scholarly journals Exploring, measuring and enhancing the coproduction of health and well-being at the national, regional and local levels through comparative case studies in Sweden and England: the ‘Samskapa’ research programme protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029723 ◽  
Author(s):  
Sofia Kjellström ◽  
Kristina Areskoug-Josefsson ◽  
Boel Andersson Gäre ◽  
Ann-Christine Andersson ◽  
Marlene Ockander ◽  
...  

IntroductionCocreation, coproduction and codesign are advocated as effective ways of involving citizens in the design, management, provision and evaluation of health and social care services. Although numerous case studies describe the nature and level of coproduction in individual projects, there remain three significant gaps in the evidence base: (1) measures of coproduction processes and their outcomes, (2) mechanisms that enable inclusivity and reciprocity and (3) management systems and styles. By focusing on these issues, we aim to explore, enhance and measure the value of coproduction for improving the health and well-being of citizens.Methods and analysisNine ongoing coproduction projects form the core of an interactive research programme (‘Samskapa’) during a 6-year period (2019–2024). Six of these will take place in Sweden and three will be undertaken in England to enable knowledge exchange and cross-cultural comparison. The programme has a longitudinal case study design using both qualitative and quantitative methods. Cross-case analysis and a sensemaking process will generate relevant lessons both for those participating in the projects and researchers. Based on the findings, we will develop explanatory models and other outputs to increase the sustained value (and values) of future coproduction initiatives in these sectors.Ethics and disseminationAll necessary ethical approvals will be obtained from the regional Ethical Board in Sweden and from relevant authorities in England. All data and personal data will be handled in accordance with General Data Protection Regulations. Given the interactive nature of the research programme, knowledge dissemination to participants and stakeholders in the nine projects will be ongoing throughout the 6 years. External workshops—facilitated in collaboration with participating case studies and citizens—both during and at the end of the programme will provide an additional dissemination mechanism and involve health and social care practitioners, policymakers and third-sector organisations.

2020 ◽  
Vol 8 (11) ◽  
pp. 1-118
Author(s):  
Ruth McDonald ◽  
Lisa Riste ◽  
Simon Bailey ◽  
Fay Bradley ◽  
Jonathan Hammond ◽  
...  

Background General practices have begun working collaboratively in general practitioner federations, which vary in scope, geographical reach and organisational form. Objectives The aim was to assess how federating affects practice processes, workforce, innovations in practices and the interface with health and social care stakeholders. Design This was a structured cross-sectional comparison of four case studies, using observation of meetings, interviews and analysis of documents. We combined inductive analysis with literature on ‘meta-organisations’ and networks to provide a theoretically informed analysis. Results All federations were ‘bottom-up’ voluntary membership organisations but with formal central authority structures. Practice processes were affected substantially in only one site. In this site, practices accepted the rules imposed by federation arrangements in a context of voluntary participation. Federating helped ease workforce pressures in two sites. Progress regarding innovations in practice and working with health and social care stakeholders was slower than federations anticipated. The approach of each federation central authority in terms of the extent to which it (1) sought to exercise control over member practices and (2) was engaged in ‘system proactivity’ (i.e. the degree of proactivity in working across a broader spatial and temporal context) was important in explaining variations in progress towards stated aims. We developed a typology to reflect the different approaches and found that an approach consisting of high levels of both top-down control and system proactivity was effective. One site adopted this ‘authoritative’ approach. In another site, rather than creating expectations of practices, the focus was on supporting them by attempting to solve the immediate problems they faced. This ‘indulgent’ approach was more effective than the approach used in the other two sites. These had a more distant ‘neglectful’ relationship with practices, characterised by low levels of both control over members and system proactivity. Other key factors explaining progress (or lack thereof) were competition between federations (if any), relationship with the Clinical Commissioning Group, money, history, leadership and management issues, size and geography; these interacted in a dynamic way. In the context of a tight deadline and fixed targets, federations were able to respond to the requirements to provide additional services as part of NHS Improving Access to General Practice policy in a way that would not have been possible in the absence of federations. However, this added to pressures faced by busy clinicians and managers. Limitations The focus was on only four sites; therefore, any federations that were more active than those federations in these four sites will have been excluded. In addition, although patients were interviewed, because most were unaware of federations, they generally had little to say on the subject. Conclusions General practices working collaboratively can produce benefits, but this takes time and effort. The approach of the federation central authority (authoritative, indulgent or neglectful) was hugely influential in affecting processes and outcomes. However, progress was generally slower than anticipated, and negligible in one case. Future work Future work would benefit from multimethod designs, which provide in-depth, longitudinal, qualitative and quantitative methods, to shed light on processes and impacts. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 11. See the NIHR Journals Library website for further project information.


2018 ◽  
Vol 15 (3) ◽  
pp. 49-51 ◽  
Author(s):  
Nick Bouras ◽  
Silvia Davey ◽  
Tracey Power ◽  
Jonathan Rolfe ◽  
Tom Craig ◽  
...  

Maudsley International was set up to help improve people's mental health and well-being around the world. A variety of programmes have been developed by Maudsley International over the past 10 years, for planning and implementing services; building capacity; and training and evaluation to support organisations and individuals, professionals and managers to train and develop health and social care provisions. Maudsley International's model is based on collaboration, sharing expertise and cultural understanding with international partners.


2021 ◽  
Vol 13 (2) ◽  
Author(s):  
Minna Tiainen ◽  
Outi Ahonen ◽  
Leena Hinkkanen ◽  
Elina Rajalahti ◽  
Alpo Värri

Digital transformation is changing the ecosystem and at the same time professionals’ competencies worldwide. Minimising health care and social welfare costs while increasing citizens’ health and well-being is challenging. Technology and digital tools play an important role in reaching this goal. However, there are inequalities concerning technology, and this has many impacts. Digitalisation brings challenges not only to health care and social welfare professionals but to citizens, too. Working with or using services in digital environments demands new skills. This has social and ethical impacts, e.g. how is equal access to services ensured. Health and social care professionals should have different competencies to respond to this, such as societal competencies. The purpose of this article is to describe how the definition of competencies in health care and social welfare version 1.0 (developed in the national SotePeda 24/7 project) was finalised as the final version 2.0 for Finnish healthcare and social welfare education by experts’ evaluation. Data was collected through an electronic questionnaire administered to selected experts (N=140) during January 2020. The number of experts who responded to the study was 52. These experts (social and health, business and IT) work or have worked in tasks related to the digitalisation of social and health care. The questionnaire was based on version 1.0 of the definition of digital competencies of health care and social welfare informatics. The questionnaire was mainly quantitative, but it also included open-ended qualitative questions. The experts agreed to a large extent on the version 1.0 definition, but some adjustments were made to the definition based on our study. The resulting definition is intended for use in the planning, implementation and evaluation of health care and social welfare education, but it can also be used for polytechnic education. The aim is to develop the digital skills of educators, degree students and in-service trainees in a multidisciplinary way (social and health, business and IT) to meet the needs of working life.


2019 ◽  
Vol 15 (4) ◽  
pp. 294-305 ◽  
Author(s):  
Lisa Merry ◽  
Nancy Edwards

Purpose The purpose of this paper is to highlight gaps in the literature regarding transnational ties, the experience of raising and caring for children in a new (high-income) country and well-being, and to propose a program of research to address these gaps. Design/methodology/approach A general review of the literature on international migration, transnationalism and parenthood was conducted. A program of research and its objectives are then described. Findings To address research gaps, the proposed program of research aims to: develop approaches and tools to examine and measure the transnational experiences of migrant families; better understand migrants’ transnational obligations, resources and movements and their impact on parenthood and the health and well-being of families; assess whether existing health and social care and services for migrant families with children consider the transnational contexts and experiences of families; and determine how health and social care and services for migrant families with children may be adapted or developed to address transnational challenges and enhance transnational resources for families. Originality/value The proposed program of research offers a new approach, transnationalism, for producing knowledge toward better understanding the health and optimizing the care of migrant families in the context of raising and caring for children in a new country. It also contributes to the agenda setting regarding the approach and priority areas for research in migrant health.


2015 ◽  
Vol 39 (4) ◽  
pp. 444 ◽  
Author(s):  
Kate Charlesworth ◽  
Maggie Jamieson ◽  
Colin D. Butler ◽  
Rachel Davey

Background Healthcare systems in Australia and around the world are failing to address the challenges of the modern world. Healthcare leaders are calling for radical, transformational change and entirely new systems of care. However it is unclear what a future, sustainable healthcare system would look like. Methods A narrative review to examine emerging trends in health and social care was conducted. Results and Conclusions Six key trends were identified. Collectively, they suggest that future systems are likely to be characterised by increasingly sophisticated technology, but at the same time greater personal and community responsibility for health and well being, innovative use of social capital, and a new approach to ageing and end-of-life care. What is known about the topic? Health care systems in Australia and around the world are failing to address the key health challenges of modern society. There are calls for radical, transformational change of our health care systems; however it is unclear what a future, sustainable system would look like. What does this paper add? In this narrative review, we identify and examine six key emerging trends in health and social care. Collectively, these trends suggest that future systems are likely to be characterised by increasingly sophisticated technology; but at the same time greater personal and community responsibility for health and well-being, innovative use of social capital, and a new approach to ageing and end-of-life-care. What are the implications for practitioners? It is becoming increasingly clear that radical change is necessary and there are emerging examples of novel and creative initiatives across many areas of practice. Practitioners need to be engaged in, contributing to and in some cases, leading, this transition to a new health and social care system.


2020 ◽  
pp. 174239532093704
Author(s):  
Amanda Wilkinson ◽  
Janel Atlas ◽  
Katrina Nelson ◽  
Hilda Mulligan

Objectives Health and social care navigation services provide support for people with long-term conditions. Such services are available in the New Zealand (NZ) context. However little is known nationally or internationally about clients’ experience of engaging with such services. This study aimed to describe client perspectives of engaging with a health and social care navigation service in a NZ metropolitan city. Methods The manager and navigators of the service recruited clients who were previous users of the service. We individually interviewed nine clients (F = 7; M = 2; aged between 30–80 years) in their homes. Many of the participants reported social isolation, and some were without regular income. We transcribed interviews verbatim and analysed data thematically. Results There was one overall theme: Restoration of my essence or being (in the Māori language, wairua), and sense of belonging (turangawaewae) through a regenerative approach developed in partnership between the navigator and the client. Thus, participants felt renewed and validated as human beings. Discussion Enabling clients to feel re-valued as human beings captures the concept of personhood whereby a person has capability and capacity for life choices. We suggest enabling a client to feel valued assists in development of self-determination and consequently improved health and well-being.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Stuart McClean ◽  
Sanda Ismail ◽  
Emma Bird

Purpose This paper aims to provide critical insight into the impact of locally embedded, community business-related approaches internationally to health and social care on users’ outcomes, in particular exploring their effectiveness in delivering outcomes for users. Design/methodology/approach The study used a robust systematic review methodology. It carefully identifies relevant studies that have been conducted on the impact of community business-related approaches, rigorously evaluates how well these studies have been carried out and combines the results from these studies to address that particular topic. Findings Health and social care-related community businesses deliver on a range of health and well-being outcomes and impacts positively on local residents’ satisfaction with their community/local area. Existing research into community businesses uses mostly qualitative methods, but a few studies have also used quantitative survey and mixed methods and demonstrate the challenges of conducting methodologically rigorous real-world research within local community settings. Research limitations/implications The review was limited to papers published in English language and may have missed relevant studies published in other languages which could have influenced the overall findings. Only one reviewer screened the titles and abstracts of the identified papers. Having multiple reviewers would have strengthened the validity of the screening process. Originality/value Community businesses offer a positive contribution to health and well-being, and highlight the significance of engaging local communities in promoting health, reducing health inequalities and addressing the wider determinants of health. This paper provides a baseline of evidence about community business’ broad impacts on health and well-being to help inform new and emerging evidence


BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e047353
Author(s):  
Henry Aughterson ◽  
Alison R McKinlay ◽  
Daisy Fancourt ◽  
Alexandra Burton

ObjectivesTo explore the psychosocial well-being of health and social care professionals working during the COVID-19 pandemic.DesignThis was a qualitative study deploying in-depth, individual interviews, which were audio-recorded and transcribed verbatim. Thematic analysis was used for coding.ParticipantsThis study involved 25 participants from a range of frontline professions in health and social care.SettingInterviews were conducted over the phone or video call, depending on participant preference.ResultsFrom the analysis, we identified 5 overarching themes: communication challenges, work-related stressors, support structures, personal growth and individual resilience. The participants expressed difficulties such as communication challenges and changing work conditions, but also positive factors such as increased team unity at work, and a greater reflection on what matters in life.ConclusionsThis study provides evidence on the support needs of health and social care professionals amid continued and future disruptions caused by the pandemic. It also elucidates some of the successful strategies (such as mindfulness, hobbies, restricting news intake, virtual socialising activities) deployed by health and social care professionals that can support their resilience and well-being and be used to guide future interventions.


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

Purpose Practitioners, organisations and policy makers in health and social care settings are increasingly recognising the need for trauma-informed approaches in organisational settings, with morbidity and financial burdens a growing concern over the past few years. Servant leadership has a unique focus on emotional healing, service to others as the first priority, in addition to the growth, well-being and personal and professional development of key stakeholders. This paper aims to discuss Trauma Informed Servant Leadership (TISL). Design/methodology/approach A targeted review of the servant leadership and trauma-informed care literature was conducted. Relevant studies, including systematic review and meta-analysis, were sourced, with the resulting interpretation informing the conceptual model. Findings Although there are general guidelines regarding how to go about instituting trauma-informed approaches, with calls for organisational leadership to adapt the often cited six trauma-informed principles, to date there has not been a leadership approach elucidated which takes as its starting point and core feature to be trauma informed. At the same time, there is a paucity of research elucidating trauma outcomes for service users or employees in the literature when a trauma-informed approach is used. However, there is a large body of evidence indicating that servant leadership has many of the outcomes at the employee level that trauma-informed approaches are attempting to attain. Thus, the author builds on a previous conceptual paper in which a model of servant leadership and servant leadership supervision are proposed to mitigate against compassion fatigue and secondary trauma in the health and social care sector. The author extends that research to this paper by recasting servant leadership as a trauma-informed model of leadership that naturally operationalises trauma-informed principles. Research limitations/implications A lack of primary data limits the extent to which conclusions can be drawn on the effectiveness of this conceptual model. However, the model is based on robust research across the differential components used; therefore, it can act as a framework for future empirical research designs to be studies at the organisational level. Both the servant leadership and trauma-informed literatures have been extended with the addition of this model. Practical implications TISL can complement the trauma-informed approach and may also be viable as an alternative to trauma-informed approaches. This paper offers guidelines to practitioners and organisations in health and social care on how to operationalise important trauma-informed principles through leadership. Social implications This conceptual model may help reduce the burden of trauma and re-traumatisation encountered by practitioners and service users in health and social care settings, impacting on morbidity. Originality/value To the best of the author’s knowledge, this is a novel approach, the first of its kind.


2013 ◽  
Vol 21 (1) ◽  
pp. 26-33 ◽  
Author(s):  
Sian Lockwood

PurposeThis paper seeks to explore the potential of micro‐enterprises to assist local health and well‐being boards in delivering their strategies, especially in relation to tackling health inequalities, prevention and community support.Design/methodology/approachThis paper draws on experience gained by Community Catalysts from its work supporting social care and health micro‐enterprise across the UK. There has been little formal research into social care and health micro‐enterprise and so the paper relies heavily on data gathered by Community Catalysts in the course of its work and uses local case studies to illustrate points.FindingsThe paper explains the importance of social care and health micro‐enterprise to the work of health and well being boards, emphasising its potential to help tackle health inequalities and contribute to effective health and well‐being strategies.Originality/valueThere are no examples as yet of imaginative health and well‐being boards engaging effectively with micro‐providers, but boards can draw on learning from local authorities actively stimulating and supporting local micro‐enterprise.


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