Response to commentary by Lorna Hallahan on “Reducing the inequality of luck: Keynote Address at the 2015 Australasian Society for Intellectual Disability National Conference” (Bonyhady, 2016) and “Regulating the quality of health and social care services in England: Lessons for Australia: Keynote Address at the 2015 Australasian Society for Intellectual Disability National Conference” (Behan, Beebee, & Dodds, 2016)

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.

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Mental Health and Social Care Providers Facing Requests of Assisted suicide from Elderly in Nursing Homes in Switzerland

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.087 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S11-S12

Author(s):

D.A. Castelli Dransart ◽

S. Voélin ◽

S. Elena

Keyword(s):

Nursing Homes ◽

Older People ◽

Assisted Suicide ◽

Social Care ◽

Home Care Services ◽

Care Providers ◽

Care Services ◽

Health And Social Care ◽

Competing Interest

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.

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Micro-Enterprise and Personalisation

10.1332/policypress/9781447319221.001.0001 ◽

2016 ◽

Cited By ~ 1

Author(s):

Catherine Needham ◽

Kerry Allen ◽

Kelly Hall

Keyword(s):

Social Care ◽

Cost Effective ◽

Local Market ◽

Care Services ◽

Health And Social Care ◽

Independent Variable ◽

Similar Cost ◽

Micro Enterprises

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.

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Political representation and effects of municipal mergers

Political Science Research and Methods ◽

10.1017/psrm.2019.17 ◽

2019 ◽

pp. 1-17 ◽

Cited By ~ 7

Author(s):

Oskari Harjunen ◽

Tuukka Saarimaa ◽

Janne Tukiainen

Keyword(s):

Public Sector ◽

Social Care ◽

Political Representation ◽

House Prices ◽

Substantial Reduction ◽

Care Services ◽

Health And Social Care ◽

Local Politicians ◽

Geocoded Data

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.

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Caring for Persons With Intellectual Disabilities and Challenging Behavior: Staff Experiences With a Web-Based Training Program

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.580923 ◽

2021 ◽

Vol 12 ◽

Author(s):

Anh Truong ◽

Catrin Alverbratt ◽

Anette Ekström-Bergström ◽

Helena Antonsson

Keyword(s):

Intellectual Disabilities ◽

Workplace Learning ◽

Challenging Behavior ◽

Social Care ◽

Web Based ◽

Staff Members ◽

Care Services ◽

Health And Social Care ◽

Municipal Health

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.

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The patient advisor, an organizational resource as a lever for an enhanced oncology patient experience (PAROLE-onco): a longitudinal multiple case study protocol

BMC Health Services Research ◽

10.1186/s12913-020-06009-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

M. P. Pomey ◽

M. de Guise ◽

M. Desforges ◽

K. Bouchard ◽

C. Vialaron ◽

...

Keyword(s):

Cancer Patients ◽

Clinical Oncology ◽

Patient Experience ◽

Emotional Support ◽

Social Care ◽

Legal Issues ◽

Care Services ◽

Health And Social Care ◽

Ethical And Legal Issues ◽

The Impact

Abstract Background Quebec is one of the Canadian provinces with the highest rates of cancer incidence and prevalence. A study by the Rossy Cancer Network (RCN) of McGill university assessed six aspects of the patient experience among cancer patients and found that emotional support is the aspect most lacking. To improve this support, trained patient advisors (PAs) can be included as full-fledged members of the healthcare team, given that PA can rely on their knowledge with experiencing the disease and from using health and social care services to accompany cancer patients, they could help to round out the health and social care services offer in oncology. However, the feasibility of integrating PAs in clinical oncology teams has not been studied. In this multisite study, we will explore how to integrate PAs in clinical oncology teams and, under what conditions this can be successfully done. We aim to better understand effects of this PA intervention on patients, on the PAs themselves, the health and social care team, the administrators, and on the organization of services and to identify associated ethical and legal issues. Methods/design We will conduct six mixed methods longitudinal case studies. Qualitative data will be used to study the integration of the PAs into clinical oncology teams and to identify the factors that are facilitators and inhibitors of the process, the associated ethical and legal issues, and the challenges that the PAs experience. Quantitative data will be used to assess effects on patients, PAs and team members, if any, of the PA intervention. The results will be used to support oncology programs in the integration of PAs into their healthcare teams and to design a future randomized pragmatic trial to evaluate the impact of PAs as full-fledged members of clinical oncology teams on cancer patients’ experience of emotional support throughout their care trajectory. Discussion This study will be the first to integrate PAs as full-fledged members of the clinical oncology team and to assess possible clinical and organizational level effects. Given the unique role of PAs, this study will complement the body of research on peer support and patient navigation. An additional innovative aspect of this study will be consideration of the ethical and legal issues at stake and how to address them in the health care organizations.

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Occupational therapists’ experiences of enabling people to participate in sport

British Journal of Occupational Therapy ◽

10.1177/0308022620973944 ◽

2020 ◽

pp. 030802262097394

Author(s):

Deborah Bullen ◽

Channine Clarke

Keyword(s):

Qualitative Study ◽

Occupational Therapy ◽

Thematic Analysis ◽

Social Care ◽

Occupational Therapists ◽

Phenomenological Approach ◽

Scope Of Practice ◽

Local Populations ◽

Care Services ◽

Health And Social Care

Introduction In response to growing demands on health and social care services there is an emphasis on communities addressing the needs of local populations to improve lives and reduce inequalities. Occupational therapists are responding to these demands by expanding their scope of practice into innovative settings, such as working with refugees, the homeless and residents of nursing homes, and within sport and leisure environments. The benefits of sport are widely acknowledged, and this paper argues that occupational therapists could play a pivotal role in enabling people to participate. Method This qualitative study drew on a phenomenological approach and used interviews and thematic analysis to explore five occupational therapists’ experiences of enabling people to participate in sport. Findings Findings revealed that participants demonstrated the uniqueness of occupational therapy when enabling people to participate in sport and practised according to their professional philosophy. There were opportunities to reach wider communities and promote the value of occupational therapy by collaborating with organisations, but there were also challenges when working outside of traditional settings. Conclusion The study emphasises the unique skills occupational therapists can bring to this setting. It highlights opportunities to expand their practice, to forge new partnerships in sports and leisure environments, and to address the national inactivity crisis.

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