scholarly journals Political representation and effects of municipal mergers

Author(s):  
Oskari Harjunen ◽  
Tuukka Saarimaa ◽  
Janne Tukiainen

AbstractWe study the effects of municipal mergers using novel geocoded data on local public sector jobs and local politicians' place of residence. We find that the mergers had no effects on municipal expenditures overall after eight years. However, the mergers led to highly unequal geographic political representation in the post-merger councils among the merged municipalities. Small and politically marginalized municipalities experienced a substantial reduction in local public jobs in administration and health and social care services relative to the municipalities with stronger representation. Development of house prices suggests that the quality of the service-tax bundle deteriorated in these politically marginalized municipalities.

2014 ◽  
Vol 22 (2) ◽  
pp. 51-61 ◽  
Author(s):  
Catherine Mangan ◽  
Robin Miller ◽  
Jeremy Cooper

Purpose – The purpose of this paper is to explore the relationship between general practitioners (GPs) and social care professionals by reflecting on a project (the Home Truths project) which sought to improve joint working between general practice and social care though an action-research process. Design/methodology/approach – iMPOWER's Home Truths project involved gathering local data regarding joint working in local areas and using this data as a catalyst for change. The Institute of Local Government Studies and the Health Services Management Centre at the University of Birmingham were asked to act as a critical friend to the project. This involved supporting the design of the data collection, offering advice on the process and to carrying out a short evaluation of the impact of the first wave. The paper reflects on the collected data from the sites and information from the impact evaluation. Findings – The paper highlights the poor quality of the relationship between GPs and social workers. Findings that illustrate this include GPs’ poor knowledge of social care services; a perception that social care services were of poor quality and rating the quality of their relationships with social workers as poor. However GPs felt that knowing more about social care could help prevent their patients going into residential care earlier than necessary and wanted to work more closely with social care to exploit the benefits and opportunities. The interventions that have been put in place to try and improve relationships focus on the day-to-day working lives of the professionals rather than attempting to introduce new initiatives. Research limitations/implications – The response rate from GPs in the areas was low (average response rate was 10 per cent in each area) and it may be that only those GPs who are interested in working with social care responded. The initiatives that have been developed appear to be reasonable responses to the issues identified. However, a lack of discrete outcomes through which to measure improvement will make it difficult to demonstrate the impact of the interventions. Originality/value – This paper underlines that despite many years of policy makers promoting better integration, the relationship between the key gate-keepers within the health and social care systems is still poor. The findings from the Home Truths surveys and action plans has gone some way to address the gap identified in the evidence base about the relationships between GPs and social workers.


2017 ◽  
Vol 41 (S1) ◽  
pp. S11-S12
Author(s):  
D.A. Castelli Dransart ◽  
S. Voélin ◽  
S. Elena

IntroductionIn some Swiss states, right-to-die associations are allowed to assist older people in nursing homes provided that certain requirements are fulfilled.ObjectivesTo investigate how health and social care providers and their institutions reacted to and dealt with requests of assisted suicide.MethodAn exploratory qualitative study was carried out in the States of Fribourg and Vaud among 40 professionals working in nursing homes, home care services or social welfare agencies.ResultsThe requests of assisted suicide questioned the professional mission, the quality of accompaniment provided to the older people and both professional and personal values. Health and social care providers were required to ponder over ethical dilemmas or decisions. Several challenges were reported, such as: taking into account and articulating personal freedom or needs with collective functioning or organizational constraints before, during and after the assisted suicide; reconciliating self-determination with protection towards vulnerable people (beneficere, non maleficere).ConclusionsAssisted suicide challenges and changes professional end-of-life practices. Education and support should be provided to health and social care providers faced with it.Disclosure of interestThe authors have not supplied their declaration of competing interest.


Author(s):  
Catherine Needham ◽  
Kerry Allen ◽  
Kelly Hall

Shifts to independent delivery of health and social care services has led to increased numbers of micro-enterprises. Could these tiny organisations with just 5 or fewer employees be the best way of delivering cost-effective health and social care services in the context of decreased budgets and increased demands? What size is 'just right' for a care provider? This book explores size as an independent variable in care services, comparing outcomes and value for money across micro, small, medium and large organisations. Using interviews and surveys with 108 people using services and careers in 27 case study organisations it focuses on the contribution micro-enterprise can make to the care sector. Findings indicate that the quality of service provided by small organisations does support the assumption of an affinity between being small and being personalised. Small and micro-enterprises can deliver more personalised services, particularly in the home. They also offer better outcomes than larger providers for a similar cost. However stability can be a problem for micro-enterprises, particularly those that employ staff and need to have a relatively consistent financial turnover. The Care Act 2014 creates a conducive policy environment for micro-enterprise, as local authorities must stimulate a diverse local market and facilitate personalisation of services. However the challenges of austerity are a powerful counterweight, discouraging the sorts of innovative and experimentation which would allow micro-enterprise to thrive.


2015 ◽  
Vol 23 (4) ◽  
pp. 232-249
Author(s):  
Christopher Edmunds ◽  
Kerry KilBride

Purpose The purpose of this paper is to recount 12 months of a pioneering collaboration between the Aneurin Bevan University Health Board, five local authorities and nine registered social landlords in South East Wales. It will aim to share the understanding that has emerged, demonstrating how a large number of agencies, many of which have different purposes or which have traditionally been in competition with each other, have been able to work collaboratively, to meet the interests of some very vulnerable people. Design/methodology/approach This reflective approach draws on the views of a large number of staff from each of the three constituent public sector service areas and their experience of collaborative working using action research principles. The study will use people’s own words to highlight real experiences, but analysed against similar collaborative activity elsewhere reflected in the literature. As there has been no established pathway for the collaboration to follow, we have adopted a Plan-Do-Study-Act cycle to capture the evolving “In One Place” (IOP) process. Findings This paper highlights the inherent systemic barriers that have to be identified and overcome if the authors are to move from wishful thinking to pragmatic realism, both within and between organisations. The sense of public sector agencies being able to work together, simply because it makes good sense, is challenged and the paper identifies both cultural and professional factors that made a difference in this collaboration, which could be harnessed elsewhere. Originality/value From the outset, a key driver for the IOP has been to align health, social care and housing processes by bringing together practitioners and senior managers to identify need and to plan and deliver services locally, offering a real benefit to individuals with complex needs. This is set within the context of increasing demand on public services, financial austerity and the history of “housing” being on the margins of discussion when considering the integration of health and social care services. The authors are able to demonstrate the benefit of housing being at the centre of such discussions.


2021 ◽  
Vol 12 ◽  
Author(s):  
Anh Truong ◽  
Catrin Alverbratt ◽  
Anette Ekström-Bergström ◽  
Helena Antonsson

Background: Clear and effective communication is a prerequisite to provide help and support in healthcare situations, especially in health, and social care services for persons with intellectual disabilities, as these clients commonly experience communication difficulties. Knowledge about how to communicate effectively is integral to ensuring the quality of care. Currently, however, there is a lack of such knowledge among staff working in the disabilities sector, which is exacerbated by challenges in the competence provision in municipal health and social care services. Therefore, the aim of the study was to explore staffs' experience of web-based training in relation to their professional caring for persons with intellectual disabilities and challenging behavior. The intention is to move toward well-evaluated and proven web-based training in order to contribute to competence provision in this specific context.Methods: Fourteen semi-structured interviews were carried out with individual staff members to gather data regarding their experiences with web-based training in relation to their profession. The collected data were analyzed using qualitative content analysis with a focus on both manifest and latent content.Results: The staff's experiences with the web-based training program were presented as a single main theme: “Web-based training for staff initiates a workplace learning process by promoting reflections on and awareness of how to better care for persons with intellectual disabilities and challenging behavior.” This theme contained three categories which are based on eight sub-categories.Conclusion and clinical implications: The benefits of web-based training for workplace learning could clearly be observed in the strengthening of professional care for persons with intellectual disabilities and challenging behavior. Staff members claimed to have gained novel insights about how to better care for clients as well as about the importance of interactions in their encounters with clients. Professional teamwork is crucial to providing effective care for persons with intellectual disabilities and challenging behavior. Hence, future research aimed at investigating the views of other healthcare professionals, such as registered nurses, is recommended to improve the competence provision within municipal health and social care services and thereby enhance the quality of care.


2011 ◽  
Vol 12 (1) ◽  
pp. 39-53 ◽  
Author(s):  
Sarah-Anne Muñoz

This paper discusses the role of social enterprise (SE) – the use of business practice to achieve a social goal – in UK health services delivery. Such SE activity has increased in recent years along with the rise in public sector commissioning of health and care services. SE has been identified as an organizational model with the potential to deliver socially and economically sustainable health and social care services. This paper presents evidence from workshops held with SE practitioners and public sector procurement professionals, during which they discussed the current and potential role of SE in health services delivery. The paper reflects on the opportunities for, but also the potential pitfalls of, greater SE involvement in the health and social care sector from the point of view of both SE practitioners and public sector procurement professionals. It demonstrates that SE-type businesses are viewed by both SE practitioners and public sector professionals as suited to working in certain areas of health and social care provision, but as falling short of what is needed in others, particularly in terms of capacity and expertise.


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