The economics of health service transformation

2015 ◽  
Vol 20 (3) ◽  
pp. 113-122 ◽  
Author(s):  
Boris T Rachev
Keyword(s):  
Health Service ◽  
Care Coordination ◽  
Social Care ◽  
Practical Interest ◽  
Economic Benefits ◽  
Local Economy ◽  
Coordinated Care ◽  
Content Type ◽  
Health And Social Care ◽  
The Uk

Purpose – This is a report on a recent development of an innovative coordinated care solution named the Care Coordination Centre (CCC), which targets coordinated care arrangements for a populations expected to benefit the most. The purpose of this paper is to identify the patients who might comprise this group, and to assess the best ways to meet their health, community, and social care needs before and after introducing the coordinated care solution across care settings. Design/methodology/approach – This is a summary of the author’s experience in the design and development of a care coordination business model for US providers and UK Clinical Commissioning Groups (CCGs) using coordinated care not only as a cost-cutting tool, but as a mechanism for creating a flexible and responsive patient-centered care. The author makes an assessment of the economic benefits of coordinated care resulting from: the shift to less costly interventions; reduction in readmissions; reduced unplanned admissions; increased time allocation efficiency of healthcare staff; and the overall reduction in per-patient costs. Findings – The health and social care systems in the USA and the UK are facing the biggest challenges in their history. Payers, providers, governments, and communities need to work to build better coordination and integration mechanisms to manage the increasing demand on health and social care in a period of stagnant health and social care budgets. New innovative models of coordinated care have been developed in both countries, at the local economy level, as the health service systems are undergoing crucial transformation from a supply to a demand-based model. In the UK, the Trafford CCG has commissioned a new CCC, responsible for the delivery of high-quality coordinated care. The CCC is designed to function at clinical, service, and community levels across multiple providers to cover, among other tasks, chronic condition patient case management, risk stratification of preventative, elective, and unscheduled care for the whole region. Originality/value – Insights from the work with Trafford CCG would be of considerable methodological and practical interest to researchers, policy makers, commissioners, healthcare professionals, and innovators.

Beyond healthcare leadership? The imperative for health and social care systems

2020 ◽  
Vol 33 (4) ◽  
pp. 351-363
Author(s):  
John Duncan Edmonstone
Keyword(s):  
Health Care ◽  
Leadership Development ◽  
Social Care ◽  
Current Model ◽  
Healthcare Leadership ◽  
Content Type ◽  
Health And Social Care ◽  
The Future ◽  
Care Systems ◽  
The Uk

Purpose This paper aims to make the case that there is a need to move beyond a focus on an approach to leadership development which is confined to health care only. It argues that, given the economic, financial, social and organisational context within which health and social care organisations in the UK operate, there is a need to develop leadership within health and social care systems, rather than within the existing “siloed” sectors. Design/methodology/approach The paper considers the context within which health and social care organisations in the UK operate; examines the nature of those organisations; makes the case for focusing on the health and social car system through systems leadership; and identifies the need for leadership, rather than leader development. Findings There is a danger of health and social care organisations “walking backwards into the future” with eyes fixed on the past. The future lies with treating health and social care as a system, rather than focusing on organisations. The current model is individual leader focused, but the emerging model is one of collective multi-agency teams. Originality/value The paper seeks to go beyond a health-care-only focus, by asserting that there is a need to regard health and social care as a single system, delivered by a multiplicity of different organisations. This has implications for the kind of leadership involved and for how this might be developed.

scholarly journals Exploring perceptions and attitudes of black Sub-Sahara African (BSSA) migrants towards residential care in England

2020 ◽  
Vol 16 (3) ◽  
pp. 307-315
Author(s):  
Mathew Nyashanu ◽  
Scovia Nalugo Mbalinda ◽  
Fungisai Mushawa ◽  
Mandu Stephene Ekpenyong
Keyword(s):  
Focus Group ◽  
Residential Care ◽  
Social Care ◽  
Death And Dying ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Early 19Th Century ◽  
Content Type ◽  
Health And Social Care ◽  
The Uk

Purpose Since the early 19th century, the UK has seen a decrease in mortality rates and increase in life expectancy. This has increased the number of elderly people being put into residential care. Change in British population demography with the arrival of many Africans from the black Sub-Sahara African (BSSA) countries has increased the need of these services. The purpose of this paper is to explore perceptions and attitude of BSSA towards residential care from potential user perspective. Design/methodology/approach This study was explorative qualitative in nature, using focus group discussions and one-on-one follow up semi-structured interviews. The focus group discussions and interviews were audio recorded and transcribed verbatim. The Silences Framework was used to guide this study, and the collection of data was done using the thematic analysis approach. Findings This study found out that the sense of confinement, lack of ownership, non-provision of culturally friendly food, non-provision of culturally friendly personal care, non-provisional of culturally orientated death and dying care, stigma for being neglected and perceived poor inclusivity leading to loneliness were found to discourage BSSA research participants from taking up residential care in the UK. Research limitations/implications In future, there is need for cross-cultural comparisons of BSSA communities living in the UK and BSSA communities living in Africa or other parts of the world. This may enhance understanding the differences and similarities based on contextual social, political and economic factors. Practical implications There is a need to understand the needs and concerns of new communities in relation to residential care and make necessary changes to enhance diversity and inclusivity. More importantly, the curriculum and professional development courses for staff in health and social care need to factor in the concepts of cultural competency and inclusivity to prepare them for the increasingly changing terrain of social care. Originality/value Owing to the changing demography and diversity in the UK population, there is a need to re-orient and re-design residential care services provision to make it diverse and inclusive of new communities from other cultures.

scholarly journals Service user and carers perspectives of joint and integrated working between health and social care

2014 ◽  
Vol 22 (2) ◽  
pp. 62-70 ◽  
Author(s):  
Ailsa Cameron ◽  
Lisa Bostock ◽  
Rachel Lart
Keyword(s):  
Mental Health ◽  
Design Methodology ◽  
Social Care ◽  
Mental Health Problems ◽  
Integrated Services ◽  
Content Type ◽  
Policy Debates ◽  
Health And Social Care ◽  
The Uk ◽  
The Impact

Purpose – The purpose of this paper is to provide an update to a review of the joint working literature in the field of health and social care for adults, with particular emphasis given to the experiences of users and carers. Design/methodology/approach – The aims of the literature review remained largely the same as those of the original, they were to identify: models of joint working, evidence of effectiveness and cost-effectiveness and the factors promoting or hindering the models. However, to reflect the growing interest in the experiences of users and carers a fourth aim was added to map these experiences. Given their prominence in terms of policy debates about integration, the review focused on jointly organised services for older people and people with mental health problems in the UK only. Findings – The review demonstrates tentative signs that some initiatives designed to join-up or integrate services can deliver outcomes desired by government. Importantly some studies that report the experiences of users of services and carers suggest that they perceive benefits from efforts to join-up or integrate services. However it is our contention that the evidence is less than compelling and does not justify the faith invested in the strategy by current or previous governments. Originality/value – The study updates our knowledge of the impact of joint working in the field of health and social care for adults. Importantly the paper highlights what is known about the experiences of users and carers of joint/integrated services.

Modernising the regulation of health and social care professionals: the Law Commissions’ final report and draft Bill

2014 ◽  
Vol 16 (6) ◽  
pp. 411-420
Author(s):  
Tim Spencer-Lane
Keyword(s):  
Design Methodology ◽  
Social Care ◽  
Legal Framework ◽  
Final Report ◽  
Content Type ◽  
Health And Social Care ◽  
The Law ◽  
Draft Bill ◽  
The Uk

Purpose – The purpose of this paper is to summarise the Law Commissions’ final report and draft Bill on the regulation of health and social care professionals. Design/methodology/approach – To summarise the key recommendations that are relevant to adult safeguarding. Findings – The final report concludes that new legislation is needed to govern the UK regulators of health and social care professionals. Originality/value – The paper sets out the recommended new legal framework.

scholarly journals Health and social care access for adults with learning disabilities across the UK during the COVID-19 pandemic in 2020

2021 ◽  
Vol 26 (3) ◽  
pp. 174-179
Author(s):  
Samantha Flynn ◽  
Chris Hatton
Keyword(s):  
Learning Disabilities ◽  
Northern Ireland ◽  
Social Care ◽  
Family Carers ◽  
Content Type ◽  
Care Services ◽  
Health And Social Care ◽  
Adults With Learning Disabilities ◽  
The Uk ◽  
The Impact

Purpose This paper aims to present data about access to health and social care services during the COVID-19 pandemic for adults with learning disabilities across England, Northern Ireland, Scotland and Wales. Design/methodology/approach Data were collected directly from 621 adults with learning disabilities and through separate proxy reports by family carers and paid support staff of another 378 adults with learning disabilities. The data were collected between December 2020 and February 2021 and concerned the use of health and social care services since the start of the first COVID-19 national lockdown in March 2020. Findings Access to and use of health and social care services significantly reduced for adults with learning disabilities across the UK during the COVID-19 pandemic between March 2020 and February 2021, with many people not receiving any services at all during that period. Similar patterns were seen across England, Northern Ireland, Scotland and Wales. However, data suggest some variations between countries for some services. Practical implications Future pandemic planning must ensure that access to these essential services is not completely lost for adults with learning disabilities and their family carers, as it was in some cases during the COVID-19 pandemic in 2020. Originality/value This is the largest study about the impact of the COVID-19 pandemic on health and social care services for adults with learning disabilities in the UK. The authors primarily collected data directly from adults with learning disabilities, and worked with partner organisations of people with learning disabilities throughout the study.

Mental health services for people with intellectual disability in the United Kingdom

2018 ◽  
Vol 12 (3/4) ◽  
pp. 91-98 ◽  
Author(s):  
Bhathika Perera ◽  
Ken Courtenay
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Intellectual Disabilities ◽  
Social Care ◽  
Community Support ◽  
Content Type ◽  
Health And Social Care ◽  
People With Intellectual Disabilities ◽  
The Uk

Purpose Services for people with intellectual disabilities in the UK have evolved over the years from hospital-based care to more community provision. There are multiple reasons for these changes, however, often it was due to changes in social policy or following a scandal in provision. The paper aims to discuss these issues. Design/methodology/approach Providing services to meet the health and social care needs of people with intellectual disabilities is well-established in the four countries of the UK with support from legislation. There are often specialist mental health and social care teams. Dedicated professionals work with people with intellectual disabilities who experience mental health problems with a focus on support in the community. A range of services for children and adults and for offenders exist across the UK that often vary in composition and structure. Findings The challenges in providing mental health services for children and adults with intellectual disabilities in the future include recruitment and training of the workforce with the remit of enhancing community support and reduced in-patient care. Practical implications This paper helps the reader to understand how ID mental health services are organised in the UK. Originality/value This paper gives a summary of the ID mental health services in the UK. Even though there are various papers looking at different aspects of mental health services for people with ID in the UK, this paper brings all that information together to help reader get a better understanding of the mental health services for people with ID.

Health and social care for older people: progress, problems and priorities

2015 ◽  
Vol 16 (1) ◽  
pp. 27-31 ◽  
Author(s):  
Richard Humphries
Keyword(s):  
Older People ◽  
Social Care ◽  
Published Data ◽  
Ageing Population ◽  
Coordinated Care ◽  
Content Type ◽  
Track Record ◽  
Health And Social Care ◽  
Care For Older People ◽  
Care System

Purpose – The purpose of this paper is to describe the principal challenges facing the health and care system in England arising from an ageing population, assess the track record of the coalition government in addressing these and offer a perspective on the priorities likely to be faced by the next incoming government in relation to health and social care for older people. Design/methodology/approach – Assessment of key policy documents and legislation and interpretation of published data on trends in health and social care activity and expenditure. Findings – An ageing population requires a fundamental shift towards a new model of care that offers better coordinated care and promotes independence and healthy ageing. The Care Act 2014 is a significant achievement and NHS spending has been protected, but resulting cuts to local government budgets have since sharp reductions in social care for older people. The next incoming government will need to address a deepening financial crisis in health and care system; the increasingly unsustainability of means tested and rationed social care alongside universal free health care; and the need to make faster progress in developing a new models of integrated care closer to home. Originality/value – The issues raised in this paper affect older people as voters, tax payers and as existing or potential users of health and social care services. As a group they will attract significant attention from political parties in the next election campaign.

scholarly journals Commissioning an ordinary life

2017 ◽  
Vol 22 (1) ◽  
pp. 38-42 ◽  
Author(s):  
Sarah Broadhurst
Keyword(s):  
Learning Disabilities ◽  
Social Care ◽  
Transformational Leaders ◽  
Care Programme ◽  
Content Type ◽  
Ordinary Life ◽  
The Past ◽  
Health And Social Care ◽  
The Uk ◽  
Inclusive Society

Purpose The purpose of this paper is to review the role and ability of commissioners to implement policy and be transformational leaders. Design/methodology/approach The role and ability of commissioners to implement policy is reviewed against the Institute of Public Care’s Commissioning Cycle and experience of working with commissioners across the UK over the past 29 years. Findings Empowering commissioners to be transformational leaders and enabling them to secure good outcomes for people with learning disabilities will require broadening the responsibilities for creating an inclusive society past commissioners of health and social care. Originality/value The Transforming Care Programme and the failure to meet targets illustrate that policy implementation in the arena of learning disabilities is still a pertinent issue. This commentary adds to the discussion by highlighting the challenges commissioners face when trying to implement policy and the need to take the conversation about inclusive communities wider than health and social care.

Commentary on “Assisting individuals ageing with learning disability: support worker perspectives”

2015 ◽  
Vol 20 (4) ◽  
pp. 223-227
Author(s):  
Martin Stevens
Keyword(s):  
Learning Disabilities ◽  
Older People ◽  
Social Care ◽  
Support Worker ◽  
Policy And Practice ◽  
Content Type ◽  
Care Services ◽  
Role Of The State ◽  
Health And Social Care ◽  
The Uk

Purpose – The purpose of this paper is to explore some of the themes identified by Wark et al.’s paper and to highlight commonalities and differences between the Australian and the UK social and health care regimes. It also points to evidence about other implications for policy and practice of the increasing numbers of people growing older who have learning disabilities. Design/methodology/approach – The commentary analyses some policy and practice documents and identifies a range of other research and commentary on this topic. Findings – Wark et al. have identified areas of importance for supporting older people with learning disabilities, particularly access to suitable and acceptable services and the importance of sufficient support worker time. They also identify gaps in the research on people’s needs and service responses. The commentary also highlights other factors for consideration in work with this group of people, particularly the implementation of personalisation policies in social care and integration between health and social care services. Research limitations/implications – There is a need for further research into developing policy and practice for health and social care for older people with learning disabilities. Some of the evidence supports the case for specialist involvement, particularly by nursing professionals. Originality/value – The paper and this commentary highlight the challenges associated with the increasing number of older people with learning disabilities in contemporary debates about the role of the state and professional specialists.

Sign in / Sign up

Export Citation Format

Share Document