Case definition for health and social care services integrated initiatives

2019 ◽  
Vol 27 (4) ◽  
pp. 264-275 ◽  
Author(s):  
Siu Mee Cheng ◽  
Cristina Catallo
Keyword(s):  
Older Adults ◽  
Social Services ◽  
Literature Search ◽  
Social Care ◽  
Case Definition ◽  
Content Type ◽  
Health And Social Services ◽  
Care Integration ◽  
Health And Social Care ◽  
Integrated Health

Purpose The purpose of this paper is to develop a case definition of integrated health and social services initiatives that serve older adults, and will provide characteristics to aid in the identification of such initiatives. The case definition is intended to ease the identification of integrated health and social care initiatives. Design/methodology/approach A limited search was undertaken of both scientific and gray literature that documented and/or examined integrated health and social services initiatives. In addition, literature on well-documented and generally accepted integrated healthcare and social services models that reflect collaborations from healthcare and social services organizations that support older adults was also used to develop the case definition. Findings The case definition is as follows: healthcare organizations from across the continuum of care working together with social services organizations, so that services are complementary and coordinated in a seamless and unified system, with care continuity for the patient/client in order to achieve desired health outcomes within a holistic perspective; the initiatives comprise at least one healthcare organization and one social care organization; and these initiatives possess 18 characteristics, grouped under 9 themes: patient care approach; program goals; measurement; service and care quality; accountability and responsibility; information sharing; culture; leadership; and staff and professional interaction. Research limitations/implications A limitation of this study is that the characteristics are based on a limited literature search. The quality of some of the literature both gray and published was not definitive: information on how they undertook the literature search was not provided; exclusion and inclusion criteria were not included; and there was insufficient detail on the design of the studies included. Furthermore, the literature reviews are based on integrated initiatives that target both seniors and non-senior’s based services. The cross-section of initiatives studied is also different in scale and type, and these differences were not explored. Practical implications The case definition is a useful tool in aiding to further the understanding of integrated health and social care initiatives. The number of definitions that exist for integrated health and social care initiatives can make it confusing to clearly understand this field and topic. The characteristics identified can assist in providing greater clarity and understanding on health and social care integration. Originality/value This study provides greater coherence in the literature on health and social care integration. It aids in better framing the phenomenon of healthcare and social services integration, thereby enhancing understanding. Finally, the study provides a very useful and concrete list of identifying characteristics, to aid in identifying integrated health and social care initiatives that serve older adults.

scholarly journals Inter-agency adult support and protection practice

2019 ◽  
Vol 27 (1) ◽  
pp. 50-63 ◽  
Author(s):  
Sundari Joseph ◽  
Susan Klein ◽  
Samantha McCluskey ◽  
Penny Woolnough ◽  
Lesley Diack
Keyword(s):  
At Risk ◽  
Social Services ◽  
Information Exchange ◽  
Social Care ◽  
Realistic Evaluation ◽  
Content Type ◽  
Health And Social Services ◽  
Evaluation Approach ◽  
Health And Social Care ◽  
Adult Support

Purpose Collaborative inter-agency working is of paramount importance for the public protection agenda worldwide. The purpose of this paper is to disseminate the findings from a research study on the inter-agency working within adult support and protection (ASP) roles in the police, health and social care. Design/methodology/approach This realistic evaluation study with two inter-related phases was funded by the Scottish Institute for Policing Research. This paper reports on Phase 1 which identified existing gaps in the implementation of effective inter-agency practice by reviewing the “state of play” in inter-agency collaboration between the police and health and social care professionals. In total, 13 focus groups comprising representatives from Police Scotland (n=52), Social Care (n=31) and Health (n=18), engaged in single profession and mixed profession groups addressing issues including referral and information exchange. Findings On analysing context-mechanism-outcome (CMO), gaps in joint working were identified and attributed to the professionals’ own understanding of inter-agency working and the expectations of partner agencies. It recommended the need for further research and inter-agency training on public protection. Research limitations/implications This unique Scottish study successfully identified the inter-agency practices of health, social services and police. By means of a modified realistic evaluation approach, it provides an in-depth understanding of the challenges that professionals face on a day-to-day basis when safeguarding adults and informed strategic recommendations to overcome the barriers to good practices in organisational working. The methods used to determine CMO could benefit other researchers to develop studies exploring the complexities of multi-causal effects of cross-boundary working. The use of the same case study in each focus group helped to neutralise bias. However, the voluntary nature of participation could have resulted in biased perceptions. The limited numbers of health professionals may have resulted in less representation of health sector views. Practical implications This paper reports on a Scottish study that focused on the coordinated and integrated practices amongst the police, health and social services’ professionals who support and protect adult members of society at risk of harm and has implications for their practice. Social implications Whilst the focus of this study has been on ASP, the conclusions and recommendations are transferable to public protection issues in many other contexts. Originality/value Studies on the joint-working practices amongst police and health and social services’ professionals who support and protect adult members of society at risk of harm are uncommon. This study investigated professionals’ perceptions of gaps and concerns pertaining to integrated working by means of a realistic evaluation approach. It recommended the need for further research and inter-agency training on public protection.

Collaborating across health and social care: joint funding an adult protection Coordinator post in Caerphilly, UK

2015 ◽  
Vol 17 (2) ◽  
pp. 139-147
Author(s):  
Andrea Giordano ◽  
Alison Neville
Keyword(s):  
Social Services ◽  
Social Care ◽  
Service Improvement ◽  
Health Board ◽  
Content Type ◽  
Health And Social Care ◽  
Abuse And Neglect ◽  
Vulnerable Adults ◽  
Adult Protection

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.

A new health and social care context in Wales

2017 ◽  
Vol 25 (4) ◽  
pp. 265-270 ◽  
Author(s):  
Stewart Greenwell ◽  
Daniel Antebi
Keyword(s):  
Social Services ◽  
Social Care ◽  
Well Being ◽  
Content Type ◽  
Frontline Workers ◽  
The People ◽  
Specialist Services ◽  
The Social ◽  
Health And Social Care ◽  
Making A Difference

Purpose The Social Services and Wellbeing (Wales) Act 2014 and the Well-being of Future Generations (Wales) Act 2015 provide a direction of travel for all public services in Wales and a framework for delivering the aspirations in the legislation. Although specifically referring to social care, both pieces of legislation are as relevant to the NHS as they are to other public bodies, providing an opportunity for NHS Wales and local government, in particular, to be equal partners in making a difference to the people and communities they serve. The paper aims to discuss these issues. Design/methodology/approach A viewpoint paper. Findings In Wales the time is right to do things differently in health and social care, so the authors will reflect on why current services are struggling and propose an approach that is rooted in communities rather than in specialities. The authors suggest developing a centre of gravity in the community through a multi-agency collaboration to achieve the greatest health, social care and economic impact. Originality/value Attention needs to be directed to supporting people, communities and frontline workers to become more resilient, rather than our current focus on specialist services.

Deprivation of Liberty Safeguards: complexity, confusion and case law – a commentary

2014 ◽  
Vol 5 (4) ◽  
pp. 245-255 ◽  
Author(s):  
Chris Lennard
Keyword(s):  
Health Care Professionals ◽  
Design Methodology ◽  
Literature Search ◽  
Social Care ◽  
Case Law ◽  
Best Interests ◽  
Content Type ◽  
Critical Studies ◽  
Health And Social Care ◽  
Definition Of

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.

scholarly journals Developing a joint outcomes contracting model for integrated health and social care for older people

2016 ◽  
Vol 24 (5/6) ◽  
pp. 282-299
Author(s):  
Jenny Billings ◽  
Alison Davis
Keyword(s):  
Older People ◽  
Social Care ◽  
Local Development ◽  
Chronically Ill ◽  
Long Term Conditions ◽  
Content Type ◽  
Health And Social Care ◽  
Integrated Health ◽  
Contracting Model ◽  
Whole Systems

Purpose Current debates surrounding the NHS contract in England are suggesting that it is in need of change to support an integrated health and social care transformation agenda that meets the needs of an ageing chronically ill population. The purpose of this paper is to describe a three-phase project in England that sought to develop and validate a whole systems contracting model for integrated health and social care focusing on older people with long-term conditions, and based on joint outcomes. Design/methodology/approach A participative mixed-method approach for the development of the contracting model was used; this consisted of a literature review, a design phase drawing on consensus method through stakeholder discussions and an international validation phase. Findings The final contracting model consists of four overarching and interrelated core elements: outcomes; partnership, collaboration and leadership; financial: incentives and risk; and legal criteria. Each core element has a series of more detailed contracting criteria, followed by further specifications attached to each criteria. Research limitations/implications While the policy environment appears to be conducive to change and encourages the adoption of new ways of thinking, there are difficulties with the implementation of new innovative models that challenge the status quo, and this is discussed. Practical implications The paper concludes with reflections on the way forward for local development and implementation. Originality/value There is currently much discussion for the need to realign contracting for integrated care that has a better fit for the transformation agenda, but until now, there have been no attempts to develop a whole systems approach that focusses on joint outcomes. This research bridges the gap but recognizes the challenges to implementation.

scholarly journals The Use of Internet-Based Health and Care Services by Elderly People in Europe and the Importance of the Country Context: Multilevel Study (Preprint)

2019 ◽  
Author(s):  
Sebastian Merkel ◽  
Moritz Hess
Keyword(s):  
Digital Divide ◽  
Elderly People ◽  
Social Services ◽  
Social Care ◽  
The Internet ◽  
Health And Social Services ◽  
Care Services ◽  
Country Level ◽  
Health And Social Care ◽  
Use Of Internet

BACKGROUND Digital health care is becoming increasingly important, but it has the risk of further increasing the digital divide, as not all individuals have the opportunity, skills, and knowledge to fully benefit from potential advantages. In particular, elderly people have less experience with the internet, and hence, they are in danger of being excluded. Knowledge on the influences of the adoption of internet-based health and care services by elderly people will help to develop and promote strategies for decreasing the digital divide. OBJECTIVE This study examined if and how elderly people are using digital services to access health and social care. Moreover, it examined what personal characteristics are associated with using these services and if there are country differences. METHODS Data for this study were obtained from the Special Eurobarometer 460 (SB 460), which collected data on Europeans’ handling of and attitudes toward digital technologies, robots, and artificial intelligence, including data on the use of internet-based health and social care services, among 27,901 EU citizens aged 15 years or older. Multilevel logistic regression models were adopted to analyze the association of using the internet for health and social care services with several individual and country-level variables. RESULTS At the individual level, young age, high education, high social class, and living in an urban area were positively associated with a high probability of using internet-based health and social services. At the country level, the proportion of elderly people who participated in any training activity within the last month was positively associated with the proportion of elderly people using these services. CONCLUSIONS The probability of using internet-based health and social services and their accompanying advantages strongly depend on the socioeconomic background. Training and educational programs might be helpful to mitigate these differences.

Challenges and chances for local health and social care integration – Lessons from Greater Manchester, England

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Ming-Fang Chang
Keyword(s):  
Social Care ◽  
Qualitative Interviews ◽  
Complex Structure ◽  
Local Health ◽  
Collaborative Partnerships ◽  
Content Type ◽  
Local Leadership ◽  
Care Plans ◽  
Care Integration ◽  
Health And Social Care

PurposeSustainability and transformation partnerships (STPs) were introduced to England, asking 44 local areas to submit their health and social care plans for the period from October 2016 to March 2021. This study aims to offer a deeper understanding of the complex structure in the local practice, and to discuss the associated challenges and chances.Design/methodology/approachDocumentary analysis, qualitative interviews and questionnaire survey are used for this study. Findings have been compared and analysed thematically.FindingsThe study participants reported that apart from pooled budgets, past collaborative experience and local leadership are crucial elements for transforming health and social care integration in Greater Manchester (GM). Also, this study provides policy recommendations to promote effective collaborative partnerships in local practices and mitigate local inequity of funding progress.Research limitations/implicationsThe findings of this paper cannot be extrapolated to all stakeholders due to the limited samples. Meanwhile, some of the discussions about the case of GM may not be transferrable to other STPs.Originality/valueThis study argues that the success of pooled budgets is the result, rather than the cause, of effective negotiations between various stakeholders; and therefore, there is no evidence suggesting that pooled budgets can resolve the discoordination of health and social care. Moreover, due to the bottom-up approach adopted by STPs, more effective boroughs tend to receive additional funding, resulting in an increasing gap of development between effective and ineffective boroughs.

Co-production in integrated health and social care programmes: a pragmatic model

2018 ◽  
Vol 26 (1) ◽  
pp. 87-96 ◽  
Author(s):  
Axel Kaehne ◽  
Andrea Beacham ◽  
Julie Feather
Keyword(s):  
Social Care ◽  
Good Practice ◽  
Essential Elements ◽  
Discussion Paper ◽  
Content Type ◽  
Academic Knowledge ◽  
Care Services ◽  
Current Thinking ◽  
Health And Social Care ◽  
Integrated Health

Purpose The purpose of this paper is to outline the current thinking on co-production in health and social care, examine the challenges in implementing genuine co-production and argue for a pragmatic version of co-production that may assist programme managers in deciding which type of co-production is most suitable for which programme. Design/methodology/approach A discussion paper based on the professional and academic knowledge and insights of the authors. A focus group interview schedule was used to guide discussions between authors. Findings The authors argue for a pragmatic approach to co-production within integrated care programmes. The authors set out the basic parameters of such an approach containing procedural rather than substantive standards for co-production activities leaving sufficient room for specific manifestations of the practice in particular contexts. Practical implications The authors put forward a pragmatic model of co-production that defines the essential elements of a process for ensuring services are designed to meet with the needs of patients yet allowing the process itself to be adapted to different circumstances. Originality/value The paper summarises the discussion on co-production in relation to integration programmes. It formulates a pragmatic model of co-production that may assist programme managers in establishing good practice co-production frameworks when designing or implementing integrated health and social care services.

scholarly journals Health and social care leaders’ self-rated competence and learning needs in small and medium-sized enterprises

2019 ◽  
Vol 7 (2) ◽  
pp. 62
Author(s):  
Mari Helena Salminen-Tuomaala ◽  
Kirsi Paavola ◽  
Paula Paussu
Keyword(s):  
Social Services ◽  
Group Dynamics ◽  
Qualitative Data ◽  
Social Care ◽  
Development Project ◽  
Learning Needs ◽  
Health And Social Services ◽  
Health And Social Care ◽  
Simulation Based ◽  
Dialogic Interaction

Objective: The study is a descriptive survey based on quantitative and qualitative data. Its purpose is to describe leaders’ self-assessed competence and learning needs in small and medium-sized health and social care enterprises as part of a larger research and development project in Finland. The information produced will be used in planning a simulation-based coaching intervention. The project partners are a health technology enterprise and two educational institutions.Methods: Data were collected in late 2017 from 23 leaders of 20 enterprises using an internet-based questionnaire. The quantitative data were analyzed using SPSS for Windows and the qualitative data using inductive content analysis.Results: The leaders felt confident about their ability to organize day-to-day activities, but reported learning needs related to interaction and entrepreneurship. Training was required in supporting staff in challenging situations, in understanding group dynamics and in developing dialogic interaction and emotional intelligence. The leaders were interested in learning how to market their services and improve the competitiveness of their enterprise with help of digitalization and networking, and how to prepare for the reform of health and social services. Most leaders were involved in practical care work and reported a need to update their clinical skills.Conclusions: Increasing self-management contents and fostering an entrepreneurial attitude in nursing and social work curricula may provide one answer to the learning needs reported in this study. Simulation-based education can provide an effective learning environment for both students and professionals in health and social services.

Space, time and demographic change

2017 ◽  
Vol 25 (1) ◽  
pp. 39-48 ◽  
Author(s):  
Hamish Robertson
Keyword(s):  
Integrated Care ◽  
Social Care ◽  
Care Service ◽  
Population Ageing ◽  
Social Care Service ◽  
Content Type ◽  
Care Integration ◽  
Health And Social Care ◽  
Geographical Perspective ◽  
Practical Implications

Purpose The purpose of this paper is to explore the potential value of applying spatial science and technology to the issue of care integration across what are the often fragmented domains of health and social care provision. The issue of focus for this purpose is population ageing because it challenges existing information and practice silos. Better integration, the author proposes, needs to adopt a geographic approach to deal with the challenges that population ageing present to health and social care as they currently function in many countries. Design/methodology/approach The approach utilised here explores the role that could be played by enhancing spatial perspectives in care integration. Spatial and temporal strategies need to be coordinated to produce systems of integrated care that are needed to meet the needs of growing numbers of older people. Findings The author’s premise is that, with some rare exceptions, geographies of care are needed to address important shifts in demography such as population ageing and their epidemiological consequences. The rising intersection between the ageing and disability concepts illustrates how the fluid nature of health and social care client groups will challenge existing systems and their presuppositions. Health and medical geography offer a theoretical and practical response to some of these emerging problems. Research limitations/implications This is a brief conceptual piece in favour of integrating geographic concepts and methods in the context of changing demography and the social, economic and service implications of such changes. It is limited in scope and a more detailed explanation would be required for a proof of concept. Practical implications Practically we know that all human services vary across space as do both healthcare and related social services and supports. Issues of quality and safety are numerous in these policy domains generally, with aged care evidencing a growing number of problems and challenges. Being able to inquire on significant challenges in health and social care through a spatial lens has the potential to provide another, highly practical, kind of evidence in this field of work. This lens is, the author contends, very poorly integrated into either health or social care at present. However, doing so would have a variety of useful outcomes for monitoring and intervening on real problems in care integration. An example could be “frequent flyers” in emergency departments as has been done in Camden, New Jersey through patient mapping. Social implications The author’s position in this paper is that the challenges we face in providing integrated care to ageing and increasingly disabled (including both physical and cognitive impairments) populations will only grow in the face of variable governmental responses and increasingly complex funding and service provider arrangements. Without a geographical perspective and the concepts and tools of spatial science the author does not see an adequate response emerging. The shift to community-based care for many groups, including the aged, means that location will become more important rather than less so. This is a societal concern of major proportions and the very concept of integrated care requires of us a geographical perspective. Originality/value This is a short but, the author believes, conceptually rich piece with a variety of potential practical implications for health and social care service provision. Issues of equity, quality, safety and even basic access can only grow as population ageing progresses and various forms of chronic disease and disability continue to grow. Knowing where the most affected people and their social and service connections are located will support better integration. And better integration may resolve some of the financial and related resource problems that are already evident but which can only continue to increase. In this context, the author suggests that the integrated care of the future needs to be geographically informed to be effective.

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