“When we say ‘urgent’ it means now …”

2015 ◽  
Vol 23 (3) ◽  
pp. 143-152 ◽  
Author(s):  
Laura Griffith ◽  
Jon Glasby
Keyword(s):  
Social Care ◽  
Professional Culture ◽  
Practical Case ◽  
Front Line ◽  
Senior Leaders ◽  
Content Type ◽  
Policy Debates ◽  
Health And Social Care ◽  
Structural Solutions

Purpose – The purpose of this paper is to describe the perceptions which senior health and social care leaders have of their own organisations and of partner agencies, illustrating a possible method for beginning to think and talk about organisational and professional culture in settings. Design/methodology/approach – This is a practical case study, with a group of senior leaders from across the health and social care system. Findings – Different groups were often more critical of their own organisations than of others, but could still identify certain characteristics that they associated with partner agencies. While there is much that we admire about ourself and others, we seldom get chance to share this positive feedback. Equally, we rarely have the scope to give each other more challenging feedback and this – when carefully facilitated – can help build stronger relationships in the longer term. Research limitations/implications – Inter-agency working is often influenced by the implicit assumptions and stereotypes we hold about each other’s professional culture. Surfacing these in a safe, facilitated setting can help to explore and challenge such assumptions (where appropriate), reflect on how we see others and better understand how others see us. Originality/value – Policy debates about integrated care too often focus on structural “solutions” and arguably pay insufficient attention to the importance of culture. While work with front-line practitioners often tries to explore different perceptions of each other, it is less common for such an approach to be attempted with senior leaders.

Shifting the balance of care…and making the money add up

2017 ◽  
Vol 25 (4) ◽  
pp. 256-264 ◽  
Author(s):  
John Wilderspin
Keyword(s):  
Social Care ◽  
Community Setting ◽  
Evidence Base ◽  
Service Users ◽  
Front Line ◽  
Senior Leaders ◽  
Content Type ◽  
Care Community ◽  
Health And Social Care ◽  
Balance Of Care

Purpose A critical commentary on policy and practice over time in English health and social care. The paper aims to discuss these issues. Design/methodology/approach Personal reflections based on prior experience as a senior leader in the English health and care system, combined with insights and relevant evidence from other senior leaders and health and care “think-tanks”. Findings Shifting the balance of care from a hospital to a community setting can potentially be cost-effective as well as improving quality for service users. However, it will require a change in the approach to planning and implementation, by focussing on service users and communities, rather than on statutory organisations. It will also require a greater level of integration between primary care, community health services, social care and the voluntary sector, and greater levels of “co-production” with service users and the public. Research limitations/implications Front-line health and care leaders are generally unaware of the evidence base in this field. Emergent findings in this field need to be rapidly evaluated and then communicated to front-line leaders and practitioners. Originality/value Incorporates direct experience of senior leaders in the field together with the existing and emerging evidence base.

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.

scholarly journals Responding to the NHS and social care workforce crisis

2019 ◽  
Vol 9 (2) ◽  
pp. 175-188 ◽  
Author(s):  
Neil Hanney ◽  
Helen Karagic
Keyword(s):  
Social Care ◽  
Positive Impact ◽  
Further Education ◽  
Content Type ◽  
Care Services ◽  
Apprenticeship Learning ◽  
Health And Social Care ◽  
The Government ◽  
Further Education Colleges

Purpose The purpose of this paper is to describe and analyse the development of a foundation degree, including a higher apprenticeship route, which enables learners to access both higher education (HE) and health and social care professional programmes. The underpinning rationale is the urgent workforce crisis in health and social care services. Design/methodology/approach The authors will review the multiple drivers which stimulated course development and the creation of a community of practice to ensure quality management. This case study illustrates the potential of a higher apprenticeship to enable both personal and professional development. Findings The paper provides insight into working with a number of further education colleges, how to ensure consistency in delivery and assessment and the strategies which contribute to quality assurance. This case study illustrates the potential of work-based learning to transform lives and to provide the workforce required by our public services. Practical implications This paper explores the lessons learnt from setting up a new collaborative partnership and the processes that need to be in place for success. Social implications The paper discusses the potential of widening access into HE, the positive impact on recruitment to professional courses and the long-term effect on the public service workforce. Originality/value The government is committed to the expansion of apprenticeship learning in health and social care. This paper shares the authors’ experience of working with a range of employers and education providers, the challenges and successes and recommendations for development.

The impact of the Health and Social Care Act, 2012 on the health and wellbeing of rough sleepers

2016 ◽  
Vol 24 (5/6) ◽  
pp. 249-259 ◽  
Author(s):  
James Sebastian Fuller
Keyword(s):  
Service User ◽  
Public Involvement ◽  
Social Care ◽  
Service Providers ◽  
Patient Choice ◽  
Front Line ◽  
Support Worker ◽  
Content Type ◽  
Health And Social Care ◽  
The Impact

Purpose The purpose of this paper is to explore the impact of the Health and Social Care Act, 2012 on London’s rough sleepers as seen from the perspective of one former homeless service user (currently working as a support worker in a day centre providing outreach and “drop in” facilities for people who are street homeless and other vulnerable adults including female sex workers). The discussion centres on some of the unintended impacts of changes to healthcare commissioning; the new arrangements for patient, public representation; and the enhanced role of local councils. Design/methodology/approach This paper is grounded in front line practitioner reflection/opinion and draws on practical experience and observation at Spires, as well as research and government papers published by other service providers. The aspirations of the Health and Social Care Act, 2012 are set out before its practical application are examined from the rough sleeper’s dimension. Findings Putting clinicians and GPs centre stage in the commissioning and purchasing of healthcare may have some benefits for individual patient choice, but it can also dilute patient public involvement in health and social care with negative effects for vulnerable and excluded groups, including rough sleepers. The terms of reference ascribed to Local Healthwatch Organisations, the official representatives of the people, are narrower than previously and limit their ability to influence official policy. The Act centralises control whilst devolving operational responsibility, especially for public health provision on which rough sleepers often rely. It is suggested that local voluntary organisations and specialist “inclusion” health groups are increasingly being expected to take over responsibility for delivering health and social care and that mainstream collaboration is much reduced rather than enhanced by this fragmentation. Research limitations/implications This review is based on the opinion of an “expert by experience” which may not be representative. Originality/value This is one of few papers which present a front line service user/practitioner perspective on the impact of clinical commissioning on services for marginalised groups.

scholarly journals “Being brave”

2016 ◽  
Vol 24 (4) ◽  
pp. 201-213 ◽  
Author(s):  
Catherine Mangan ◽  
Mark Pietroni ◽  
Denise Porter
Keyword(s):  
Peer Review ◽  
Social Care ◽  
Positive Impact ◽  
Peer Review Process ◽  
Content Type ◽  
Health And Social Care ◽  
Local Stakeholders ◽  
Inappropriate Admissions

Purpose – The purpose of this paper is to report on the use of an innovative peer review approach to identifying and addressing the causes of inappropriate admissions from hospital to nursing homes in South Gloucestershire (SG). It explains the methodology that was developed, the findings of the peer review process and reflects on the effectiveness of the process. Design/methodology/approach – The peer review consisted of two stages. The first stage involved a panel of local stakeholders carrying out an audit of a random selection of cases where people had been assessed as needing permanent nursing or residential care. From this four cases of inappropriate admissions were identified. Stage two involved an externally facilitated process with two peer challenge panels; one of local stakeholders and the other external experts. The two panels analysed the cases of inappropriate admissions, identified the system causes and suggested actions to tackle the issues which were fed back to an audience of local stakeholders. Findings – The combination of case audit and peer review was successful in providing robust challenge to the processes in SG by identifying shortcomings in the system and suggesting actions to improve outcomes. Research limitations/implications – The approach was taken in one Council area and therefore may not be replicable in another area. Practical implications – The case study suggests that a peer review approach using both local and external peers, including providers, is an effective way to identify weaknesses in the health and social care processes. The insights offered by external peers and providers is helpful for councils in identifying where to focus resources and suggests that other areas should consider proactive adaptations to the peer review methodology that is offered as part of the LGA’s programme of sector-led improvement. Social implications – The case study suggests that a peer review approach could have a positive impact on the quality of care and quality of life for older people who are admitted to hospital. Originality/value – The case study offers an innovative and original use of the peer review approach in social care that can be shared with other councils and partners. The Southwest Improvement Board have identified it as of particular interest to other areas seeking to work with partners to identify and implement positive change.

A case study evaluation of a community multidisciplinary team in South East England using a mixed-method approach

2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711569
Author(s):  
Jessica Wyatt Muscat
Keyword(s):  
Mental Health ◽  
Mixed Method ◽  
Social Care ◽  
Free Form ◽  
Normalisation Process Theory ◽  
Multidisciplinary Teams ◽  
Mixed Method Approach ◽  
Health And Social Care ◽  
Method Approach

BackgroundCommunity multidisciplinary teams (MDTs) represent a model of integrated care comprising health, social care, and the voluntary sector where members work collaboratively to coordinate care for those patients most at risk.AimThe evaluation will answer the question, ‘What are the enablers and what are the restrictors to the embedding of the case study MDT into the routine practice of the health and social care teams involved in the project?’MethodThe MDT was evaluated using a mixed-method approach with normalisation process theory as a methodological tool. Both quantitative and qualitative data were gathered through a questionnaire consisting of the NoMAD survey followed by free-form questions.ResultsThe concepts of the MDT were generally clear, and participants could see the potential benefits of the programme, though this was found to be lower in GPs. Certain professionals, particularly mental health and nursing professionals, found it difficult to integrate the MDT into normal working patterns because of a lack of resources. Participants also felt there was a lack of training for MDT working. A lack of awareness of evidence supporting the programme was shown particularly within management, GP, and nursing roles.ConclusionSpecific recommendations have been made in order to improve the MDT under evaluation. These include adjustments to IT systems and meeting documentation, continued education as to the purpose of the MDT, and the engagement of GPs to enable better buy-in. Recommendations were made to focus the agenda with specialist attendance when necessary, and to expand the MDT remit, particularly in mental health and geriatrics.

A journey towards integrated person-centred care: a case study of a mental health perspective in the voluntary sector

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Louise Kermode
Keyword(s):  
Mental Health ◽  
Best Practice ◽  
Care Delivery ◽  
Voluntary Sector ◽  
Assessment Tools ◽  
Valuable Insight ◽  
Physical And Mental Health ◽  
Content Type ◽  
Health And Social Care

PurposePerson-centred care is a fundamental component of any service. This case study aims to explore the delivery of person-centred care in the voluntary sector, discussing how integrating support can be achieved to benefit individuals. It identifies challenges, best practice and learning that can be applied across sectors and promotes further enquiry.Design/methodology/approachThis case study is the result of a service audit at a mental health charity. The findings are a blend of reflections, observations and examples from service delivery, synthesised with national policy to provide evidence of best practice and processes that enable person-centred care.FindingsA focus on need not diagnosis, creating accessible and inclusive services, employing dual trained practitioners, having a varied skill mix along with holistic self-assessment tools are all enablers for integrated person-centred support. Multi-agency assessment frameworks, collaboration across services, cross-agency supervision and a shared vision for integration and person-centred care support services to coordinate more effectively. Barriers to integrated person-centred support include complex physical and mental health needs and harmful risk and safeguarding. The diversity of the voluntary sector, a lack of resources along with complex and competitive funding also hinder integration.Originality/valueThis case study provides a valuable insight into the voluntary sector and shares its findings to enhance best practice. It aims to promote interest and invites further research into health and social care delivery by the voluntary sector. As this delivery continues to increase, it is vital to examine the interface between the voluntary and statutory sector. Through better understanding and further research across all sectors, the author can identify how they can achieve person-centred outcomes and deliver the national policies.

Is co-production working well in recovery colleges? Emergent themes from a systematic narrative review

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Karen Louise Bester ◽  
Anne McGlade ◽  
Eithne Darragh
Keyword(s):  
Mental Health ◽  
Lived Experience ◽  
Social Care ◽  
The Body ◽  
Bibliographic Databases ◽  
Service Users ◽  
Content Type ◽  
Practitioner Attitudes ◽  
Health And Social Care ◽  
The Impact

Purpose “Co-production” is a process in health and social care wherein service users and practitioners work in partnership. Recovery colleges (RCs) are educational establishments offering mental health education; a cornerstone feature is that courses are designed and delivered in parity by both mental health practitioners and “peers” – people with lived experience of mental illness. This paper aims to consider, through the identification of key themes, whether co-production within RCs is operating successfully. Design/methodology/approach The paper is a systematic review of qualitative literature. Relevant concept groups were systematically searched using three bibliographic databases: Medline, Social Care Online and Scopus. Articles were quality appraised and then synthesised through inductive thematic analysis and emergent trends identified. Findings Synthesis identified three key themes relating to the impact of co-production in RCs: practitioner attitudes, power dynamics between practitioners and service users, and RCs’ relationships with their host organisations. As a result of RC engagement, traditional practitioner/patient hierarchies were found to be eroding. Practitioners felt they were more person-centred. RCs can model good co-productive practices to their host organisations. The review concluded, with some caveats, that RC co-production was of high fidelity. Originality/value RC research is growing, but the body of evidence remains relatively small. Most of what exists examine the impact of RCs on individuals’ overall recovery and mental health; there is a limited empirical investigation into whether their flagship feature of parity between peers and practitioners is genuine.

Trauma-informed servant leadership in health and social care settings

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Daryl Mahon
Keyword(s):  
Servant Leadership ◽  
Conceptual Model ◽  
Social Care ◽  
Large Body ◽  
Well Being ◽  
Service Users ◽  
Content Type ◽  
Starting Point ◽  
Health And Social Care ◽  
Trauma Informed

Purpose Practitioners, organisations and policy makers in health and social care settings are increasingly recognising the need for trauma-informed approaches in organisational settings, with morbidity and financial burdens a growing concern over the past few years. Servant leadership has a unique focus on emotional healing, service to others as the first priority, in addition to the growth, well-being and personal and professional development of key stakeholders. This paper aims to discuss Trauma Informed Servant Leadership (TISL). Design/methodology/approach A targeted review of the servant leadership and trauma-informed care literature was conducted. Relevant studies, including systematic review and meta-analysis, were sourced, with the resulting interpretation informing the conceptual model. Findings Although there are general guidelines regarding how to go about instituting trauma-informed approaches, with calls for organisational leadership to adapt the often cited six trauma-informed principles, to date there has not been a leadership approach elucidated which takes as its starting point and core feature to be trauma informed. At the same time, there is a paucity of research elucidating trauma outcomes for service users or employees in the literature when a trauma-informed approach is used. However, there is a large body of evidence indicating that servant leadership has many of the outcomes at the employee level that trauma-informed approaches are attempting to attain. Thus, the author builds on a previous conceptual paper in which a model of servant leadership and servant leadership supervision are proposed to mitigate against compassion fatigue and secondary trauma in the health and social care sector. The author extends that research to this paper by recasting servant leadership as a trauma-informed model of leadership that naturally operationalises trauma-informed principles. Research limitations/implications A lack of primary data limits the extent to which conclusions can be drawn on the effectiveness of this conceptual model. However, the model is based on robust research across the differential components used; therefore, it can act as a framework for future empirical research designs to be studies at the organisational level. Both the servant leadership and trauma-informed literatures have been extended with the addition of this model. Practical implications TISL can complement the trauma-informed approach and may also be viable as an alternative to trauma-informed approaches. This paper offers guidelines to practitioners and organisations in health and social care on how to operationalise important trauma-informed principles through leadership. Social implications This conceptual model may help reduce the burden of trauma and re-traumatisation encountered by practitioners and service users in health and social care settings, impacting on morbidity. Originality/value To the best of the author’s knowledge, this is a novel approach, the first of its kind.

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