Achieving digital health sustainability: Breaking Free and CGL

2017 ◽  
Vol 22 (2) ◽  
pp. 72-82 ◽  
Author(s):  
Jonathan Ward ◽  
Glyn Davies ◽  
Stephanie Dugdale ◽  
Sarah Elison ◽  
Prun Bijral
Keyword(s):  
Free Group ◽  
Substance Misuse ◽  
Digital Health ◽  
Health Sector ◽  
Third Sector ◽  
Computer Assisted ◽  
Behavioural Science ◽  
Content Type ◽  
Health And Social Care ◽  
The Uk

Purpose Multiple challenges remain in achieving sustainability of digital health innovations, with many failing to realise their potential due to barriers to research, development and implementation. Finding an approach that overcomes these challenges is important if society is to derive benefit from these new approaches to healthcare. Having been commissioned by local authorities, NHS Trusts, prisons, charities, and third sector providers across the UK, Breaking Free Group, who in 2010 launched Breaking Free Online (BFO), a computer-assisted therapy programme for substance misuse, have overcome many of these challenges. This has been possible through close collaborative working with partner organisations, to overcome barriers to implementation and sustainability. The paper aims to discuss these issues. Design/methodology/approach This paper synthesises findings from a series of qualitative studies conducted by Breaking Free Group in collaboration with health and social care charity, Change, Grow, Live (CGL), which explore barriers and facilitators of implementation and sustainability of BFO at CGL. Data are analysed using thematic analyses with findings conceptualised using behavioural science theory. Findings This partnership has resulted in UK wide implementation of BFO at CGL, enhanced focus on digital technologies in substance misuse recovery, and a growing body of published collaborative research. Originality/value Valuable lessons have been learnt through the partnership between Breaking Free Group and CGL, which will be of interest to the wider digital health community. This paper outlines those lessons, in the hope that they will provide guidance to other digital health developers and their partners, to contribute to the continued evolution of a sustainable digital health sector.

Third sector partnerships for older people: insights from live at home schemes in the UK

2018 ◽  
Vol 22 (3) ◽  
pp. 148-153 ◽  
Author(s):  
Olumide Adisa
Keyword(s):  
Older People ◽  
Online Survey ◽  
Third Sector ◽  
Later Life ◽  
Evidence Base ◽  
Content Type ◽  
Health And Social Care ◽  
Wide Range ◽  
The Uk ◽  
At Home

Purpose While there is a rich literature on the role of partnerships between statutory agencies and third sector organisations for public service delivery in health and social care, the evidence base on, partnerships between community-based groups and charities for older people in the UK is lacking. Drawing on quantitative and qualitative data, the purpose of this paper is to examines partnerships within 46 live at home (LAH) schemes. These schemes were specifically designed to tackle isolation and promote independence and wellbeing by providing a wide range of activities, based on the needs of its members. Design/methodology/approach This study is based on an online survey of 46 LAH schemes and face-to-face interviews with seven scheme managers to capture data on the various partnership initiatives within the LAH schemes. Findings Third sector partnerships for older people varied by type – formal, semi-formal and informal. In addition, third sector partnership working fosters the achievement of clear outcomes for older people who LAH and could be a mechanism for building social capital in communities. The study also identified barriers to developing third sector partnerships within this context. Mapping existing partnerships in LAH schemes were considered to be useful in engaging with partners. LAH scheme managers were better able to identify partnerships that could be deepened and broadened, depending on the desired outcomes. Originality/value To the author’s knowledge, there are few studies on third sector partnership working in LAH schemes for older people. According to Age UK, there are 1.2m chronically lonely older people in the UK. Over half of all people aged 75 and over live alone (ONS, 2015). Loneliness and social isolation in later life are considered to be two of the largest health concerns we face. Scaling up these third sector partnerships may offer a credible way to shore up support for older people who live alone or want to live at home.

Implementation of computer-assisted therapy for substance misuse: a qualitative study of Breaking Free Online using Roger's diffusion of innovation theory

2014 ◽  
Vol 14 (4) ◽  
pp. 207-218 ◽  
Author(s):  
Sarah Elison ◽  
Jonathan Ward ◽  
Glyn Davies ◽  
Mark Moody
Keyword(s):  
Diffusion Of Innovation ◽  
Social System ◽  
Substance Misuse ◽  
Social Care ◽  
Computer Assisted ◽  
Innovation Theory ◽  
Diffusion Of Innovation Theory ◽  
Content Type ◽  
Adoption And Implementation ◽  
The Social

Purpose – The purpose of this paper is to explore the adoption and implementation of computer-assisted therapy (CAT) using Breaking Free Online (BFO) in a social care and health charity working with people affected by drugs and alcohol dependence, Crime Reduction Initiatives (CRI). Design/methodology/approach – Semi-structured interviews were conducted with service managers, practitioners, peer mentors and service users. Data were thematically analysed and themes conceptualised using Roger's Diffusion of Innovation Theory (Rogers, 1995, 2002, 2004). Findings – A number of perceived barriers to adoption of BFO throughout CRI were identified within the social system, including a lack of IT resources and skills. However, there were numerous perceived benefits of adoption of BFO throughout CRI, including broadening access to effective interventions to support recovery from substance dependence, and promoting digital inclusion. Along with the solutions that were found to the identified barriers to implementation, intentions around longer-term continuation of adoption of the programme were reported, with this process being supported through changes to both the social system and the individuals within it. Research limitations/implications – The introduction of innovations such as BFO within large organisations like CRI can be perceived as being disruptive, even when individuals within the organisation recognise its benefits. For successful adoption and implementation of such innovations, changes in the social system are required, at organisational and individual levels. Practical implications – The learning points from this study may be relevant to the substance misuse sector, and more widely to criminal justice, health and social care organisations. Originality/value – This study is the first of its kind to use a qualitative approach to examine processes of implementation of CAT for substance misuse within a large treatment and recovery organisation.

scholarly journals Corporate social disclosures: a user perspective on assurance

2014 ◽  
Vol 27 (5) ◽  
pp. 863-887 ◽  
Author(s):  
Renfred Wong ◽  
Andrew Millington
Keyword(s):  
Empirical Studies ◽  
Third Sector ◽  
Stakeholder Perceptions ◽  
Content Type ◽  
Responsible Investment ◽  
Stakeholder Perspective ◽  
Stakeholder Preferences ◽  
Representational Faithfulness ◽  
The Uk ◽  
Corporate Social

Purpose – The purpose of this paper is to investigate corporate social disclosure (CSD) assurance from a stakeholder perspective within a study which encompasses both stakeholder preferences and demand drivers of CSD assurance. Design/methodology/approach – Stakeholder perceptions of and their demand for CSD assurance are examined through a questionnaire survey. The analysis is based on responses in an empirical study from 147 organisations which are investing, procuring and third-sector stakeholders. Findings – Overall, stakeholder comments suggest an emphasis on the importance of specialist environmental assurors and the role of trust. The demand for assurance is positively related to stakeholders’ assessment of the value of CSD and the use of information from information intermediaries such as responsible investment indices, and negatively related to stakeholder perceptions of CSD representational faithfulness. Research limitations/implications – This paper only draws on data from the UK. Similar research can be explored in a context outside the UK. Practical implications – Better understanding of stakeholder defined determinants of the demand for CSD assurance as well as their perceptions of CSD assurance will inform regulators and enable companies to better discharge accountability towards stakeholders. Originality/value – This is one of the few empirical studies that investigate CSD assurance and one of the first to focus on stakeholder perceptions of, and demand for, CSD assurance within a multiple stakeholder perspective, rather than practitioner or corporate perceptions of CSD assurance.

scholarly journals Unpacking the foundational dimensions of work integration social enterprise

2018 ◽  
Vol 14 (1) ◽  
pp. 60-70 ◽  
Author(s):  
Rosemary Lysaght ◽  
Michael J. Roy ◽  
Jack S. Rendall ◽  
Terry Krupa ◽  
Liam Ball ◽  
...  
Keyword(s):  
Organizational Development ◽  
Assessment Tool ◽  
Empirical Studies ◽  
Health Sector ◽  
Field Tests ◽  
Social Enterprises ◽  
Response Scale ◽  
Content Type ◽  
Work Integration ◽  
The Uk

Purpose The aim of this exploratory, mixed methods study was to develop and test a tool that identifies foundational dimensions of work integration social enterprises (WISEs) for use in empirical studies and enterprise self-assessment. Construction of the initial prototype was based upon a review of the literature and prior qualitative research by the authors. Design/methodology/approach A 20-item question pool with a four-point response scale was constructed to explore WISE business and employment practices and strategies for worker growth and development. Three sequential field tests were conducted with the prototype – the first with 5 Canadian WISEs, the second with 14 WISEs in the UK and the third with 6 Canadian WISEs involved in an outcome study in the mental health sector. Each field test included completion of the questionnaire by persons with managerial responsibility within the WISE and evaluative feedback captured through questions on the applicability and interpretability of the items. Findings Testing of the prototype instrument revealed the inherent diversity in the field and the difficulty in creating questions that both embrace that diversity and produce unidimensional variables definable along a spectrum. A number of challenges with question structure were identified and have been modified throughout the iterative testing process. Research limitations/implications This study identified central domains for inclusion in a multi-dimensional WISE assessment tool. Further testing will help further refine scaling and establish psychometric properties. Originality/value This measure will provide a descriptive profile of WISEs across sectors and identify WISE core dimensions for research and organizational development.

Improving access to adult vaccination: a tool for healthy ageing

2014 ◽  
Vol 18 (2) ◽  
pp. 58-66 ◽  
Author(s):  
Jonathan Scrutton ◽  
David Sinclair ◽  
Trinley Walker
Keyword(s):  
Older People ◽  
Group Discussion ◽  
Grey Literature ◽  
Healthy Ageing ◽  
Active Ageing ◽  
Content Type ◽  
Health And Social Care ◽  
Potential Benefits ◽  
The Government ◽  
The Uk

Purpose – The purpose of this paper is to demonstrate how access to vaccination for older people in the UK can be both improved and used as a tool for healthy ageing. Design/methodology/approach – ILC-UK released a report “Adult Immunisation in the UK”, which applied a UK perspective to a 2013 Supporting Active Ageing Through Immunisation (SAATI) report on immunisation. The ILC report combined the SAATI findings with a traditional literature review, a policy review incorporating grey literature and the outcomes of a focus group discussion. This paper highlights the key findings of the ILC-UK report. Findings – Vaccination needs to be included as part of proactive strategies to promote healthy and active ageing. Initiatives need to be explored that increase the rate of delivery of vaccinations. Barriers to the vaccination of health and social care professionals working with older people need to be removed. The government should explore using psychological insights into human behaviour to improve the take-up of vaccinations amongst adults. The range of settings where older people can receive vaccination needs to be expanded. Information on the potential benefits of immunisation should be made readily available and easily accessible to older people. Practical implications – The paper calls for a structural shift in how vaccination services in the UK are organised. Social implications – The paper calls for a cultural shift in how society views immunisation and the role it has to play in the healthy ageing process. Originality/value – The paper uses new European research on immunisation and applies it to the UK's situation.

The rate and impact of substance misuse in psychiatric intensive care units (PICUs) in the UK

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Hattie Catherine Ann Moyes ◽  
Lana MacNaboe ◽  
Kate Townsend
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Substance Misuse ◽  
Well Being ◽  
Training Programme ◽  
Content Type ◽  
National Quality ◽  
Improvement Programme ◽  
The Uk ◽  
The Impact

Purpose This paper aims to understand the current scale of substance misuse in psychiatric intensive care units (PICUs), identify how substance misuse affects members of staff, patients and the running of wards and explore with staff what resources would be most useful to more effectively manage substance misuse and dual diagnosis on PICUs. Design/methodology/approach The paper used a mixed-methods approach, using a quantitative survey to determine the extent of substance use in PICUs and a co-design workshop to understand the impact of substance misuse on PICU wards, staff and patients. Findings The estimated rate of substance misuse in PICUs over a 12-month period is 67%, with cannabis the most frequently used substance. Despite the range of problems experienced on PICUs because of substance misuse, the availability of training and resources for staff was mixed. Research limitations/implications The findings may not be fully generalisable as research participants were members of a national quality improvement programme, and therefore, may not be representative of all PICUs. Data was collected from clinicians only; if patients were included, they might have provided another perspective on substance misuse on PICUs. Practical implications This paper emphasises the importance of substance misuse training for PICU staff to adequately respond to patients who misuse substances, improve the ward environment, staff well-being and patient outcomes. Originality/value This paper provides an updated estimation of rates of substance misuse in PICUs over a 12-month period and make suggestions for a training programme that can better support staff to address substance misuse on PICUs.

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 Beyond landscape designation

2015 ◽  
Vol 26 (2) ◽  
pp. 172-194 ◽  
Author(s):  
Richard Clarke
Keyword(s):  
Cultural Heritage ◽  
Third Sector ◽  
Formal System ◽  
Developed Country ◽  
Local Initiative ◽  
Content Type ◽  
Landscape Governance ◽  
Intensive Farming ◽  
The Uk ◽  
Practical Implications

Purpose – In Europe, as in other developed regions of the world, formal protected areas (PA) are, almost by definition, conservation islands within a wider landscape of intensive farming, towns, industry and transport links. The recognised need for “more, bigger, better and joined” implies the need for complementary approaches. The purpose of this paper is to examine some innovative funding and delivery mechanisms in the UK and their strengths – and weaknesses – compared to the formal system of PA. Design/methodology/approach – Building on recent research undertaken for the UK Heritage Lottery Fund (HLF) the HLF landscape partnership (LP) programme is described and related to other area-based approaches including the Wildlife Trust’s Living Landscapes, the Futurescapes programme of the Royal Society for the Protection of Birds and the UK government’s Nature Improvement Areas (NIA). Findings – LPs represent an increasingly important vehicle for securing conservation of the natural and cultural heritage alongside the formal system of designated PA. Their reliance upon local initiative, community engagement and multi-agency participation presents significant advantages. The strength of the LP approach is that it is “bottom up” and in some ways opportunistic. Practical implications – Non-tax funding of innovative approaches to landscape governance presents significant opportunity for natural and cultural heritage conservation, particularly in their capacity to mobilise local enthusiasm and support. However, it fits also with neo-liberal approaches which seek to transfer to the “third sector” responsibilities previously the province of local and national government. Originality/value – This paper is one of a very limited number of studies of developed-country LPs. It widens the concept of “PA” beyond formal IUCN categories and indicates the potential for innovations in funding and governance.

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.

Partnership working across sectors: a multi-professional perspective

2019 ◽  
Vol 27 (4) ◽  
pp. 328-345 ◽  
Author(s):  
Nancy El-Farargy
Keyword(s):  
Integrated Care ◽  
Workforce Development ◽  
Social Care ◽  
Third Sector ◽  
Adult Health ◽  
Content Type ◽  
The Third ◽  
Health And Social Care ◽  
Professional Perspective ◽  
The Third Sector

Purpose The Public Bodies (Joint Working) (Scotland) Act 2014 set the framework for the integration of adult health and social care services. Teams, organisations and sectors are now required to work in partnership and interdependently to deliver shared outcomes for the people they serve. The purpose of this paper is to explore any features, practices and behaviours that could influence effective partnership working across sectors. Design/methodology/approach A questionnaire was designed and distributed to a range of stakeholders working in health, social care and the third sector. With reference to the changing health and social care reform agenda, the aims of the survey were to gather views, experiences and perceptions of working across sectors, and any workforce development needs. Findings The majority of respondents were from the NHS (80.3 per cent, 118/147), and experiences were largely drawn from those working with the third sector. The utility of working with the third sector was positively highlighted; however, there were limited opportunities to fully engage. Whilst formal education and training was welcomed, workforce development needs were mostly related to fostering relationships and building mutual trust. Originality/value This paper highlights views, perceptions, enablers and barriers to integrated care in Scotland. Whilst the Scottish integration landscape is currently not fully fledged, insights into prevailing attitudes towards integrated care, by a cohort of the Scottish health and care workforce, are offered. In particular, reflections by the NHS workforce to working with third sector services are discussed.

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