scholarly journals Integrating primary care and social services for older adults with multimorbidity: A qualitative study

2021 ◽  
Author(s):  
Hajira Dambha-Miller ◽  
Glenn Simpson ◽  
Lucy Hobson ◽  
Doyinsola Olaniyan ◽  
Sam Hodgson ◽  
...  
Keyword(s):  
Primary Care ◽  
Social Services ◽  
Large Scale ◽  
Social Care ◽  
Care Staff ◽  
Successful Implementation ◽  
Ageing Population ◽  
Stakeholder Views ◽  
Qualitative Interview Study ◽  
Health And Social Care

AbstractBackgroundGrowing demand from an ageing population, chronic preventable disease and multimorbidity has resulted in complex health and social care needs requiring more integrated services. Integrating primary care with social services could more efficiently utilise resources, and improve experiences for patients, their families and carers. There is limited evidence on progress including key barriers and drivers of integration to inform large-scale national change.AimTo elicit stakeholder views on drivers and barriers of integrated primary care and social services. and highlight opportunities for successful implementation.Design and settingA qualitative interview study.MethodSemi-structured interviews with maximum variation sampling to capture stakeholder views across services and professions.ResultsThirty-seven interviews were conducted across England including GPs, nurses, social care staff, commissioners, local government, voluntary and private sectors, patients and carers. Drivers of integration included groups of like-minded individuals supported by good leadership, expanded interface roles to bridge gaps between systems and co-location of services. Barriers included structural and interdisciplinary tension between professions, organisational self-interest and challenges in record-sharing.ConclusionsDrivers and barriers to integration identified in other contexts are also present in primary care and social services. Benefits of integration are unlikely to be realised if these are not addressed in the design and execution of new initiatives. Efforts should go beyond local and professional level change to include wider systems and policy-level initiatives. This will support a more systems-wide approach to integrated care reform, which is necessary to meet the complex and growing needs of an ageing multimorbid population.

scholarly journals Integrating primary care and social services for older adults with multimorbidity: A qualitative study

2021 ◽  
pp. BJGP.2020.1100
Author(s):  
Hajira Dambha-Miller ◽  
Glenn William Simpson ◽  
Lucy Hobson ◽  
Doyinsola Olaniyan ◽  
Sam Hodgson ◽  
...  
Keyword(s):  
Primary Care ◽  
Social Services ◽  
Large Scale ◽  
Social Care ◽  
Care Staff ◽  
Successful Implementation ◽  
Ageing Population ◽  
Stakeholder Views ◽  
Qualitative Interview Study ◽  
Health And Social Care

Background: Growing demand from an ageing population, chronic preventable disease and multimorbidity has resulted in complex health and social care needs requiring more integrated services. Integrating primary care with social services could more efficiently utilise resources, and improve experiences for patients, their families and carers. There is limited evidence on progress including key barriers and drivers of integration to inform large-scale national change. Aim: To elicit stakeholder views on drivers and barriers of integrated primary care and social services. and highlight opportunities for successful implementation. Design and setting: A qualitative interview study. Method: Semi-structured interviews with maximum variation sampling to capture stakeholder views across services and professions. Results: Thirty-seven interviews were conducted across England including GPs, nurses, social care staff, commissioners, local government, voluntary and private sectors, patients and carers. Drivers of integration included groups of like-minded individuals supported by good leadership, expanded interface roles to bridge gaps between systems and co-location of services. Barriers included structural and interdisciplinary tension between professions, organisational self-interest and challenges in record-sharing. Conclusions: Drivers and barriers to integration identified in other contexts are also present in primary care and social services. Benefits of integration are unlikely to be realised if these are not addressed in the design and execution of new initiatives. Efforts should go beyond local and professional level change to include wider systems and policy-level initiatives. This will support a more systems-wide approach to integrated care reform, which is necessary to meet the complex and growing needs of an ageing multimorbid population.

Progress Towards Partnership? The Development of Relations between Primary Care Organisations and Social Services Concerning Older People's Services in the UK

2004 ◽  
Vol 3 (1) ◽  
pp. 33-42 ◽  
Author(s):  
Kirstein Rummery
Keyword(s):  
Primary Care ◽  
Older People ◽  
Social Services ◽  
Large Scale ◽  
Social Care ◽  
Theoretical Work ◽  
Care Services ◽  
Care Groups ◽  
Health And Social Care ◽  
The Uk

This paper will present evidence from the interim results of a large scale longitudinal project designed to track the development of partnership working between the new primary care organisations (Primary Care Groups and Trusts) entrusted with the commissioning and in some cases provision of health care, and local authority social services departments, regarding health and social care services for older people in the UK. Drawing on theoretical work concerning the role of partnership working in the governance of welfare, the author uses a framework originally devised by the Nuffield Centre for Health at the University of Leeds to analyse the interim data, and to draw conclusions about the feasibility of current policy pushes towards partnership working and service integration around health and social care for older people.

“Sliding Doors”: innovative approaches to supporting culture change

2014 ◽  
Vol 22 (4) ◽  
pp. 154-164 ◽  
Author(s):  
Gill Walker ◽  
Laura Gillies
Keyword(s):  
Older People ◽  
Social Services ◽  
Social Care ◽  
Care Staff ◽  
Educational Drama ◽  
Content Type ◽  
The People ◽  
Health And Social Care ◽  
The Difference ◽  
Policy Direction

Purpose – Reshaping Care for Older People (RCOP) and Integration of Health and Social Care are central to providing a care system in Scotland that meets older people's current and future needs. Their implementation requires a workforce with the appropriate knowledge, skills and values to engage with older people across health and social care sectors, which requires a change in professionals’ thinking about services. The paper aims to discuss these issues. Design/methodology/approach – NHS Education for Scotland, the Scottish Social Services Council and a learning and development consultancy designed and delivered innovative education resources to support health and social care staff across Scotland to understand the new agenda and recognise its meaning for practice. Findings – Two related resources were developed: workshop using actors to depict scenarios from older people's lives to support participants to reflect on the new policy direction and outcomes-focused approaches; and an online resource using the same characters that can be delivered locally for groups and individuals. Participants were enabled to identify what they need to do differently and how they can support one another to make necessary changes. A formal evaluation has been commissioned. Originality/value – The resource characters represent the people the new policy is designed to affect. By following their lives through an educational drama approach, health and social care staff can understand the difference RCOP and the integration agenda can make and recognise their part in effecting change.

scholarly journals The general practice perspective on barriers to integration between primary and social care: a London, United Kingdom-based qualitative interview study

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e029702
Author(s):  
Danial Naqvi ◽  
Anam Malik ◽  
Mohaimen Al-Zubaidy ◽  
Falak Naqvi ◽  
Anas Tahir ◽  
...  
Keyword(s):  
United Kingdom ◽  
Social Services ◽  
General Practitioners ◽  
Social Care ◽  
Care Staff ◽  
Frontline Staff ◽  
Team Meetings ◽  
The United Kingdom ◽  
Qualitative Interview Study ◽  
Barriers To Integration

ObjectiveThere is an ongoing challenge of effective integration between primary and social care in the United Kingdom; current systems have led to fragmentation of services preventing holistic patient-centred care for vulnerable populations. To improve clinical outcomes and achieve financial efficiencies, the barriers to integration need to be identified and addressed. This study aims to explore the unique perspectives of frontline staff (general practitioners and practice managers) towards these barriers to integration.DesignQualitative study using semistructured interviews and thematic analysis to obtain results.SettingGeneral practices within London.Participants18 general practitioners (GPs) and 7 practice managers (PMs) based in London with experience of working with social care.ResultsThe study identified three overarching themes where frontline staff believed problems exist: accessing social services, interprofessional relationships and infrastructure. Issues with contacting staff from other sectors creates delays in referrals for patient care and perpetuates existing logistical challenges. Likewise, professionals noted a hostile working culture between sectors that has resulted in silo working mentalities. In addition to staff being overworked as well as often inefficient multidisciplinary team meetings, poor relationships across sectors cause a diffusion of responsibility, impacting the speed with which patient requests are responded to. Furthermore, participants identified that a lack of interoperability between information systems, lack of pooled budgets and misaligned incentives between managerial staff compound the infrastructural divide between both sectors.ConclusionIn this study, primary care staff identify intangible barriers to integration such as poor interprofessional relationships, in addition to more well-described structural issues such as insufficient funding and difficulty accessing social care. Participants believe that educating the next generation of medical professionals may lead to the development of collaborative, instead of siloed, working cultures and that change is needed at both an interpersonal and institutional level to successfully integrate care.

Going round in circles? Joint working between primary health and social care

2015 ◽  
Vol 23 (2) ◽  
pp. 53-61 ◽  
Author(s):  
Anna Coleman ◽  
Caroline Glendinning
Keyword(s):  
Social Services ◽  
Early Development ◽  
Large Scale ◽  
Social Care ◽  
Well Being ◽  
Early Years ◽  
Content Type ◽  
Care Groups ◽  
Health And Social Care ◽  
Operational Activities

Purpose – The purpose of this paper is to examine research evidence on collaboration between primary and adult social care in strategic, rather than operational, activities at two different time points, following large-scale changes within the health and social care environments; and discuss the prospects for the future. Design/methodology/approach – This paper reports evidence from two substantial longitudinal studies (Dowling and Glendinning, 2003; Checkland et al., 2012) which followed the development of Primary Care Groups and Trusts (PCG/Ts) and Clinical Commissioning Groups (CCGs), respectively. Each used a combination of national surveys and local in-depth case studies to trace the early development of new structures and ways of working following major changes in the NHS and local government. Findings – PCG/Ts had limited success in collaborating with adult social care partners. Health and Well-being Boards offer a new overarching organisational framework for collaborative strategic working between GP-led CCGs and adult social care services. Mandated joint strategic needs assessments also provide a shared framework within which commissioning decisions by both CCGs and social services are made. However, there remains evidence of long-standing barriers, particularly differences in geographic boundaries and in organisational and professional cultures. Research limitations/implications – Evidence from both studies is based on the early years of the respective new organisations; later evidence may have yielded a different picture. Originality/value – This is the first paper reflecting on developments in strategic relations between primary and social care from researchers involved with two longitudinal investigations of the early development of PCG/Ts (1999-2002) and CCGs (2011-ongoing).

scholarly journals Impact of dementia education and training on health and social care staff knowledge, attitudes and confidence: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e039939
Author(s):  
Sahdia Parveen ◽  
Sarah Jane Smith ◽  
Cara Sass ◽  
Jan R Oyebode ◽  
Andrea Capstick ◽  
...  
Keyword(s):  
Online Survey ◽  
Social Care ◽  
Education And Training ◽  
Care Staff ◽  
Cross Sectional ◽  
Health And Social Care ◽  
Training Content ◽  
The Impact ◽  
And Training ◽  
Dementia Education

ObjectivesThe aim of this study was to establish the impact of dementia education and training on the knowledge, attitudes and confidence of health and social care staff. The study also aimed to identify the most effective features (content and pedagogical) of dementia education and training.DesignCross-sectional survey study. Data collection occurred in 2017.SettingsHealth and social care staff in the UK including acute care, mental health community care trusts, primary care and care homes.ParticipantsAll health and social care staff who had completed dementia education and training meeting the minimal standards as set by Health Education England, within the past 5 years were invited to participate in an online survey. A total of 668 health and social care staff provided informed consent and completed an online survey, and responses from 553 participants were included in this study. The majority of the respondents were of white British ethnicity (94.4%) and identified as women (88.4%).OutcomesKnowledge, attitude and confidence of health and social care staff.ResultsHierarchical multiple regression analysis was conducted. Staff characteristics, education and training content variables and pedagogical factors were found to account for 29% of variance in staff confidence (F=4.13, p<0.001), 22% of variance in attitude (knowledge) (F=3.80, p<001), 18% of the variance in staff knowledge (F=2.77, p<0.01) and 14% of variance in staff comfort (attitude) (F=2.11, p<0.01).ConclusionThe results suggest that dementia education and training has limited impact on health and social care staff learning outcomes. While training content variables were important when attempting to improve staff knowledge, more consideration should be given to pedagogical factors when training is aiming to improve staff attitude and confidence.

scholarly journals Psychosocial impact on frontline health and social care professionals in the UK during the COVID-19 pandemic: a qualitative interview study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e047353
Author(s):  
Henry Aughterson ◽  
Alison R McKinlay ◽  
Daisy Fancourt ◽  
Alexandra Burton
Keyword(s):  
Personal Growth ◽  
Social Care ◽  
Well Being ◽  
Work Conditions ◽  
Individual Interviews ◽  
Work Related ◽  
Qualitative Interview Study ◽  
Health And Social Care ◽  
Communication Challenges ◽  
The Uk

ObjectivesTo explore the psychosocial well-being of health and social care professionals working during the COVID-19 pandemic.DesignThis was a qualitative study deploying in-depth, individual interviews, which were audio-recorded and transcribed verbatim. Thematic analysis was used for coding.ParticipantsThis study involved 25 participants from a range of frontline professions in health and social care.SettingInterviews were conducted over the phone or video call, depending on participant preference.ResultsFrom the analysis, we identified 5 overarching themes: communication challenges, work-related stressors, support structures, personal growth and individual resilience. The participants expressed difficulties such as communication challenges and changing work conditions, but also positive factors such as increased team unity at work, and a greater reflection on what matters in life.ConclusionsThis study provides evidence on the support needs of health and social care professionals amid continued and future disruptions caused by the pandemic. It also elucidates some of the successful strategies (such as mindfulness, hobbies, restricting news intake, virtual socialising activities) deployed by health and social care professionals that can support their resilience and well-being and be used to guide future interventions.

The COVID-19 vaccine: a programme of protection

2021 ◽  
Vol 17 (2) ◽  
pp. 57-58
Author(s):  
Linda Nazarko
Keyword(s):  
Social Care ◽  
Care Staff ◽  
Frontline Staff ◽  
Health And Social Care

Frontline health and social care staff are routinely exposed to the COVID-19 virus during their work. NHS staff were among the first to be offered vaccination and 93% of frontline staff have now been vaccinated. London and Wales have much lower levels of vaccination. Linda Nazarko examines the reasons and outlines the benefits of vaccination

A logic model of the implementation of a regional workforce strategy in positive behavioural support

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Steve Noone ◽  
Alison Branch ◽  
Melissa Sherring
Keyword(s):  
Large Scale ◽  
Social Care ◽  
Building Blocks ◽  
Logic Model ◽  
Competency Framework ◽  
Health Staff ◽  
Content Type ◽  
Behavioural Support ◽  
Health And Social Care ◽  
Wide Range

Purpose Positive behavioural support (PBS) as a framework for delivering quality services is recognised in important policy documents (CQC, 2020; NICE, 2018), yet there is an absence in the literature on how this could be implemented on a large scale. The purpose of this paper is to describe a recent implementation of a workforce strategy to develop PBS across social care and health staff and family carers, within the footprint of a large integrated care system. Design/methodology/approach A logic model describes how an initial scoping exercise led to the production of a regional workforce strategy based on the PBS Competence Framework (2015). It shows how the creation of a regional steering group was able to coordinate important developmental stages and integrate multiple agencies into a single strategy to implement teaching and education in PBS. It describes the number of people who received teaching and education in PBS and the regional impact of the project in promoting cultural change within services. Findings This paper demonstrates a proof of concept that it is possible to translate the PBS Competency Framework (2015) into accredited courses. Initial scoping work highlighted the ineffectiveness of traditional training in PBS. Using blended learning and competency-based supervision and assessment, it was possible to create a new way to promote large-scale service developments in PBS supported by the governance of a new organisational structure. This also included family training delivered by family trainers. This builds on the ideas by Denne et al. (2020) that many of the necessary building blocks of implementation already exist within a system. Social implications A co-ordinated teaching and education strategy in PBS may help a wide range of carers to become more effective in supporting the people they care for. Originality/value This is the first attempt to describe the implementation of a framework for PBS within a defined geographical location. It describes the collaboration of health and social care planners and a local university to create a suite of courses built around the PBS coalition competency framework.

scholarly journals Introducing the Care Certificate Evaluation: Innovative practice

Dementia ◽  
2017 ◽  
Vol 19 (2) ◽  
pp. 512-517
Author(s):  
Elaine Argyle ◽  
Louise Thomson ◽  
Antony Arthur ◽  
Jill Maben ◽  
Justine Schneider ◽  
...  
Keyword(s):  
Staff Development ◽  
Social Care ◽  
Policy Research ◽  
Research Programme ◽  
Direct Care ◽  
Care Staff ◽  
Care Provision ◽  
Front Line ◽  
Department Of Health ◽  
Health And Social Care

Although investment in staff development is a prerequisite for high-quality and innovative care, the training needs of front line care staff involved in direct care have often been neglected, particularly within dementia care provision. The Care Certificate, which was fully launched in England in April 2015, has aimed to redress this neglect by providing a consistent and transferable approach to the training of the front line health and social care workforce. This article describes the early stages of an 18-month evaluation of the Care Certificate and its implementation funded by the Department of Health Policy Research Programme.

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