Powerless positions, silenced voices? – critical views on health and social care management

2014 ◽  
Vol 28 (5) ◽  
pp. 590-601 ◽  
Author(s):  
Anneli Hujala ◽  
Sanna Laulainen ◽  
Kajsa Lindberg

Purpose – The purpose of this paper is to provide background to this special issue and consider how critically oriented research can be applied to health and social care management. Design/methodology/approach – Basic principles of critical management studies are introduced briefly to frame subsequent papers in this issue. Findings – In order to identify the wicked problems and darker sides of the care field, there is a need to study things in alternative ways through critical lenses. Giving a voice to those in less powerful positions may result in redefinition and redesign of conventional roles and agency of patients, volunteers and professionals and call into question the taken-for-granted understanding of health and social care management. Originality/value – The special issue as a whole was designed to enhance critical approaches to the discussion in the field of health and social care. This editorial hopefully raises awareness of CMS and serves as an opening for further discussion on critical views in the research on management and organization in this field.

2018 ◽  
Vol 19 (4) ◽  
pp. 273-285 ◽  
Author(s):  
Charles Musselwhite

Purpose The purpose of this paper is to examine how older people who are almost entirely housebound use a view from their window to make sense of the world and stay connected to the outside space that they cannot physically inhabit. Design/methodology/approach Semi-structured interviews with 42 individuals were carried out who were living at home, were relatively immobile and had an interesting view outside they liked from one or more of their windows. Findings The findings suggest that immobile older people enjoy watching a motion-full, changing, world going on outside of their own mobility and interact and create meaning and sense, relating themselves to the outside world. Practical implications Findings suggest that those working in health and social care must realise the importance of older people observing the outdoors and create situations where that is enabled and maintained through improving vantage points and potentially using technology. Originality/value This study builds and updates work by Rowles (1981) showing that preference for views from the window involves the immediate surveillance zone but also further afield. The view can be rural or urban but should include a human element from which older people can interact through storytelling. The view often contains different flows, between mundane and mystery and intrigue, and between expected and random.


2014 ◽  
Vol 22 (2) ◽  
pp. 62-70 ◽  
Author(s):  
Ailsa Cameron ◽  
Lisa Bostock ◽  
Rachel Lart

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.


2014 ◽  
Vol 16 (6) ◽  
pp. 411-420
Author(s):  
Tim Spencer-Lane

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.


2014 ◽  
Vol 5 (4) ◽  
pp. 245-255 ◽  
Author(s):  
Chris Lennard

Purpose – As a healthcare professional caring for people who lack capacity, the author has noted a wide variation in knowledge and awareness by staff of the Deprivation of Liberty Safeguards (DoLS). The purpose of this paper is to examine the DoLS and the background to their coming into being, describes their operation and qualifying requirements, and the continuing problems with their application nationwide. Design/methodology/approach – Utilising a literature search of government papers, official reports of statutory bodies, and critical studies, it examines the central criticisms of DoLS, particularly the lack of a clear statutory definition of deprivation of liberty, and reports on the wide variation in knowledge of the legislation by staff in health and social care, and uneven application of the safeguards nationwide. Findings – It cites evidence from studies showing that even professionals with high levels of expertise in the field find the legislation confusing, and presents testimony from legal experts that case law has failed to clarify the issues for professionals. Originality/value – Finally, it argues that the legislation is now too complex to successfully amend, and tentatively suggests that, pending a government review to make the process more understandable, health care professionals make ‘precautionary’ applications for DoLS. The author argues that, notwithstanding its faults, the process is a worthwhile exercise in care planning and ensuring that people's care is in their best interests and the least restrictive available.


2014 ◽  
Vol 16 (1) ◽  
pp. 41-51
Author(s):  
David Hewitt

Purpose – This paper aims to consider the recent consultation on a new safeguarding power of entry and seeks to provide a critique of the government's conclusions in that regard. Design/methodology/approach – The paper analyses the report of the consultation exercise and sets it against those of earlier, comparable ones. Findings – The government's conclusions were supported by only a minority of respondents. A majority of respondents, and an overwhelming majority of health and social care professionals, came to a very different conclusion. Originality/value – This is believed to be the first time the government's conclusions have been analysed in this way or placed in their present context.


2014 ◽  
Vol 15 (4) ◽  
pp. 187-196 ◽  
Author(s):  
Anthea Tinker ◽  
Nesar Gilani ◽  
Isabella Luthra ◽  
Olivia Richardson ◽  
Alexander Howells ◽  
...  

Purpose – The purpose of this paper is to start a debate about older people who are in groups that are not readily visible to policy makers and practitioners. Design/methodology/approach – The paper is based on information obtained from academic literature, government statistics and other publications from relevant organisations. The authors investigated one “invisible” group each and comparisons and conclusions were then made collaboratively. Findings – Many groups of older people seem to be absent from statistics and from policy making. The paper suggests that there needs to be more research to identify the scale of any problems and how they may be solved. Research limitations/implications – This is not a systematic review but a preliminary account of the problem. Practical implications – There are practical implications for health and social care professionals if they do not recognise that there are groups in society about whom little is known. Lack of knowledge and empathy may affect their approach to these groups. Social implications – There are implications for society if these groups are not taken into account in decision making and especially over the allocation of resources. Originality/value – There is little written which brings together the lack of attention paid to these groups as a whole.


2014 ◽  
Vol 28 (5) ◽  
pp. 619-634 ◽  
Author(s):  
Johanna Andersson ◽  
Ewa Wikström

Purpose – The purpose of this paper is to analyse how accounts of collaboration practice were made and used to construct accountability in the empirical context of coordination associations, a Swedish form of collaboration between four authorities in health and social care. They feature pooled budgets, joint leadership and joint reporting systems, intended to facilitate both collaboration and (shared) accountability. Design/methodology/approach – Empirical data were collected in field observations in local, regional and national settings. In addition, the study is based on analysis of local association documents such as evaluations and annual reports, and analysis of national agency reports. Findings – Accountability is constructed hierarchically with a narrow focus on performance, and horizontal (shared) accountability as well as outcomes are de-emphasised. Through this narrow construction of accountability the coordination associations are re-created as hierarchical and accountability is delegated rather than shared. Research limitations/implications – Features such as pooled budgets, joint leadership and joint reporting systems can support collaboration but do not necessarily translate into shared accountability if accountability is interpreted and constructed hierarchically. Practical implications – When practice conforms to what is counted and accounted for, using the hierarchical and narrow construction of accountability, the result may be that the associations become an additional authority. That would increase rather than decrease fragmentation in the field. Originality/value – This research derives from first-hand observations of actor-to-actor episodes complemented with the analysis of documents and reports. It provides critical analysis of the construction and evaluation of accounts and accountability related to practice and performance in collaboration. The main contribution is the finding that despite the conditions intended to facilitate inter-organisational collaboration and horizontal accountability, the hierarchical accountability persisted.


2014 ◽  
Vol 22 (1) ◽  
pp. 4-9 ◽  
Author(s):  
Christopher Handy

Purpose – There are clear links between health, housing and social care. The homeless live much shorter lives as do those people living in poorer quality accommodation and areas of deprivation. Life expectancy and the quality of life in later years are both drastically affected by Marmot's (2010) social gradient, with people from poorer backgrounds often doing worse. A decent home is fundamental to a healthy and a good life. The paper aims to discuss these issues. Design/methodology/approach – The research approach reviewed existing articles, examples from the housing sector and analysis of a range of data from organisations including the NHS. Findings – Good housing helps to support better health but it is not the only answer – joined up working between agencies and Marmot's proposal of proportionate universalism are significant factors in finding solutions to this long-standing issue. Social implications – Costs to the government, health services and local authorities and other agencies could be reduced by wider thinking around the link between housing, health and other support. Originality/value – This paper focuses on the existing links between health, housing and social care.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Zoe Hodges

Purpose This paper aims to reflect upon the usefulness of the word “acopia” as a diagnosis in relation to individuals in hospital. Design/methodology/approach A response to existing literature and consideration of application to practice with adults who may be vulnerable. Findings The term “acopia” is derived from medicine but has gained popularity throughout health and social care. It is a term that has no diagnostic tool or agreed characteristics. Practical implications Practitioners across a number of professional disciplines need to be aware of the individual circumstances, preferences and priorities of individuals to secure the most appropriate care and support for each person. Failure to acknowledge complexity of an individual’s presenting condition at hospital admission may have fatal consequences. Originality/value The importance of language used to refer to adults who are likely to be vulnerable may influence the quality of the care and treatment that they receive.


2021 ◽  
Vol 26 (1) ◽  
pp. 9-13
Author(s):  
Edwin Jones

Purpose This paper aims to present a conceptual viewpoint highlighting the utility of active support in implementing capable environments and to extend this by presenting a three-tiered preventative model of positive behavioural support (PBS) in UK health and social care. Design/methodology/approach Provision of a commentary on “Building capable environments using practice leadership” by Linda Hume, Nadia Khan and Martin Reilly. Findings Capable environments and active support should be key, universal and essential PBS tier one supports in UK health and social care. Training staff in Active Support and developing practice leadership help implement capable environments. Originality/value The three-tiered PBS model was recently proposed by Leitch et al. (2020) and is worthy of further debate and refinement with the involvement of stakeholders. It has several practical implications including refocussing efforts on early intervention to get tier one supports implemented effectively in recognition that PBS is much wider than intense tier three supports. It could reinforce and motivate existing providers of quality support and indicate where and how other providers can commence the process of implementing PBS. Future research could consider the effectiveness of applying implementation science to the field of learning disabilities and PBS in particular.


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