scholarly journals Education for integration: four pedagogical principles

2015 ◽  
Vol 23 (6) ◽  
pp. 317-326 ◽  
Author(s):  
Ailsa Cook ◽  
John Harries ◽  
Guro Huby

Purpose – The purpose of this paper is to consider how postgraduate education can contribute to the effective integration of health and social care through supporting public service managers to develop the skills required for collaborative working. Design/methodology/approach – Review of documentation from ten years of delivery of a part-time postgraduate programme for health and social care managers, critical reflection on the findings in light of relevant literature. Findings – The health and social care managers participating in this postgraduate programme report working across complex, shifting and hidden boundaries. Effective education for integration should: ground learning in experience; develop a shared language; be inter-professional and co-produced; and support skill development. Originality/value – This paper addresses a gap in the literature relating to the educational and development needs of health and social care managers leading collaborative working.

2019 ◽  
Vol 27 (1) ◽  
pp. 64-72 ◽  
Author(s):  
Martin William Fraser

Purpose The purpose of this paper is to report on the findings of the first stage of a project seeking to evaluate and overcome inter-professional barriers between health and social care staff within a single, co-located, integrated community team. The project seeks to answer the following questions: first, Do inter-professional barriers to integrated working exist between health and social care staff at the interface of care delivery? Second, If inter-professional barriers exist, can joint health and social care assessments help to overcome them? The paper develops the current evidence base through findings from a staff questionnaire and the initial findings of a pilot study of joint health and social care assessments aimed at overcoming inter-professional barriers to integration. Design/methodology/approach The first stage of the project involved running an anonymous, online questionnaire with health and social care staff within a single, co-located community adult health and social care team. The questionnaire aimed to explore staffs’ perceptions of inter-professional collaboration when assessing the health and care needs of service users with a high degree of complexity of need. The second element of the study presents the initial findings of a small pilot of joint health and social care assessments. A second staff survey was used in order to provide a “before and after” comparative analysis and to demonstrate the effect of joint assessments on staffs’ perceptions of inter-professional collaboration at the interface of care delivery. Findings Health and social care staff value joint working as a means of improving quality of care. However, they also felt that inter-professional collaboration did not occur routinely due to organisational limitations. Staff members who participated in the pilot of joint assessments believed that this collaborative approach improved their understanding of other professional roles, was an effective means of enabling others to understand their own roles and helped to better identify the health and care needs of the most complex service users on their caseloads. Initial findings suggest that joint assessments may be a practical means of overcoming inter-professional barriers related to a lack of communication and lack of understanding of job roles. Practical implications The questionnaires highlighted the need for integration strategies that are aimed at facilitating collaborative working between staff of different professions, in order to achieve the aims of integration, such as a reduction in duplication of work and hand-offs between services. Originality/value To date, few studies have explored either staff perceptions of collaborative working or the effectiveness of joint assessments as a means of overcoming inter-professional barriers. This paper adds new data to an important area of integration that legislators and researchers increasingly agree requires more focus. Although the findings are limited due to the small scale of the initial pilot, they provide interesting and original data that will provide insight into future workforce integration strategies.


2017 ◽  
Vol 25 (2) ◽  
pp. 110-119
Author(s):  
Elaine Argyle ◽  
Tony Kelly ◽  
John Gladman ◽  
Rob Jones

Purpose Recent years have seen an increasing reliance on social support at home for people with dementia and the advocacy of a person centred and integrated approach in its provision. However, little is known about the effective ingredients of this support and how they differ from more generic or health-based services. The purpose of this paper is to explore the existing evidence base. Design/methodology/approach A review of relevant literature was carried out, combining a systematic search and selection of articles with a narrative analysis. Findings The review identified 14 relevant studies of varying research designs which yielded conflicting findings with regard to the optimal timing of interventions and their overall impact. This highlights the problems of review and generalisability when attempting to compare findings of research in this area. This was exacerbated by the blurred divide between health and social care and ambiguities in the meaning of the latter. Research limitations/implications This methodological heterogeneity demonstrates the need for consistency in research approaches if comparisons are to be made. Further questions include the precise components that distinguish social care from health care, the optimal timing for the introduction of this care and whether adherence to good practice in this area can be linked to cost effectiveness. Originality/value The review identifies relevant issues in need of further investigation and tentative themes emerging from the literature which suggest the utility of an adequately resourced, integrated and responsive approach to intervention.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Karen Louise Bester ◽  
Anne McGlade ◽  
Eithne Darragh

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.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Daryl Mahon

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.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Steve Noone ◽  
Alison Branch ◽  
Melissa Sherring

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.


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.


2018 ◽  
Vol 21 (3/4) ◽  
pp. 108-122
Author(s):  
Patricia Dearnaley ◽  
Joanne E. Smith

Purpose The purpose of this paper is to stimulate a wider debate around the coordination of workforce planning in non-statutory services (in this case, specialist housing for older people or those with long-term health and social care needs, such as learning disabilities). The authors argue that current NHS reforms do not go far enough in that they fail to include specialist housing and its workforce in integration, and by doing so, will be unable to optimise the potential efficiencies and streamlining of service delivery to this group. Design/methodology/approach The paper used exploratory study using existing research and data, enhanced by documentary analysis from industry bodies, regulators and policy think tanks. Findings That to achieve the greatest operational and fiscal impact upon the health care services, priority must be given to improving the efficiency and coordination of services to older people and those requiring nursing homes or registered care across the public and third sectors through the integration of service delivery and workforce planning. Research limitations/implications Whilst generalisable and achievable, the model proposed within the paper cannot be fully tested theoretically and requires further testing the in real health and social care market to evidence its practicality, improved quality of care and financial benefits. Originality/value The paper highlights some potential limitations to the current NHS reforms: by integrating non-statutory services, planned efficiency savings may be optimised and service delivery improved.


2015 ◽  
Vol 23 (1) ◽  
pp. 3-9 ◽  
Author(s):  
Alison Taylor

Purpose – In this paper, the Scottish Government's approach to improving outcomes for patients and service users by integrating health and social care planning and provision is described. The Scottish Parliament passed primary legislation in February 2014, which places requirements on Health Boards and Local Authorities to work together more closely than ever before. The paper aims to discuss these issues. Design/methodology/approach – This paper sets out the Scottish Government's legislative approach to integrating health and social care, based on previous experience of encouraging better partnership between health and social care working without legislative compulsion. Findings – The Scottish Government has concluded that legislation is required to create the integrated environment necessary for health and social care provision to meet the changing needs of Scotland's ageing population. Research limitations/implications – The paper is confined to experience in Scotland. Practical implications – Legislation is now complete, and implementation of the new arrangements is starting. Evaluation of their impact will be ongoing. Social implications – The new integrated arrangements in Scotland are intended to achieve a significant shift in the balance of care in favour of community-based support rather than institutional care in hospitals and care homes. Its social implications will be to support greater wellbeing, particularly for people with multimorbidities within communities. Originality/value – Scotland is taking a unique approach to integrating health and social care, focusing on legislative duties on Health Boards and Local Authorities to work together, rather than focusing on structural change alone. The scale of planned integration is also significant, with planning for, at least, all of adult social care and primary health care, and a proportion of acute hospital care, included in the new integrated arrangements.


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.


2015 ◽  
Vol 17 (2) ◽  
pp. 139-147
Author(s):  
Andrea Giordano ◽  
Alison Neville

Purpose – The purpose of the paper is to improve the consistency and quality of the response to vulnerable adults who experience abuse and neglect within NHS, independent healthcare and social care settings is noted by practitioners, agencies and patients. Health and social care policy frameworks promote principles of service improvement and consistency, along with a focus on outcomes and resource effectiveness and interagency collaboration. The Protection of Vulnerable Adults (POVA) coordinator role carries the responsibility of coordinating a response to individual referrals of abuse and neglect as described as part of the Designated Lead Manager role in the Wales Interim POVA Policy and Procedures for the POVA from abuse (Wales Adult Protection Coordinators Group, 2013). Design/methodology/approach – This paper will explore the benefits realised through a registered nurse being seconded from the Aneurin Bevan University Health Board into a newly created joint adult protection Health Coordinator post within the Caerphilly County Borough Council social services department POVA team. Findings – This is the first example of such partnership working in adult protection in Wales and has provided a number of benefits in relation to: providing adult protection advice; coordinating the response to referrals of vulnerable adult abuse and neglect within health and social care settings; carrying out or buddying others to complete adult protection investigations; facilitating the two day non-criminal POVA investigation training course and, awareness raising within the local Health Board. The development of a student nurse placement in the social services POVA team cements the multiagency collaborative approach that this development sought to achieve. Originality/value – The need to improve the consistency and quality of the response to vulnerable adults who experience abuse and neglect within NHS, independent healthcare and social care settings is noted by practitioners, agencies and patients.


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