROM AUTHOR]

This article examines the wealthier inhabitants of Croydon in the late sixteenth and early seventeenth centuries, focusing on differences in wealth, ownership of property and social relationships. Using wills and subsidy lists, four broad categories of people were identified: gentlemen, yeomen, tradesmen and craftsmen and widows. There was no simple gradation of wealth between these groups; although gentlemen were generally among the richest subsidy payers, yeomen and tradesmen could also figure. In terms of social relationships and the ownership of property, there were differences. Gentlemen tended to marry within their own social group, appoint other gentlemen as overseers in their wills and were more likely to own land outside Croydon. The social relationships of yeomen and tradesmen/craftsmen were more focused on the town itself, as were their land purchases. Two groups of individuals can therefore be seen, not one homogenous entity as some scholars have argued. [ABSTRACT FROM AUTHOR]

John Laing plc and Croydon in the UK, have created a £450 million regeneration programme. The first deal of its kind in the UK, this is a new model of public-private partnership, utilising an asset-backed urban regeneration vehicle into which Croydon Council will invest land and John Laing equity. This forms part of Croydon Council's regeneration aspirations, delivering sustainable facilities to benefit the entire community and supporting its ambitions to make Croydon a hub of living, retail, culture and business in south London and south east England. [ABSTRACT FROM AUTHOR]

The article discusses the ineffectivity of population screening on the prevention and control of tuberculosis (TB) in Croydon, England which emphasizes that it should be replaced with early diagnosis. It notes that only one case of TB is diagnosed by TB screening per 951 entrants screened and the three patients diagnosed are non-infectious. It furthers that close links with the agencies which are involved in the management of direct referral to TB nurses must be developed.

Perinatal mental health is a major concern among women of childbearing age. Women from a black and minority ethnic background are widely believed to have particular needs that are often not given the attention they deserve. NHS Croydon launched a perinatal mental health project to develop a closer and better partnership between the Primary Care Trust (PCT), Croydon Council and black and minority ethnic (BME) voluntary organisations through an action learning approach. Experience was shared to improve engagement and use of health services by mothers from BME communities in Croydon who had encountered mental health problems during pregnancy or following childbirth. By exploring and identifying such issues and problems, the action learning set endeavoured to find solutions for a joined-up approach to achieve identifiable benefits. Some problems were encountered, such as a lack of communication between health professionals and BME community groups. The learning outcomes were to raise awareness and to recognise the cultural differences with mothers of BME background experiencing perinatal mental health problems. The learning from the project will be disseminated to a wider audience to promote best practice. [ABSTRACT FROM AUTHOR]

Objectives: The Croydon care home support team (CHST) was developed in response to reports of patient abuse within long-term care. It presents a novel strategy for improving standards of care within care homes. A qualitative methodology was used to assess the perceived impact of the CHST. Method: In-depth interviews were conducted with 14 care home managers and 24 members of care home staff across 14 care homes. Grounded theory principles guided the collection and analysis of the data. Results: Reports of improved communication between staff, improved staff development and confidence, and improved quality of care point towards the effectiveness of the CHST model. The collaborative approach of the CHST was considered pivotal to its success and presented as an effective method of engaging care home managers and staff. The CHST adopted a systemic approach that placed an equal emphasis on the social, mental health and nursing needs of residents and aimed to address the whole culture of care within the individual homes. Conclusions: The data demonstrate the potential for specialist multi-disciplinary teams to raise standards of care across long-term care settings. Increased awareness of safeguarding issues, improved staff morale and communication and ongoing opportunities for discussion and problem solving promised to sustain improvements. Such services could be instrumental in meeting the government priority of preventing abuse among vulnerable adults. [ABSTRACT FROM AUTHOR]

Focuses on the Lunar House for inspecting papers of aliens in Croydon, England. Registration with the General Medical Council; Efforts of doctors from overseas in waiting at the office; Immigration control for the National Health Service.