scholarly journals Challenges in integrating health and social care: the Better Care Fund in England

2019 ◽  
Vol 25 (2) ◽  
pp. 86-93 ◽  
Author(s):  
Jenny Harlock ◽  
James Caiels ◽  
Joanna Marczak ◽  
Michele Peters ◽  
Raymond Fitzpatrick ◽  
...  
Keyword(s):  
Social Care ◽  
National Policy ◽  
Shared Vision ◽  
Local Health ◽  
Method Evaluation ◽  
Organizational Issues ◽  
Key Stakeholders ◽  
Health And Social Care ◽  
Care Systems ◽  
Study Participants

Objectives The Better Care Fund is the first and only national policy in England that has legally mandated the use of pooled budgets to support local health and social care systems to provide better integrated care. Methods We report qualitative findings from the first national multi-method evaluation of the Better Care Fund, focusing on its implementation, perceptions of progress and expected impacts among key stakeholders. Interviews were carried out with 40 staff responsible for Better Care Fund implementation in 16 local health and social care sites between 2017 and 2018. Results Study participants reported their experiences of implementation, and we present these in relation to three themes: organizational issues, relational issues and wider contextual issues. Participants stressed the practical and political challenges of managing pooled budgets and the complexity of working across geographical boundaries. In a context of unprecedented austerity, shared vision and strong leadership were even more vital to achieve collaborative outcomes. Conclusion Pooling budgets through the Better Care Fund can lever closer collaboration between sectors and services. Shared vision and leadership are essential to develop and foster this closer collaboration. Although some successes were reported, the study highlights that there are major cultural, operational and territorial barriers to overcome.

scholarly journals Adaptation to extreme weather events in complex health and social care systems: The example of older people’s services in England

2017 ◽  
Vol 36 (1) ◽  
pp. 67-91 ◽  
Author(s):  
Sarah Curtis ◽  
Katie Oven ◽  
Jonathan Wistow ◽  
Christine Dunn ◽  
Lena Dominelli
Keyword(s):  
Case Studies ◽  
Complexity Theory ◽  
Social Care ◽  
National Policy ◽  
Extreme Weather ◽  
Extreme Weather Events ◽  
Weather Events ◽  
Local Case ◽  
Health And Social Care ◽  
Care Systems

Our findings contribute to a growing international literature on how conceptual models from complexity theory may be relevant to inform planning in health and social care systems, helping to adapt and improve preparedness and resilience to extreme weather events. We focus on findings from two case studies in England and their relationship to national policy for adaptation. Complexity theory helped to frame strategies for planning for events that are emergent and unpredictable. We find from our case studies that, in spite of the uncertainty involved, some ‘principles’ derived from parts of the literature on complexity theory may provide a helpful framework for the development of more robust preparedness strategies in the health and social care sector. By viewing health and social care as a ‘system of systems’, adaptation planning recognises the interrelationships of built, institutional and social infrastructures. The idea of local systems, with variable, path-dependent attributes, which are partially closed, but permeable to other parts of the wider network, leads to an actionable model of adaptation which emphasises the potential value of local self-organisation, but also underlines the importance of co-evolution across the wider system and the vital role of national initiatives and support for adaptation strategies. The value of sharing experience from local case studies across the national system, as well as among local partners, is very apparent in the experience reported here.

scholarly journals Health and Wellbeing Boards: The new system stewards?

2016 ◽  
Author(s):  
Anna Coleman ◽  
Surindar Dhesi ◽  
Stephen Peckham
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Care ◽  
Local Level ◽  
Local Health ◽  
Health And Wellbeing ◽  
Care Services ◽  
Health And Social Care ◽  
Care Systems ◽  
New System

Health and Wellbeing Boards (HWBs) emerged from debates about the Health and Social Care Bill (2011) as a key coordinating mechanism or steward for local health and social care systems. For many this is yet a further attempt to improve coordination between health and social care services which historically has been a mixed experience. The rationale for HWBs, however, includes a broader coordinating function across local authority services with a role in addressing the wider social determinants of health such as housing, education and planning, as well as social care. This chapter examines the development of HWBs and draws on the findings of studies conducted by the authors and considers whether or not HWBs are emerging as system stewards. By this the authors mean HWBs acting at a strategic level to coordinate and set the direction of health and social care developments at the local level, as well as encouraging integrated working.

scholarly journals More that unites us than divides us? A qualitative study of integration of community health and social care services

2020 ◽  
Author(s):  
Claire Mitchell ◽  
Abigail Tazzyman ◽  
Susan J. Howard ◽  
Damian Hodgson
Keyword(s):  
Community Health ◽  
Social Care ◽  
National Policy ◽  
Shared Vision ◽  
Relationship Building ◽  
Care Staff ◽  
Structured Interviews ◽  
Care Services ◽  
Effective Discharge ◽  
Health And Social Care

Abstract Background The integration of community health and social care services has been widely promoted nationally as a vital step to improve patient centred care, reduce costs, reduce admissions to hospital and facilitate timely and effective discharge from hospital. The complexities of integration raise questions about the practical challenges of integrating health and care given embedded professional and organisational boundaries in both sectors. We describe how an English city created a single, integrated care partnership organisation, to fully integrate community health and social care services. This led to the development of twelve integrated neighbourhood teams, combining and co-locating professionals across three separate localities. The aim of this research is to identify the context and the factors enabling and hindering integration from a qualitative process evaluation. Methods Twenty-four semi-structured interviews were conducted with equal numbers of health and social care staff at strategic and operational level. The data was subjected to thematic analysis. Results We describe three key themes: 1) shared vision and leadership; 2) organisational factors; 3) professional workforce factors. We found a clarity of vision and purpose of integration throughout the partnership organisation, but there were challenges related to the introduction of devolved leadership. There were widespread concerns that the specified outcome measures did not capture the complexities of integration. Organisational challenges included a lack of detail around clinical and service delivery planning, tensions around variable human resource practices and barriers to data sharing. A lack of understanding and trust meant professional workforce integration remained a key challenge, although integration was also seen as a potential solution to engender relationship building. Conclusions Given the long-term national policy focus on integration this ambitious approach to fully integrate community health and social care has highlighted implications for leadership, organisational design and inter-professional working. Given the ethos of valuing the local assets of individuals and networks within the new partnership organisation we found the integrated neighbourhood teams could all learn from each other. Many of the challenges of integration could benefit from embracing the inherent capabilities across the integrated neighbourhood teams and localities of this city.

scholarly journals More that unites us than divides us? A qualitative study of integration of community health and social care services

2020 ◽  
Author(s):  
Claire Mitchell ◽  
Abigail Tazzyman ◽  
Susan J. Howard ◽  
Damian Hodgson
Keyword(s):  
Community Health ◽  
Social Care ◽  
National Policy ◽  
Shared Vision ◽  
Relationship Building ◽  
Care Staff ◽  
Structured Interviews ◽  
Care Services ◽  
Effective Discharge ◽  
Health And Social Care

Abstract Background: The integration of community health and social care services has been widely promoted nationally as a vital step to improve patient centred care, reduce costs, reduce admissions to hospital and facilitate timely and effective discharge from hospital. The complexities of integration raise questions about the practical challenges of integrating health and care given embedded professional and organisational boundaries in both sectors. We describe how an English city created a single, integrated care partnership, to integrate community health and social care services. This led to the development of twelve integrated neighbourhood teams, combining and co-locating professionals across three separate localities. The aim of this research is to identify the context and the factors enabling and hindering integration from a qualitative process evaluation.Methods: Twenty-four semi-structured interviews were conducted with equal numbers of health and social care staff at strategic and operational level. The data was subjected to thematic analysis. Results: We describe three key themes: 1) shared vision and leadership; 2) organisational factors; 3) professional workforce factors. We found a clarity of vision and purpose of integration throughout the partnership, but there were challenges related to the introduction of devolved leadership. There were widespread concerns that the specified outcome measures did not capture the complexities of integration. Organisational challenges included a lack of detail around clinical and service delivery planning, tensions around variable human resource practices and barriers to data sharing. A lack of understanding and trust meant professional workforce integration remained a key challenge, although integration was also seen as a potential solution to engender relationship building. Conclusions: Given the long-term national policy focus on integration this ambitious approach to integrate community health and social care has highlighted implications for leadership, organisational design and inter-professional working. Given the ethos of valuing the local assets of individuals and networks within the new partnership we found the integrated neighbourhood teams could all learn from each other. Many of the challenges of integration could benefit from embracing the inherent capabilities across the integrated neighbourhood teams and localities of this city.

scholarly journals More that unites us than divides us? A qualitative study of integration of community health and social care services

2019 ◽  
Author(s):  
Claire Mitchell ◽  
Abigail Tazzyman ◽  
Susan J. Howard ◽  
Damian Hodgson
Keyword(s):  
Community Health ◽  
Social Care ◽  
National Policy ◽  
Shared Vision ◽  
Care Staff ◽  
Structured Interviews ◽  
Care Services ◽  
Effective Discharge ◽  
Health And Social Care ◽  
Delivery Planning

Abstract Background The integration of community health and social care services has been widely promoted nationally as a vital step to improve patient centred care, reduce costs, reduce admissions to hospital and facilitate timely and effective discharge from hospital. The complexities of integration raise questions about the practical challenges of integrating health and care given embedded professional and organisational boundaries in both sectors. We describe how an English city created a single, integrated care partnership organisation, to fully integrate community health and social care services. This led to the development of twelve integrated neighbourhood teams, combining and co-locating professionals across three separate localities. The aim of this research is to identify the context and the factors enabling and hindering integration from a qualitative process evaluation.Methods Twenty-four semi-structured interviews were conducted with equal numbers of health and social care staff at strategic and operational level. The data was subjected to thematic analysis.Results We describe three key themes: 1) shared vision and leadership; 2) organisational factors; 3) professional workforce factors. We found a clarity of vision and purpose of integration throughout the partnership organisation, but there were challenges related to the introduction of devolved leadership. There were widespread concerns that the specified outcome measures did not capture the complexities of integration. Organisational challenges included a lack of detail around clinical and service delivery planning, tensions around variable human resource practices and barriers to data sharing. A lack of understanding and trust meant professional workforce integration remained a key challenge, although integration was also seen as a potential solution to engender relationship building.Conclusions Given the long-term national policy focus on integration this ambitious approach to fully integrate community health and social care has highlighted implications for leadership, organisational design and inter-professional working. Given the ethos of valuing the local assets of individuals and networks within the new partnership organisation we found the integrated neighbourhood teams could all learn from each other. Many of the challenges of integration could benefit from embracing the inherent capabilities across the integrated neighbourhood teams and localities of this city.

scholarly journals Carer Empowerment Is Key to Reduce Dementia Care Inequalities in the Middle East

2021 ◽  
Vol 18 (8) ◽  
pp. 4378
Author(s):  
Syed Fahad Javaid ◽  
Aishah Al-Zahmi ◽  
Munir Abbas
Keyword(s):  
Middle East ◽  
Social Care ◽  
Evidence Based ◽  
Political Factors ◽  
Knowledge Based ◽  
Care And Support ◽  
Health And Social Care ◽  
Care Systems ◽  
Spiritual Perspectives ◽  
Do So

Dementia represents a significant problem in the Middle East. Sociocultural and political factors that shape conceptions of health and care tend to stifle research and the dissemination of knowledge throughout the Middle East. These socio-political challenges concerning engagement with individuals living with dementia and their carers include language barriers, stigmatization, logistical constraints, lack of informal support outside of hospitals, and over-dependence on clinicians for dementia information. There is an urgent need in the Middle East to increase care and support for adults with dementia and their carers, enhance research efforts and improve the dissemination of information related to dementia in the region. One possible way to do so is to begin to promote a knowledge-based culture throughout the Middle East. This can be achieved by aligning traditional deterministic and spiritual perspectives of mental health with more Western, scientific, and evidence-based models. We suggest employing practical, multidimensional approaches to deal with the stated challenges, both at individual and societal levels. Doing so will improve knowledge of dementia and allow health and social care systems in the Middle East to begin to address a growing problem.

Health and Social Care Systems

2020 ◽  
pp. 49-66
Author(s):  
Anna Coleman ◽  
Jolanta Shields ◽  
Tim Gilling
Keyword(s):  
Social Care ◽  
Health And Social Care ◽  
Care Systems

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.

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.

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