A logic model of the implementation of a regional workforce strategy in positive behavioural support

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Steve Noone ◽  
Alison Branch ◽  
Melissa Sherring
Keyword(s):  
Large Scale ◽  
Social Care ◽  
Building Blocks ◽  
Logic Model ◽  
Competency Framework ◽  
Health Staff ◽  
Content Type ◽  
Behavioural Support ◽  
Health And Social Care ◽  
Wide Range

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.

scholarly journals Can health and social care integration make long-term progress? Findings from key informant surveys of the integration Pioneers in England

2019 ◽  
Vol 28 (1) ◽  
pp. 14-26
Author(s):  
Bob Erens ◽  
Gerald Wistow ◽  
Nicholas Mays ◽  
Tommaso Manacorda ◽  
Nick Douglas ◽  
...  
Keyword(s):  
Integrated Care ◽  
Large Scale ◽  
Social Care ◽  
Community Health Services ◽  
Content Type ◽  
Barriers To Change ◽  
Health And Social Care ◽  
Wide Range ◽  
Key Informant ◽  
Care Systems

Purpose All areas in England are expected by National Health Service (NHS) England to develop integrated care systems (ICSs) by April 2021. ICSs bring together primary, secondary and community health services, and involve local authorities and the voluntary sector. ICSs build on previous pilots, including the Integrated Care Pioneers in 25 areas from November 2013 to March 2018. This analysis tracks the Pioneers’ self-reported progress, and the facilitators and barriers to improve service coordination over three years, longer than previous evaluations in England. The paper aims to discuss these issues. Design/methodology/approach Annual online key informant (KI) surveys, 2016–2018, are used for this study. Findings By the fourth year of the programme (2017), KIs had shifted from reporting plans to implementation of a wide range of initiatives. In 2018, informants reported fewer “significant” barriers to change than previously. While some progress in achieving local integration objectives was evident, it was also clear that progress can take considerable time. In parallel, there appears to have been a move away from aspects of personalised care associated with user control, perhaps in part because the emphasis of national objectives has shifted towards establishing large-scale ICSs with a particular focus on organisational fragmentation within the NHS. Research limitations/implications Because these are self-reports of changes, they cannot be objectively verified. Later stages of the evaluation will look at changes in outcomes and user experiences. Originality/value The current study shows clearly that the benefits of integrating health and social care are unlikely to be apparent for several years, and expectations of policy makers to see rapid improvements in care and outcomes are likely to be unrealistic.

scholarly journals The Digital House of Care: information solutions for integrated care

2016 ◽  
Vol 24 (5/6) ◽  
pp. 237-248 ◽  
Author(s):  
Andrew Muirhead ◽  
Derek George Ward ◽  
Brenda Howard
Keyword(s):  
Large Scale ◽  
Social Care ◽  
Care Delivery ◽  
Service Planning ◽  
Recent Experience ◽  
Organisational Development ◽  
Digital Tool ◽  
Content Type ◽  
Health And Social Care ◽  
Care Information

Purpose The purpose of this paper is to describe the development of a digital tool in an English county striving towards a vision of integrated information that is used to underpin an increasingly integrated future of health and social care delivery. Design/methodology/approach It discusses the policy context nationally, the origins and implementation of the initiative, the authors’ experiences and viewpoint highlighting key challenges and learning, as well as examples of new work undertaken. Findings In all, 12 health and care organisations have participated in this project. The ability for local commissioners and providers of services to now understand “flow” both between and within services at a granular level is unique. Costs are modest, and the opportunities for refining and better targeting as well as validating services are significant, thus demonstrating a return on investment. Key learning includes how organisational development was equally as important as the implementation of innovative new software, that change management from grass roots to strategic leaders is vital, and that the whole system is greater than the sum of its otherwise in-silo parts. Practical implications Data linkage initiatives, whether local, regional or national in scale, need to be programme managed. A robust governance and accountability framework must be in place to realise the benefits of such as a solution, and IT infrastructure is paramount. Social implications Organisational development, collaborative as well as distributed leadership, and managing a change in culture towards health and care information is critical in order to create a supportive environment that fosters learning across organisational boundaries. Originality/value This paper draws on the recent experience of achieving large-scale data integration across the boundaries of health and social care, to help plan and commission services more effectively. This rich, multi-agency intelligence has already begun to change the way in which the system considers service planning, and learning from this county’s approach may assist others considering similar initiatives.

Practice-integrated care teams – learning for a better future

2015 ◽  
Vol 23 (2) ◽  
pp. 74-87 ◽  
Author(s):  
Angela Beacon
Keyword(s):  
General Practice ◽  
Integrated Care ◽  
Secondary Care ◽  
Social Care ◽  
Cost Savings ◽  
Building Blocks ◽  
Urgent Care ◽  
Recent Experience ◽  
Content Type ◽  
Health And Social Care

Purpose – The purpose of this paper is to present a case study of one element of the integrated work which has taken place in Central Manchester, the development of multi-disciplinary Practice-Integrated Care Teams (PICT). The paper will show how working together has become a practical reality for members of these teams, and is forming the building blocks for further integration across neighbourhoods. Design/methodology/approach – This paper draws on the author’s experience of working in the PICT project from 2012 to 2014. The report will draw on the evaluation work which took place during the project, and will include reflections from others involved in the project and members of the teams. Findings – The integrated care teams which have been developed in Central Manchester have started to make significant changes to the ways that professionals work together, to the experience that patients have and to the costs of urgent care provision. Whilst there is still a long way to go, there has been significant learning from the PICT. This includes improved patient outcomes and experience. There has been an overall reduction in secondary care activity for patients the teams have been working with, with the largest reduction being in emergency admissions. Alongside this, patient feedback has reinforced the value of this personalised approach and increased overall satisfaction with the care and advice received from health and social care professionals and an improved professional experience. Evaluation has demonstrated that amongst professionals involved in the team there is a strong commitment to the principles of integrated care and that the confidence, skills and capacity of the teams have strengthened since this way of working has been introduced. As monitoring of financial impact continues to develop, cost savings from secondary care, particularly around emergency unplanned care, are encouraging. Originality/value – This paper draws on the recent experience of designing and delivering integrated care across a range of multi-agency, multi-professional partners. The model which has been developed centres around the role of general practice, and has enabled primary care to take a key role in the development of an out-of-hospital integrated care system. This has enabled community professionals such as nurses and social workers to build a much stronger relationship with general practice and enable system linkages which will be essential to the delivery of joined-up health and social care in the future. The project has been accompanied by thorough and ongoing evaluation to support the validity of the learnings which have been reported.

Integrated care communities: putting change theory into practice

2014 ◽  
Vol 22 (4) ◽  
pp. 132-141 ◽  
Author(s):  
Elizabeth Bradbury
Keyword(s):  
Integrated Care ◽  
Complex Adaptive Systems ◽  
Adaptive Systems ◽  
Large Scale ◽  
Social Care ◽  
Content Type ◽  
North West ◽  
Health And Social Care ◽  
Capability Building ◽  
Complex Adaptive

Purpose – The purpose of this paper is to reflect on the experience of the Advancing Quality Alliance's (AQuA) regional Integrated Care Discovery Community created to translate integrated care theory into practice at scale and to test ways to address the system enablers of integrated care. Design/methodology/approach – Principles of flexibility, agility, credibility and scale influenced Community design. The theoretical framework drew on relevant complexity, learning community and change management theories. Co-designed with stakeholders, the discovery-based Community model incorporated emergent learning from change in complex adaptive environments and focused bespoke support on leadership capability building. Findings – In total, 19 health and social care economies participated. Kotter's eight-step change model proved flexible in conjunction with large-scale change theories. The tension between programme management, learning communities and the emergent nature of change in complex adaptive systems can be harnessed to inject pace and urgency. Mental models and simple rules were helpful in managing participant's desire for a directive approach in the context of a discovery programme. Research limitations/implications – This is a viewpoint from a regional improvement organisation in North West England. Social implications – The Discovery Community was a useful construct through which to rapidly develop multiple integrated health and social care economies. Flexible design and bespoke delivery is crucial in a complex adaptive environment. Capability building needs to be agile enough to meet the emergent needs of a changing workforce. Collaborative leadership has emerged as an area requiring particular attention. Originality/value – Learning from AQuA's approach may assist others in structuring large-scale integrated care or complex change initiatives.

Co-production within health and social care – the implications for Wales?

2014 ◽  
Vol 15 (1) ◽  
pp. 10-20 ◽  
Author(s):  
Andy Phillips ◽  
Gareth Morgan
Keyword(s):  
Social Care ◽  
Active Role ◽  
Policy Makers ◽  
Content Type ◽  
Professional Groups ◽  
Care Services ◽  
The People ◽  
Health And Social Care ◽  
Wide Range ◽  
Improve Health

Purpose – It is well recognised that individuals have much to contribute to the care that they receive, with attendant benefits on outcomes and reduction in cost. The recognition of individuals who access care services as interdependent citizens embedded in both formal and informal support networks is a shift that acknowledges their active role as partners in management of their own care and in service innovation and development. The purpose of this paper is therefore to explore and illustrate some of the domains of co-production. Design/methodology/approach – In this paper, the authors review the literature, both peer-reviewed and professional, in order to provide a broad and contemporary commentary on this emergent approach. This literature is critically summarised and presented along with a narrative that discusses the context in Wales, where the authors are based. The approach to this paper is to bring together existing knowledge and also propose potential avenues for further research and practise development. Findings – There is a diverse literature on this topic and the application of co-production appears potentially transformational within health and social care. Implementation of the principles of co-production has the potential to improve health and social care services in a range of settings. Real changes in outcomes and experience and reduction in societal cost can be achieved by making the people of Wales active partners in the design and delivery of their own health and social care. Originality/value – This review offers a readily accessible commentary on co-production, which may be of value to a wide range of professional groups and policy makers. This paper also reflects an original attempt to summarise knowledge and propose further areas for work. Most importantly, this paper offers a start point for co-production to become a reality for service provision with all the attendant benefits that will arise from this development.

Commentary on “Developing a logic model to guide evaluation of impact for learning disability projects: the case of the Positive Behavioural Support (PBS) Academy”

2018 ◽  
Vol 23 (3) ◽  
pp. 133-138
Author(s):  
Anne MacDonald
Keyword(s):  
Learning Disability ◽  
Design Methodology ◽  
Social Care ◽  
Logic Model ◽  
System Implementation ◽  
Content Type ◽  
Behavioural Support ◽  
Strategic Approach

Purpose The purpose of this paper is to provide a commentary on some of the issues raised in the paper “Developing a logic model to guide evaluation of impact for learning disability projects: the case of the Positive Behavioural Support (PBS) Academy”. Design/methodology/approach Drawing on the PBS literature and with reference to the Scott et al. paper, the use of a logic model as a framework for implementing PBS within social care organisations is described. Findings A logic model may be a useful framework for the implementation of PBS within social care organisations and could be used to help organisations develop a strategic approach to whole-system implementation of PBS. Originality/value This commentary adds to the discussion by considering the use of a logic model as a framework for implementing PBS within social care organisations.

Going round in circles? Joint working between primary health and social care

2015 ◽  
Vol 23 (2) ◽  
pp. 53-61 ◽  
Author(s):  
Anna Coleman ◽  
Caroline Glendinning
Keyword(s):  
Social Services ◽  
Early Development ◽  
Large Scale ◽  
Social Care ◽  
Well Being ◽  
Early Years ◽  
Content Type ◽  
Care Groups ◽  
Health And Social Care ◽  
Operational Activities

Purpose – The purpose of this paper is to examine research evidence on collaboration between primary and adult social care in strategic, rather than operational, activities at two different time points, following large-scale changes within the health and social care environments; and discuss the prospects for the future. Design/methodology/approach – This paper reports evidence from two substantial longitudinal studies (Dowling and Glendinning, 2003; Checkland et al., 2012) which followed the development of Primary Care Groups and Trusts (PCG/Ts) and Clinical Commissioning Groups (CCGs), respectively. Each used a combination of national surveys and local in-depth case studies to trace the early development of new structures and ways of working following major changes in the NHS and local government. Findings – PCG/Ts had limited success in collaborating with adult social care partners. Health and Well-being Boards offer a new overarching organisational framework for collaborative strategic working between GP-led CCGs and adult social care services. Mandated joint strategic needs assessments also provide a shared framework within which commissioning decisions by both CCGs and social services are made. However, there remains evidence of long-standing barriers, particularly differences in geographic boundaries and in organisational and professional cultures. Research limitations/implications – Evidence from both studies is based on the early years of the respective new organisations; later evidence may have yielded a different picture. Originality/value – This is the first paper reflecting on developments in strategic relations between primary and social care from researchers involved with two longitudinal investigations of the early development of PCG/Ts (1999-2002) and CCGs (2011-ongoing).

scholarly journals Can we mandate partnership working? Top down meets bottom up in structural reforms in Scotland and Norway

2018 ◽  
Vol 26 (2) ◽  
pp. 109-119 ◽  
Author(s):  
Guro Øyen Huby ◽  
Ailsa Cook ◽  
Ralf Kirchhoff
Keyword(s):  
Performance Management ◽  
Large Scale ◽  
Social Care ◽  
Structural Reforms ◽  
Top Down ◽  
Bottom Up ◽  
Content Type ◽  
Care Organisation ◽  
Health And Social Care ◽  
Local Levels

Purpose Partnership working across health and social care is considered key to manage rising service demand whilst ensuring flexible and high-quality services. Evidence suggests that partnership working is a local concern and that wider structural context is important to sustain and direct local collaboration. “Top down” needs to create space for “bottom up” management of local contingency. Scotland and Norway have recently introduced “top down” structural reforms for mandatory partnerships. The purpose of this paper is to describe and compare these policies to consider the extent to which top-down approaches can facilitate effective partnerships that deliver on key goals. Design/methodology/approach The authors compare Scottish (2015) and Norwegian (2012) reforms against the evidence of partnership working. The authors foreground the extent to which organisation, finance and performance management create room for partnerships to work collaboratively and in new ways. Findings The two reforms are held in place by different health and social care organisation and governance arrangements. Room for manoeuvre at local levels has been jeopardised in both countries, but in different ways, mirroring existing structural challenges to partnership working. Known impact of the reforms hitherto suggests that the potential of partnerships to facilitate user-centred care may be compromised by an agenda of reducing pressure on hospital resources. Originality/value Large-scale reforms risk losing sight of user outcomes. Making room for collaboration between user and services in delivering desired outcomes at individual and local levels is an incremental way to join bottom up to top down in partnership policy, retaining the necessary flexibility and involving key constituencies along the way.

Application of eco-friendly natural dye obtained from Spathodea campanulata on silk using combination of mordants

2016 ◽  
Vol 27 (1) ◽  
pp. 15-21 ◽  
Author(s):  
M Kumaresan
Keyword(s):  
Large Scale ◽  
Potassium Dichromate ◽  
Ferrous Sulphate ◽  
Research Work ◽  
Natural Dye ◽  
Alkaline Media ◽  
Silk Fabric ◽  
Content Type ◽  
Wide Range ◽  
New Research

Purpose – The purpose of this paper is to extract the eco-friendly natural dye obtained from the flower of Spathodea campanulata and apply on silk fabric using combination of mordants. The fastness properties of the flower of Spathodea campanulata dyed silk fabric have been studied using different combination (1:3, 1:1 and 3:1) of various mordants, such as myrobolan: nickel sulphate, myrobolan: aluminium sulphate, myrobolan: potassium dichromate, myrobolan: ferrous sulphate and myrobolan: stannous chloride. The wash, rub, light and perspiration fastness of the dyed samples have been evaluated. Design/methodology/approach – For dyeing there are three methods are used. They are Pre mordanting, Simultaneous mordanting and Post mordanting methods. Dyed silk materials are tested by using wash fastness, rub fastness, light and perspiration fastness methods. Findings – It is found that Spathodea campanulata dye can be successfully used for the dyeing of silk to obtain a wide range colours by using various combinations of mordants. With regards to colour fastness, test samples exhibit excellent fastness to washing, rubbing, except for pre-mordanting using myrobolan: potassium dichromate combination; and good to excellent fastness to perspiration in both acidic and alkaline media. Originality/value – Availability of literature related to this work is not available. The study of combination of mordants of this natural dye on silk is a new research work and the large scale preparation is definitely very useful to the society.

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.

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