Intermediate care models in practice

By Barbara Vaughan and Judith Lathlean King's Fund 114 pages£7.95

This brief publication makes no bones about its intentions from the outset and delivers to an extent where many others fall short. If best practice is what you are after, rather than theory and design, this King's Fund publication will prove useful.

Part one covers a very brief, but clear, rationale for the growth in intermediary care. The reader would need to go a long way to find a simpler, yet more comprehensive, explanation of the movement.

Part two includes seven different models from all over the UK demonstrating alternative perspectives in the delivery of intermediary care. Key criteria for inclusion include that each service has been established for more than two years (implying they are sustainable), funding arrangements are explicit and some form of evaluation exists.

Part three includes two reports outlining approaches to the development of a strategy encompassing intermediate care as part of mainline services. A brave attempt indeed - the jury is still out on this issue.

It is in this arena that most work needs to be done; indeed, the King's Fund may well complement this series with a further publication devoted to this single area.

Others in the field should be encouraged to offer their solutions to this most difficult, yet necessary, duty of strategic planning between commissioners and providers.

Skipping part four for a moment, part five is a directory of more than 70 developments covering alternative approaches and acting primarily as a source of contacts and ideas.

A number of these programmes will have changed by the time of publication, but that would - and should - be in the nature of new service development.

Part four is perhaps the most interesting section of the book in terms of summarising the practical steps that need to be taken in implementing any new intermediate care solution.

The benefits this resume brings are both the clarity and insight into the main themes of communication and people skills - issues relevant in any area of service development.

One omission from this list was the part politics plays in so many of these activities. Though it is an evil we would all rather do without, it is nevertheless not one to be ignored.

In conclusion, a copy of this book for background reading and as reference material would be useful to any new group considering the design and implementation of intermediate care solutions.

Peter Buckley Director of service development, St Andrew's Hospital, Northampton.