scholarly journals Exploring the impacts of the 2012 Health and Social Care Act reforms to commissioning on clinical activity in the English NHS: a mixed methods study of cervical screening

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e024156 ◽  
Author(s):  
Jonathan Hammond ◽  
Thomas Mason ◽  
Matt Sutton ◽  
Alex Hall ◽  
Nicholas Mays ◽  
...  
Keyword(s):  
Quantitative Methods ◽  
Social Care ◽  
Local Authority ◽  
Service Providers ◽  
Cervical Screening ◽  
Unintended Consequences ◽  
Clinical Activity ◽  
Local Authorities ◽  
Health And Social Care ◽  
The Impact

ObjectivesExplore the impact of changes to commissioning introduced in England by the Health and Social Care Act 2012 (HSCA) on cervical screening activity in areas identified empirically as particularly affected organisationally by the reforms.MethodsQualitative followed by quantitative methods. Qualitative: semi-structured interviews (with NHS commissioners, managers, clinicians, senior administrative staff from Clinical Commissioning Groups (CCGs), local authorities, service providers), observations of commissioning meetings in two metropolitan areas of England. Quantitative: triple-difference analysis of national administrative data. Variability in the expected effects of HSCA on commissioning was measured by comparing CCGs working with one local authority with CCGs working with multiple local authorities. To control for unmeasured confounders, differential changes over time in cervical screening rates (among women, 25–64 years) between CCGs more and less likely to have been affected by HSCA commissioning organisational change were compared with another outcome—unassisted birth rates—largely unaffected by HSCA changes.ResultsInterviewees identified that cervical screening commissioning and provision was more complex and ‘fragmented’, with responsibilities less certain, following the HSCA. Interviewees predicted this would reduce cervical screening rates in some areas more than others. Quantitative findings supported these predictions. Areas where CCGs dealt with multiple local authorities experienced a larger decline in cervical screening rates (1.4%) than those dealing with one local authority (1.0%). Over the same period, unassisted deliveries decreased by 1.6% and 2.0%, respectively, in the two groups.ConclusionsArrangements for commissioning and delivering cervical screening were disrupted and made more complex by the HSCA. Areas most affected saw a greater decline in screening rates than others. The fact that this was identified qualitatively and then confirmed quantitatively strengthens this finding. The study suggests large-scale health system reforms may have unintended consequences, and that complex commissioning arrangements may be problematic.

scholarly journals How to Implement Digital Services in a Way That They Integrate Into Routine Work: Qualitative Interview Study Among Health and Social Care Professionals

10.2196/31668 ◽  
2021 ◽  
Vol 23 (12) ◽  
pp. e31668
Author(s):  
Janna Nadav ◽  
Anu-Marja Kaihlanen ◽  
Sari Kujala ◽  
Elina Laukka ◽  
Pirjo Hilama ◽  
...  
Keyword(s):  
Social Care ◽  
Service Providers ◽  
Qualitative Content Analysis ◽  
Implementation Process ◽  
Digital Services ◽  
Routine Work ◽  
Qualitative Interview Study ◽  
Health And Social Care ◽  
Work Tasks ◽  
The Impact

Background Although the COVID-19 pandemic has significantly boosted the implementation of digital services worldwide, it has become increasingly important to understand how these solutions are integrated into professionals’ routine work. Professionals who are using the services are key influencers in the success of implementations. To ensure successful implementations, it is important to understand the multiprofessional perspective, especially because implementations are likely to increase even more. Objective The aim of this study is to examine health and social care professionals’ experiences of digital service implementations and to identify factors that support successful implementations and should be considered in the future to ensure that the services are integrated into professionals’ routine work. Methods A qualitative approach was used, in which 8 focus group interviews were conducted with 30 health and social care professionals from 4 different health centers in Finland. Data were analyzed using qualitative content analysis. The resulting categories were organized under the components of normalization process theory. Results Our results suggested 14 practices that should be considered when implementing new digital services into routine work. To get professionals to understand and make sense of the new service, (1) the communication related to the implementation should be comprehensive and continuous and (2) the implementation process should be consistent. (3) A justification for the service being implemented should also be given. The best way to engage the professionals with the service is (4) to give them opportunities to influence and (5) to make sure that they have a positive attitude toward the service. To enact the new service into professionals’ routine work, it is important that (6) the organization take a supportive approach by providing support from several easy and efficient sources. The professionals should also have (7) enough time to become familiar with the service, and they should have (8) enough know-how about the service. The training should be (9) targeted individually according to skills and work tasks, and (10) it should be diverse. The impact of the implementation on the professionals’ work should be evaluated. The service (11) should be easy to use, and (12) usage monitoring should happen. An opportunity (13) to give feedback on the service should also be offered. Moreover, (14) the service should support professionals’ work tasks. Conclusions We introduce 14 practices for organizations and service providers on how to ensure sustainable implementation of new digital services and the smooth integration into routine work. It is important to pay more attention to comprehensive and continuing communication. Organizations should conduct a competence assessment before training in order to ensure proper alignment. Follow-ups to the implementation process should be performed to guarantee sustainability of the service. Our findings from a forerunner country of digitalization can be useful for countries that are beginning their service digitalization or further developing their digital services.

Financial sustainability of NHS Foundation Trusts in England five years after the enactment of the Health and Social Care Act of 2012

2019 ◽  
Vol 25 (6) ◽  
pp. 1-9
Author(s):  
Rachael S Coates ◽  
Reza Mofidi
Keyword(s):  
Structural Changes ◽  
Social Care ◽  
Clinical Activity ◽  
Financial Indicators ◽  
Financial Position ◽  
Total Capital ◽  
Health And Social Care ◽  
The Mean ◽  
Foundation Trusts ◽  
The Impact

Background/Aims The enactment of the Health and Social Care Act (2012) led to significant structural changes in how hospital services are commissioned and has introduced direct competition with the private sector. The aim of this study was to assess the impact of the act on the financial position of the Shelford Group of NHS Trusts, 5 years after the act's enactment. Methods The levels of clinical activity, annual accounts and statements of financial position produced by the 10 Trusts for the financial years 2010/2011 to 2017/2018 were examined. Findings The key financial indicators for each organisation were collected. Key financial indicators for the period just before the Act were compared with the corresponding values for the period of 5 years after the enactment of the Act. The Shelford group of NHS Trusts provided 15 047 304 patient care episodes in 2017/2018, which represented a rise of 6.34% over 5 years. This was a significant slowdown in clinical, which had grown by 18.57% in the 4 years immediately before the act. There were no significant differences in the mean operating surplus returned by the Shelford Group in the 5 years after the Act, compared to before its implementation. The median cost of finance for each organisation increased by 35.4% from £18 245 000 to £24 703 000. The total capital employed remained static over the 5 years following enactment of the Act. There were no significant differences in levels of liquidity and leverage of the Shelford Group in the 5 years after the Act compared to before. Conclusions The financial position of the Shelford Group of Trusts has not been adversely affected by the Health and Social Care Act (2012) , although there was some evidence that the operational finances of these NHS Trusts were less robust in the 5 years following the Act.

Introducing Role and Service Changes in Health and Social Care: The Impact and Influence of User Involvement in England and Wales

2006 ◽  
Vol 5 (2) ◽  
pp. 249-268 ◽  
Author(s):  
Ruth Young
Keyword(s):  
Social Care ◽  
User Involvement ◽  
Improve Patient Care ◽  
Local Authorities ◽  
New Ways Of Working ◽  
Health And Social Care ◽  
Practical Experiences ◽  
The Impact ◽  
Effective Service ◽  
Improve Patient

A key characteristic of the English and Welsh system of care provision is that the supply function is divided between two types of organisation: the National Health Service (NHS) and local authorities. These inter-organisational and the related inter-professional divides have long been recognised as problematic from a user and carer viewpoint; and various policy changes have attempted to address them. This paper draws on three different research projects to describe practical experiences of user and carer involvement in this context (a) the Evaluation of the 1999 Health Act Section 31 flexibilities encouraging more effective service delivery partnerships between the NHS and local authorities in England; (b) a Baseline Study of Partnership Working and Flexibilities Use in Wales; and (c) the Evaluation of the NHS Changing Workforce Programme, which implemented new ways of working to improve patient care across health and social care in England. In synthesising the studies' findings, the paper also begins to explore relationships between involvement effectiveness and different types of NHS–local authority partnership as they seek to introduce change and deliver more effective services.

scholarly journals Health and social care providers’ perspectives of older people’s drinking: a systematic review and thematic synthesis of qualitative studies

2020 ◽  
Vol 49 (3) ◽  
pp. 453-467 ◽  
Author(s):  
Bethany Kate Bareham ◽  
Eileen Kaner ◽  
Liam Spencer ◽  
Barbara Hanratty
Keyword(s):  
Older Adults ◽  
Alcohol Use ◽  
Social Care ◽  
Service Providers ◽  
Qualitative Studies ◽  
Care Providers ◽  
Thematic Synthesis ◽  
Care Recipients ◽  
Health And Social Care ◽  
The Impact

Abstract Background alcohol may increase risks to late-life health, due to its impact on conditions or medication. Older adults must weigh up the potential risks of drinking against perceived benefits associated with positive roles of alcohol in their social lives. Health and social care workers are in a key position to support older people’s decisions about their alcohol use. Objective to systematically review and synthesise qualitative studies exploring health and social care providers’ views and experiences of older people’s drinking and its management in care services. Method a pre-specified search strategy was applied to five electronic databases from inception to June 2018. Grey literature, relevant journals, references and citations of included articles were searched. Two independent reviewers sifted and quality-appraised articles. Included study findings were analysed through thematic synthesis. Results 18 unique studies were included. Four themes explained findings: uncertainty about drinking as a legitimate concern in care provision for older people; the impact of preconceptions on work with older adults; sensitivity surrounding alcohol use in later life; and negotiating responsibility for older adults’ alcohol use. Discipline- and country-specific patterns are highlighted. Conclusions reservations about addressing alcohol could mean that service providers do not intervene with older adults. Judgements of whether older care recipients’ drinking warrants intervention are complex. Providers will need support and training to recognise and provide appropriate intervention for drinking amongst older care recipients.

scholarly journals The Scottish Social Care Survey (SCS) and the Scottish Care Home Census (SCHC)

2019 ◽  
Vol 4 (1) ◽  
Author(s):  
David Alexander Gunn Henderson ◽  
Jennifer Kirsty Burton ◽  
Ellen Lynch ◽  
David Clark ◽  
Julie Rintoul ◽  
...  
Keyword(s):  
Social Care ◽  
Local Authority ◽  
Care Home ◽  
Population Level ◽  
Probabilistic Methods ◽  
Local Authorities ◽  
Term Care ◽  
Match Rate ◽  
Health And Social Care ◽  
Care Survey

IntroductionLinked health care datasets have been used effectively in Scotland for some time. Use of social care data has been much more limited, partly because responsibility for these services is distributed across multiple local authorities. However, there are substantial interactions between health and social care (also known internationally as long-term care) services, and keen policy interest in better understanding these. We introduce two social care resources that can now be linked to health datasets at a population level across Scotland to study these interdependencies. These data emerge from the Scottish Government’s centralised collation of data from mandatory returns provided by local authorities and care homes. MethodsDeterministic and Probabilistic methods were used to match the Social Care Survey (SCS) and Scottish Care Home Census (SCHC) to the Community Health Index (CHI) number via the National Records of Scotland (NRS) Research Indexing Spine. ResultsFor the years 2010/11 to 2015/16, an overall match rate of 91.2% was achieved for the SCS to CHI from 31 of Scotland’s 32 local authority areas. This rate varied from 76.7% to 98.5% for local authority areas. A match rate of 89.8% to CHI was achieved for the SCHC in years 2012/13 to 2015/16 but only 52.5% for the years 2010/11 to 2011/12. ConclusionIndexing of the SCS and SCHC to CHI offers a new and rich resource of data for health and social care research.

scholarly journals How to Implement Digital Services in a Way That They Integrate Into Routine Work: Qualitative Interview Study Among Health and Social Care Professionals (Preprint)

2021 ◽  
Author(s):  
Janna Nadav ◽  
Anu-Marja Kaihlanen ◽  
Sari Kujala ◽  
Elina Laukka ◽  
Pirjo Hilama ◽  
...  
Keyword(s):  
Social Care ◽  
Service Providers ◽  
Qualitative Content Analysis ◽  
Implementation Process ◽  
Digital Services ◽  
Routine Work ◽  
Qualitative Interview Study ◽  
Health And Social Care ◽  
Work Tasks ◽  
The Impact

BACKGROUND Although the COVID-19 pandemic has significantly boosted the implementation of digital services worldwide, it has become increasingly important to understand how these solutions are integrated into professionals’ routine work. Professionals who are using the services are key influencers in the success of implementations. To ensure successful implementations, it is important to understand the multiprofessional perspective, especially because implementations are likely to increase even more. OBJECTIVE The aim of this study is to examine health and social care professionals’ experiences of digital service implementations and to identify factors that support successful implementations and should be considered in the future to ensure that the services are integrated into professionals’ routine work. METHODS A qualitative approach was used, in which 8 focus group interviews were conducted with 30 health and social care professionals from 4 different health centers in Finland. Data were analyzed using qualitative content analysis. The resulting categories were organized under the components of normalization process theory. RESULTS Our results suggested 14 practices that should be considered when implementing new digital services into routine work. To get professionals to understand and make sense of the new service, (1) the communication related to the implementation should be comprehensive and continuous and (2) the implementation process should be consistent. (3) A justification for the service being implemented should also be given. The best way to engage the professionals with the service is (4) to give them opportunities to influence and (5) to make sure that they have a positive attitude toward the service. To enact the new service into professionals’ routine work, it is important that (6) the organization take a supportive approach by providing support from several easy and efficient sources. The professionals should also have (7) enough time to become familiar with the service, and they should have (8) enough know-how about the service. The training should be (9) targeted individually according to skills and work tasks, and (10) it should be diverse. The impact of the implementation on the professionals’ work should be evaluated. The service (11) should be easy to use, and (12) usage monitoring should happen. An opportunity (13) to give feedback on the service should also be offered. Moreover, (14) the service should support professionals’ work tasks. CONCLUSIONS We introduce 14 practices for organizations and service providers on how to ensure sustainable implementation of new digital services and the smooth integration into routine work. It is important to pay more attention to comprehensive and continuing communication. Organizations should conduct a competence assessment before training in order to ensure proper alignment. Follow-ups to the implementation process should be performed to guarantee sustainability of the service. Our findings from a forerunner country of digitalization can be useful for countries that are beginning their service digitalization or further developing their digital services.

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

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

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

scholarly journals ‘Intended’ and ‘unintended’ consequences of the privatisation of health and social care systems in Italy in light of the pandemic

2021 ◽  
pp. 102425892110284
Author(s):  
Andrea Ciarini ◽  
Stefano Neri
Keyword(s):  
Social Care ◽  
Health Care Systems ◽  
Unintended Consequences ◽  
Long Term Effects ◽  
Regional Health ◽  
Regional Health Care ◽  
Italian Regions ◽  
Health And Social Care ◽  
Care Systems ◽  
The Impact

This article analyses the long-term effects of privatisation and marketisation on the Italian regional health and social care systems. The research focuses on three Italian regions – Lombardy, Veneto and Lazio – which are representative of three different models of governance in these sectors. We examine the effects of privatisation and marketisation on the health and social care system by discussing how the regional health-care systems have managed the impact of the COVID-19 pandemic. We also shed light on the dramatic consequences of the pandemic crisis on employment levels and working conditions.

scholarly journals The patient advisor, an organizational resource as a lever for an enhanced oncology patient experience (PAROLE-onco): a longitudinal multiple case study protocol

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M. P. Pomey ◽  
M. de Guise ◽  
M. Desforges ◽  
K. Bouchard ◽  
C. Vialaron ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Clinical Oncology ◽  
Patient Experience ◽  
Emotional Support ◽  
Social Care ◽  
Legal Issues ◽  
Care Services ◽  
Health And Social Care ◽  
Ethical And Legal Issues ◽  
The Impact

Abstract Background Quebec is one of the Canadian provinces with the highest rates of cancer incidence and prevalence. A study by the Rossy Cancer Network (RCN) of McGill university assessed six aspects of the patient experience among cancer patients and found that emotional support is the aspect most lacking. To improve this support, trained patient advisors (PAs) can be included as full-fledged members of the healthcare team, given that PA can rely on their knowledge with experiencing the disease and from using health and social care services to accompany cancer patients, they could help to round out the health and social care services offer in oncology. However, the feasibility of integrating PAs in clinical oncology teams has not been studied. In this multisite study, we will explore how to integrate PAs in clinical oncology teams and, under what conditions this can be successfully done. We aim to better understand effects of this PA intervention on patients, on the PAs themselves, the health and social care team, the administrators, and on the organization of services and to identify associated ethical and legal issues. Methods/design We will conduct six mixed methods longitudinal case studies. Qualitative data will be used to study the integration of the PAs into clinical oncology teams and to identify the factors that are facilitators and inhibitors of the process, the associated ethical and legal issues, and the challenges that the PAs experience. Quantitative data will be used to assess effects on patients, PAs and team members, if any, of the PA intervention. The results will be used to support oncology programs in the integration of PAs into their healthcare teams and to design a future randomized pragmatic trial to evaluate the impact of PAs as full-fledged members of clinical oncology teams on cancer patients’ experience of emotional support throughout their care trajectory. Discussion This study will be the first to integrate PAs as full-fledged members of the clinical oncology team and to assess possible clinical and organizational level effects. Given the unique role of PAs, this study will complement the body of research on peer support and patient navigation. An additional innovative aspect of this study will be consideration of the ethical and legal issues at stake and how to address them in the health care organizations.

scholarly journals Impact of dementia education and training on health and social care staff knowledge, attitudes and confidence: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e039939
Author(s):  
Sahdia Parveen ◽  
Sarah Jane Smith ◽  
Cara Sass ◽  
Jan R Oyebode ◽  
Andrea Capstick ◽  
...  
Keyword(s):  
Online Survey ◽  
Social Care ◽  
Education And Training ◽  
Care Staff ◽  
Cross Sectional ◽  
Health And Social Care ◽  
Training Content ◽  
The Impact ◽  
And Training ◽  
Dementia Education

ObjectivesThe aim of this study was to establish the impact of dementia education and training on the knowledge, attitudes and confidence of health and social care staff. The study also aimed to identify the most effective features (content and pedagogical) of dementia education and training.DesignCross-sectional survey study. Data collection occurred in 2017.SettingsHealth and social care staff in the UK including acute care, mental health community care trusts, primary care and care homes.ParticipantsAll health and social care staff who had completed dementia education and training meeting the minimal standards as set by Health Education England, within the past 5 years were invited to participate in an online survey. A total of 668 health and social care staff provided informed consent and completed an online survey, and responses from 553 participants were included in this study. The majority of the respondents were of white British ethnicity (94.4%) and identified as women (88.4%).OutcomesKnowledge, attitude and confidence of health and social care staff.ResultsHierarchical multiple regression analysis was conducted. Staff characteristics, education and training content variables and pedagogical factors were found to account for 29% of variance in staff confidence (F=4.13, p<0.001), 22% of variance in attitude (knowledge) (F=3.80, p<001), 18% of the variance in staff knowledge (F=2.77, p<0.01) and 14% of variance in staff comfort (attitude) (F=2.11, p<0.01).ConclusionThe results suggest that dementia education and training has limited impact on health and social care staff learning outcomes. While training content variables were important when attempting to improve staff knowledge, more consideration should be given to pedagogical factors when training is aiming to improve staff attitude and confidence.

Sign in / Sign up

Export Citation Format

Share Document