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 Háziorvosok és idősellátás egy kérdőíves kutatás tükrében

2018 ◽  
Vol 159 (8) ◽  
pp. 312-319
Author(s):  
Anett Mária Tróbert ◽  
Zsuzsanna Széman
Keyword(s):  
Health Care ◽  
General Practitioners ◽  
Social Care ◽  
The Elderly ◽  
Care Process ◽  
Efficient Operation ◽  
Health And Social Care ◽  
Care Systems ◽  
Care System

Abstract: According to statistical data, the number of healthy life years is not increasing in proportion with the longer average life expectancy. In the ageing societies, the long-term care systems are increasingly overburdened; cost-efficient operation and the related coordination of services is one of the key questions for their sustainability. The present separation of the health care and social care systems causes numerous difficulties. One aim of the online research by questionnaire was to survey the attitude of general practitioners – who play a very important part in care for the elderly – towards their elder patients, the patients’ family members, and social workers providing eldercare. The other aim was to gather information on shortcomings experienced by doctors in the care system and on what possibilities general practitioners see for the improvement of eldercare. Semi-structured questionnaires were applied and analysed by descriptive and content methodology. The questionnaires were sent out to 5060 addresses around the country: a total of 145 were returned filled in. The respondents made many recommendations for the improvement of eldercare in the categories of development of social services, family support, development of health services, and societal cooperation. The areas in need of development named by the general practitioners are closely interrelated: the reform of social care would support the health care system and vice versa. More effective operation of the health and social care systems would ease the burdens of families, and at the same time encourage more active participation of families in the care process. And the systematic education of society and communities is a long-term investment that would strengthen a positive attitude towards old age and a value-oriented view of the ageing process that is one of the basic conditions for successful social integration of the elderly. Orv Hetil. 2018; 159(8): 312–319.

scholarly journals Creating allegiance: leading transformational change within the NHS

BMJ Leader ◽  
2018 ◽  
Vol 2 (3) ◽  
pp. 110-114 ◽  
Author(s):  
Alison Tweed ◽  
Andrew Singfield ◽  
Julia R A Taylor ◽  
Lucy Gilbert ◽  
Paul Mount
Keyword(s):  
Social Care ◽  
Transformational Change ◽  
System Level ◽  
Senior Leaders ◽  
Template Analysis ◽  
Health And Social Care ◽  
Care Systems ◽  
Uk National Health Service ◽  
The Uk ◽  
Healthcare Transformation

BackgroundWithin the UK National Health Service (NHS) the move to Sustainable Transformation Plans/Partnerships and Integrated Care Systems reflect the increasing need and expectation for transformational change at a system level across both health and social care boundaries. Transformational change is complex, emergent and dynamic requiring new, non-traditional forms of leadership which are highly relational and persuasive.Aim of the studyThe current study aimed to explore a small number of NHS senior leaders’ experiences of undertaking transformational change within their localities over a period of a year following participation in a national transformational change programme designed to enhance personal capabilities.MethodFour pairs of leaders working on different change programmes took part in the study and were interviewed at three time points about their approach to their change work. The data were analysed qualitatively using template analysis.ResultsA core theme of Creating Allegiance to an Emergent Future World was developed. The senior leaders created allegiance to the transformational change through a process of Connecting on three levels: relational, with purpose and vision and through practice. Allegiance creation was attempted even if the transformational change work at the year-end was deemed successful or not.ConclusionsThe study highlights the types of leadership behaviours employed by the participants reflecting the complexity and social construction of their transformational work. The findings provide further evidence to the existing system leadership literature as well as emphasising the importance of creating stakeholder, multilevel buy-in to healthcare transformation.

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.

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.

Modernising the regulation of health and social care professionals: the Law Commissions’ final report and draft Bill

2014 ◽  
Vol 16 (6) ◽  
pp. 411-420
Author(s):  
Tim Spencer-Lane
Keyword(s):  
Design Methodology ◽  
Social Care ◽  
Legal Framework ◽  
Final Report ◽  
Content Type ◽  
Health And Social Care ◽  
The Law ◽  
Draft Bill ◽  
The Uk

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.

scholarly journals The cost associated with disease-related malnutrition in Ireland

2012 ◽  
Vol 15 (10) ◽  
pp. 1966-1972 ◽  
Author(s):  
Niamh Rice ◽  
Charles Normand
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Large Scale ◽  
Social Care ◽  
Health Care Utilisation ◽  
Increased Risk ◽  
Health And Social Care ◽  
The Republic ◽  
The Uk ◽  
The Cost

AbstractObjectiveThe present study aimed to establish the annual public expenditure arising from the health and social care of patients with diet-related malnutrition (DRM) in the Republic of Ireland.DesignCosts were calculated by (i) estimating the prevalence of DRM in health-care settings derived from age-standardised comparisons between available Irish data and large-scale UK surveys and (ii) applying relevant costs from official sources to estimates of health-care utilisation by adults with DRM. No attempt has been made to estimate separately the costs of DRM and any associated disease, since each can be a cause or consequence of the other. The methods used are adapted from an evaluation of the cost of malnutrition in the UK by the British Association for Parenteral and Enteral Nutrition (2009).SettingsHospitals, nursing homes, out-patient clinics, primary-care clinics and home care.SubjectsAll adult patients receiving hospital in-patient, out-patient or specified community health-care services.ResultsThe annual public health and social care cost associated with adult malnourished patients in Ireland is estimated at over €1·4 billion, representing 10 % of the health-care budget. Most of this cost arises in acute hospital or residential care settings (i.e. 70 %), with nutritional support estimated to account for <3 % of spend.ConclusionsThe cost associated with the care of patients with DRM is substantial and may rise as the proportion of older people within the population increases, a group at increased risk of DRM. Despite growing pressure on health-care budgets, little attention has been focused on the economic burden associated with DRM in Ireland or the potential for savings arising from improved detection and treatment of those at risk.

scholarly journals Health and social care access for adults with learning disabilities across the UK during the COVID-19 pandemic in 2020

2021 ◽  
Vol 26 (3) ◽  
pp. 174-179
Author(s):  
Samantha Flynn ◽  
Chris Hatton
Keyword(s):  
Learning Disabilities ◽  
Northern Ireland ◽  
Social Care ◽  
Family Carers ◽  
Content Type ◽  
Care Services ◽  
Health And Social Care ◽  
Adults With Learning Disabilities ◽  
The Uk ◽  
The Impact

Purpose This paper aims to present data about access to health and social care services during the COVID-19 pandemic for adults with learning disabilities across England, Northern Ireland, Scotland and Wales. Design/methodology/approach Data were collected directly from 621 adults with learning disabilities and through separate proxy reports by family carers and paid support staff of another 378 adults with learning disabilities. The data were collected between December 2020 and February 2021 and concerned the use of health and social care services since the start of the first COVID-19 national lockdown in March 2020. Findings Access to and use of health and social care services significantly reduced for adults with learning disabilities across the UK during the COVID-19 pandemic between March 2020 and February 2021, with many people not receiving any services at all during that period. Similar patterns were seen across England, Northern Ireland, Scotland and Wales. However, data suggest some variations between countries for some services. Practical implications Future pandemic planning must ensure that access to these essential services is not completely lost for adults with learning disabilities and their family carers, as it was in some cases during the COVID-19 pandemic in 2020. Originality/value This is the largest study about the impact of the COVID-19 pandemic on health and social care services for adults with learning disabilities in the UK. The authors primarily collected data directly from adults with learning disabilities, and worked with partner organisations of people with learning disabilities throughout the study.

Regional themes

2016 ◽  
Author(s):  
Andrew Molodynski
Keyword(s):  
Health Care ◽  
Social Care ◽  
Real Life ◽  
Regional Research ◽  
Stigma Reduction ◽  
Health Care Availability ◽  
Health And Social Care ◽  
Care Systems ◽  
International Conventions ◽  
Care Availability

This chapter draws together the chapters that gave an overview of regional research and practice around the world. It teases out common themes from the different continents. There are vast social and economic differences between these regions and between the health and social care systems of the different countries. There are several common themes, however: the economy and its crucial importance in making health care available and the increasingly wide-ranging legislation but poor ‘real life’ adoption of international conventions and safeguards. There are also causes for optimism, as in the description of the situation in Indonesia following the tsunami and the crucial work on health-care availability, rights, and stigma reduction.

Significance of scientific evidence in organizing care processes

2016 ◽  
Vol 30 (4) ◽  
pp. 597-612 ◽  
Author(s):  
Henna Hasson ◽  
Staffan Blomberg ◽  
Anna Dunér ◽  
Anneli Sarvimäki
Keyword(s):  
Health Care ◽  
Ad Hoc ◽  
Social Care ◽  
Scientific Evidence ◽  
Health Care Organization ◽  
Controlled Study ◽  
Care Organization ◽  
Content Type ◽  
Health And Social Care ◽  
Care Practices

Purpose – The purpose of this paper is to analyze how staff and managers in health and social care organizations use scientific evidence when making decisions about the organization of care practices. Design/methodology/approach – Document analysis and repeated interviews (2008-2010) with staff (n=39) and managers (n=26) in health and social care organizations. The respondents were involved in a randomized controlled study about testing a continuum of care model for older people. Findings – Scientific evidence had no practical function in the social care organization, while it was a prioritized source of information in the health care organization. This meant that the decision making regarding care practices was different in these organizations. Social care tended to rely on ad hoc practice-based information and political decisions when organizing care, while health care to some extent also relied in an unreflected manner on the scientific knowledge. Originality/value – The study illustrates several difficulties that might occur when managers and staff try to consider scientific evidence when making complicated decisions about care practices.

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