Social Inclusion and Individualised Service Provision in High Risk Community Care: Balancing Regulation, Judgment and Discretion

2012 ◽  
Vol 12 (2) ◽  
pp. 299-308 ◽  
Author(s):  
Anne-Maree Sawyer ◽  
David Green
Keyword(s):  
High Risk ◽  
Service Provision ◽  
Social Inclusion ◽  
Community Care ◽  
Service Users ◽  
Life Choices ◽  
Late Twentieth ◽  
The Uk ◽  
Exercise Of Discretion ◽  
Depth Interviews

Since the late twentieth century, health and welfare policy in Australia and the UK has focused on enhancing the freedom, life choices and participation of service users. Public policy, based on the construct of social inclusion, requires greater individualisation of services, active engagement with service users, and innovative partnerships between different providers. At the same time, however, the management of risk through a range of compliance procedures can discourage the exercise of discretion by workers, limit the participation of their clients and reduce incentives for innovative cooperation between services. Drawing on in-depth interviews with community care professionals and their managers engaged in high risk social care in Australia, this article gives particular attention to the relevance of risk to social inclusion and individualised service provision.

Meaningful service user participation in the pathway

2018 ◽  
Author(s):  
Nikki Jeffcote ◽  
Karen Van Gerko ◽  
Emma Nicklin
Keyword(s):  
High Risk ◽  
Personality Disorder ◽  
Social Integration ◽  
Service Provision ◽  
User Involvement ◽  
Well Being ◽  
User Participation ◽  
Community Services ◽  
Service Users ◽  
Careful Management

This chapter describes the context, aims, challenges, and growth of a user involvement programme spanning both prison and community services in the Offender Personality Disorder (OPD) pathway. Involving and empowering high-risk individuals to enhance pathway service provision has the potential to bring significant benefits in terms of social integration, well-being, and desistance from offending, while also requiring careful management of internal and external safety. The chapter describes the particular challenges involved and the support and governance framework that has enabled the user involvement programme to flourish within the London Community Pathway. Successful initiatives are described and service users’ own narrative accounts of their experience of involvement are included throughout. The chapter concludes with a review of the challenges that have emerged as the programme has grown, the learning they have afforded, and ideas for future continuing developments.

scholarly journals Using creativity, co-production and the common third in a communication skills module to identify and mend gaps between the stakeholders of social work education

2020 ◽  
Author(s):  
Emma Reith-Hall
Keyword(s):  
Social Work ◽  
Communication Skills ◽  
Social Work Education ◽  
Social Inclusion ◽  
Social Work Students ◽  
Service Users ◽  
Social Pedagogy ◽  
The Common ◽  
The Uk ◽  
Work Education

The involvement of stakeholders – academics, service users and carers, students and practitioners – is thought to improve the quality of social work education, although few approaches and strategies for achieving this have been articulated. Even service-user and carer involvement, which is firmly embedded within social work courses in the UK, would benefit from being better theorised and researched. This paper considers how creativity, co-production and the common third helped social work academics from an English university and service users and carers from a local user-led organisation to design, deliver and evaluate a communication skills module for social work students. In spite of some challenges, effective and supportive relationships have developed, with a range of benefits becoming increasingly apparent. However, the strengths of this partnership highlighted gaps in the relationships with other stakeholders. In a conscious effort to overcome paternalistic traditions of transmission-oriented teaching, some gap-mending strategies were developed to involve students in the module’s design, delivery and evaluation. It is proposed that social pedagogy, with its focus on social inclusion and social justice, might help fulfil a current aim of British higher education, to work with students as partners and increase meaningful involvement and collaboration.

Research Watch: therapists’ working conditions and their implications for service users’ social inclusion

2019 ◽  
Vol 23 (1) ◽  
pp. 5-11
Author(s):  
Sue Holttum
Keyword(s):  
Working Conditions ◽  
Social Inclusion ◽  
Additional Stress ◽  
Service Users ◽  
Behaviour Therapy ◽  
Content Type ◽  
Physical Conditions ◽  
The Social ◽  
Cognitive Behaviour ◽  
The Uk

Purpose The purpose of this paper is to highlight possible implications of therapists’ working conditions on social inclusion of service users. Design/methodology/approach A search was carried out for recent papers on cognitive behaviour therapy (CBT) therapists. Findings One study highlighted that over half of their sample of 201 UK therapists in Improving Access to Psychological Therapy (IAPT) services reported burnout. In a second study, in interviews with ten IAPT workers in inner London services, therapists said they had to fight for extra time to adapt CBT for people who had learning disabilities, and the additional stress made them feel less positive about working with these clients. A third study, on therapists working with people with multiple sclerosis, highlights the importance of adapting CBT for people with physical conditions. Originality/value Taken together, these three papers highlight concerning implications of current working conditions for many therapists working in IAPT services. They highlight that sources of stress include services’ rigid focus on targets and inability to make expected adjustments. With regard to the UK, this may be due to the current national service model, but it has implications for the social inclusion of some service users.

”When You’re in the Hospital, You’re in a Sort of Bubble.”

Crisis ◽  
2014 ◽  
Vol 35 (3) ◽  
pp. 154-160 ◽  
Author(s):  
Amanda Owen-Smith ◽  
Olive Bennewith ◽  
Jenny Donovan ◽  
Jonathan Evans ◽  
Keith Hawton ◽  
...  
Keyword(s):  
Lived Experience ◽  
Service Providers ◽  
Small Sample Size ◽  
Small Sample ◽  
Service Users ◽  
Number Of Factors ◽  
Increased Risk ◽  
Self Harm ◽  
The Uk ◽  
Depth Interviews

Background: Individuals are at a greatly increased risk of suicide and self-harm in the months following discharge from psychiatric hospital, yet little is known about the reasons for this. Aims: To investigate the lived experience of psychiatric discharge and explore service users’ experiences following discharge. Method: In-depth interviews were undertaken with recently discharged service users (n = 10) in the UK to explore attitudes to discharge and experiences since leaving hospital. Results: Informants had mixed attitudes to discharge, and those who had not felt adequately involved in discharge decisions, or disagreed with them, had experienced urges to self-harm since being discharged. Accounts revealed a number of factors that made the postdischarge period difficult; these included both the reemergence of stressors that existed prior to hospitalization and a number of stressors that were prompted or exacerbated by hospitalization. Conclusion: Although inferences that can be drawn from the study are limited by the small sample size, the results draw attention to a number of factors that could be investigated further to help explain the high risk of suicide and self-harm following psychiatric discharge. Findings emphasize the importance of adequate preparation for discharge and the maintenance of ongoing relationships with known service providers where possible.

Information disclosure to family caregivers: Applying Thiroux’s framework

2010 ◽  
Vol 17 (4) ◽  
pp. 435-444 ◽  
Author(s):  
John Rowe
Keyword(s):  
Family Caregivers ◽  
Information Disclosure ◽  
Community Care ◽  
Service Users ◽  
Truth Telling ◽  
Mental Health Nurses ◽  
Strict Adherence ◽  
Ethical Argument ◽  
Complex Relationships ◽  
The Uk

In the UK, community care has led to more complex relationships for mental health nurses. They need to respect the rights of service users to confidentiality while also respecting the rights of family caregivers to information that directly affects them. An unsatisfactory situation has arisen in which utilitarian and legally driven motives have seen family caregivers’ interests become subsidiary to those of service users and providers. An ethical case is made for sharing information with family caregivers, even against the wishes of service users. Through the use of a conceptual framework based on elements proposed by Thiroux — value of life, goodness or rightness, justice or fairness, truth-telling or honesty, and individual freedom — the article concludes that there is an ethical argument for sharing some information with family caregivers and that nurses should respect caregivers’ rights through their actions. Nurses’ actions are a commitment to seeking what is ‘good’ by making judgements based on what matters. It is argued that people and their relationships matter more than strict adherence to laws and codes.

scholarly journals The Potential for Co-production in Developing Violence against Women Services in Wales

2017 ◽  
Vol 17 (2) ◽  
pp. 193-208 ◽  
Author(s):  
Melanie McCarry ◽  
Cath Larkins ◽  
Vashti Berry ◽  
Lorraine Radford ◽  
Nicky Stanley
Keyword(s):  
Violence Against Women ◽  
Service Provision ◽  
Service Providers ◽  
Service Users ◽  
Conservative Government ◽  
Provider Perspectives ◽  
History Of ◽  
The Uk ◽  
Funding Cuts ◽  
Domestic Violence And Abuse

The UK Conservative government has committed to increasing funding for domestic violence and abuse (DVA) services in England but this has not been extended to Wales. Wales has however made clear commitments to developing these services, through the Violence against Women, Domestic Abuse and Sexual Violence (Wales) Act 2015. This article draws on focus groups and interviews with fifty-three service users and thirty-one purposively selected service providers to explore their perspectives on Violence Against Women (VAW) service provision in Wales. There are clear shared priorities and some tensions between service user and provider perspectives on appropriate services. Drawing on the long history of intermediate co-production in VAW services, the article argues that co-production at the strategic level is now needed. This would provide an arena for resolving tensions, setting standards and developing funding criteria to enable co-produced VAW policy and build resistance to funding cuts.

scholarly journals Value co-creation in high-involvement services: the animal healthcare sector

2017 ◽  
Vol 45 (5) ◽  
pp. 518-531 ◽  
Author(s):  
Alison Z. Pyatt ◽  
Gillian H. Wright ◽  
Keith E. Walley ◽  
Emma Bleach
Keyword(s):  
Service Provision ◽  
Healthcare Sector ◽  
Latent Factors ◽  
High Involvement ◽  
Content Type ◽  
Client Group ◽  
Service Sectors ◽  
The Uk ◽  
Levels Of Service ◽  
Depth Interviews

Purpose The purpose of this paper is to investigate the significance of value co-creation to the UK animal healthcare sector from the perspective of the key industry stakeholders: clients, veterinarians and paraprofessionals. Design/methodology/approach Value co-creation constructs in the sector were identified and measured using a mixed methods approach comprised of qualitative NVivo© thematic analysis of depth interviews (n=13) and quantitative exploratory factor analysis (EFA) (n=271). Findings Qualitative results revealed nine underlying dimensions regarding service delivery in the sector: trustworthiness, communication, value for money, empathy, bespoke, integrated care, tangibles, accessibility and outcome driven service. EFA of professional survey data loaded onto seven latent factors, with strong value co-creation dimensions identified. Research limitations/implications The sampling process is sufficiently representative and diverse to present meaningful and valuable results, however, surveying should be extended to include the client group. Due to the originality of the research replication of the study will be beneficial to the broader understanding and application of value co-creation to the high-involvement services of animal healthcare. Practical implications Recognition of the importance of value co-creation to the sector should encourage professional stakeholders to develop and adopt integrated models of service provision and to provide improved levels of service quality. Originality/value The paper makes an original contribution to knowledge regarding value co-creation in respect of high-involvement service provision. Its findings should be of value to academics interested in value co-creation in service sectors as well as animal healthcare practitioners seeking to offer better value and quality service provision.

scholarly journals SCOPE 2021: a new scorecard for osteoporosis in Europe

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
John A. Kanis ◽  
Nicholas Norton ◽  
Nicholas C. Harvey ◽  
Trolle Jacobson ◽  
Helena Johansson ◽  
...  
Keyword(s):  
European Union ◽  
High Risk ◽  
Service Provision ◽  
Policy Framework ◽  
Background Information ◽  
The European Union ◽  
Traffic Light ◽  
Single Sheet ◽  
Receive Treatment ◽  
The Uk

Abstract Summary This scorecard summarises key indicators of the burden of osteoporosis and its management in the 27 member states of the European Union, as well as the UK and Switzerland. The resulting scorecard elements, assembled on a single sheet, provide a unique overview of osteoporosis in Europe. Introduction The scorecard for osteoporosis in Europe (SCOPE) is a project of the International Osteoporosis Foundation (IOF) that seeks to raise awareness of osteoporosis care in Europe. The aim of this project was to develop a scorecard and background documents to draw attention to gaps and inequalities in the provision of primary and secondary prevention of fractures due to osteoporosis. Methods The SCOPE panel reviewed the information available on osteoporosis and the resulting fractures for each of the 27 countries of the European Union plus the UK and Switzerland (termed EU27+2). The information obtained covered four domains: background information (e.g. the burden of osteoporosis and fractures), policy framework, service provision and service uptake, e.g. the proportion of men and women at high risk that do not receive treatment (the treatment gap). Results There was a marked difference in fracture risk among the EU27+2 countries. Of concern was the marked heterogeneity in the policy framework, service provision and service uptake for osteoporotic fracture that bore little relation to the fracture burden. For example, despite the wide availability of treatments to prevent fractures, in the majority of the EU27+2, only a minority of patients at high risk receive treatment even after their first fracture. The elements of each domain in each country were scored and coded using a traffic light system (red, orange, green) and used to synthesise a scorecard. The resulting scorecard elements, assembled on a single sheet, provide a unique overview of osteoporosis in Europe. Conclusions The scorecard enables healthcare professionals and policy makers to assess their country’s general approach to the disease and provide indicators to inform the future provision of healthcare.

Country profile: intellectual and developmental disability in Nigeria

2017 ◽  
Vol 22 (2) ◽  
pp. 87-93 ◽  
Author(s):  
Precious Nonye Sango
Keyword(s):  
Developing Countries ◽  
Developmental Disability ◽  
Service Provision ◽  
Social Inclusion ◽  
Design Methodology ◽  
Colonial Era ◽  
Content Type ◽  
Intellectual And Developmental Disability ◽  
The Uk ◽  
Populous Country

Purpose The purpose of this paper is to provide a contextual and general overview of intellectual and developmental disability (IDD) in Nigeria. Design/methodology/approach The paper uses a chronological approach, providing an assessment of the understanding and treatment of people with IDD from the pre-colonial era to the present. Findings Nigeria has experienced a different historical path in terms of treatment and service provision for people with IDD compared to industrialised and developing countries such as the UK and Brazil. Originality/value Nigeria is the most populous country in Africa with an emerging economy and thus important to review the treatment and social inclusion of people with IDD in the country’s development.

An Exploration of Aftercare Services for Female Drug Users

2018 ◽  
Vol 30 (2) ◽  
Author(s):  
Talent Mhangwa ◽  
Madhu Kasiram ◽  
Sibonsile Zibane
Keyword(s):  
South Africa ◽  
Qualitative Study ◽  
Drug Users ◽  
Service Providers ◽  
Service Users ◽  
Rehabilitation Centre ◽  
Aftercare Services ◽  
Data Source ◽  
Female Drug Users ◽  
Depth Interviews

The number of female drug users has been on the rise in South Africa, with statistics reflecting a rise in the number of women who attend treatment centres annually. This article presents empirical data from a broader qualitative study which aimed to explore perceptions concerning the effectiveness of aftercare programmes for female recovering drug users. The main data source was transcripts of in-depth interviews and focus groups with both service users and service providers from a designated rehabilitation centre in Gauteng, South Africa. Framed within a biopsychosocial-spiritual model, this article explores the perceptions and meanings which the female recovering drug users and the service providers attach to aftercare programmes. The findings of the research outlined the range of factors promoting recovery, alongside noteworthy suggestions for improvement in aftercare services. While acknowledging multiple influences on behaviour, this article highlights the significance of these findings in planning and implementing holistic aftercare programmes.

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