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 Analysing local public health action plans: development of a tool for the French CLoterreS Study

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
Y Le Bodo ◽  
R Fonteneau ◽  
C Harpet ◽  
H Hudebine ◽  
F Jabot ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Promotion ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Care ◽  
Local Health ◽  
The Social ◽  
Prevention And Health Promotion ◽  
Living Circumstances

Abstract Background The potential contribution of local authorities to prevention and health promotion is well recognized. In France, since 2009, Local Health Contracts (LHCs) are mobilising Regional Health Agencies, local elected officials and stakeholders to intervene in 4 areas: health promotion, prevention, health care and social care. LHCs remain poorly documented policy instruments. Methods As part of the CLoterreS study, a multidimensional coding tool was developed and tested by two coders to explore the place of prevention and health promotion in LHCs. Its development was based on the WHO conceptual framework for action on the social determinants of health and the Self-assessment tool for the evaluation of essential public health operations in the WHO European Region. Preliminary results concern a random sample of 17 LHCs from as many French regions selected among the 165 LHCs signed between 2015 and March 2018. Results On average, the LHCs featured 26 action forms (AF) (min: 5; max: 56). In a LHC, the average proportion of AF addressing either the social determinants of health, living circumstances or other determinants targeted by health protection, promotion or primary prevention interventions (SDoH-HPP-P1) was 79% while 44% of the AF address secondary/tertiary prevention, social care or the organization of health care and services. Among the SDoH-HPP-P1 themes (double coding permitted): psychosocial life circumstances were addressed in the 17 LHCs and concerned, on average, 31% of their AF; material living circumstances were addressed to a lesser extent (16 LHCs, 13%); other key themes include environmental health (12, 14%), mental health (16, 12%), alcohol abuse (15, 11%), drug use (14, 11%), smoking (13, 9%), physical activity (13, 12%), healthy eating (12, 12%). Conclusions This work confirms that LHCs are instruments with prevention and health promotion at their core. Explanation of the differing investments in this area across our sample will be further explored. Key messages Local Health Contracts are promising instruments to address locally a broad range of health determinants. The CLoterreS analytical tool has proven effective in capturing multiple themes and shedding light on differences between Local Health Contracts’ action plans.

scholarly journals How Do People Who Are Homeless Find Out about Local Health and Social Care Services: A Mixed Method Study

2021 ◽  
Vol 19 (1) ◽  
pp. 46
Author(s):  
Vanessa Heaslip ◽  
Sue Green ◽  
Bibha Simkhada ◽  
Huseyin Dogan ◽  
Stephen Richer
Keyword(s):  
Mixed Methods Research ◽  
Research Study ◽  
Social Care ◽  
Third Sector ◽  
Local Health ◽  
Care Services ◽  
Study Results ◽  
Health And Social Care ◽  
One To One ◽  
The Uk

Background: There are significant numbers of people experiencing homelessness both in the UK and internationally. People who are homeless are much more likely to die prematurely and, therefore, need strong access to ongoing health and social care support if we hope to address the health disparity they face. Objectives: The aim of the research was to explore how people who are homeless identify and locate appropriate health and social care services. Design: A mixed methods research study was applied on people who are currently homeless or had previously experienced homelessness. Settings: The research study was based in an urban area in the southwest of England. The area was chosen as it was identified to be in the top 24 local authorities for the number of homeless individuals. Participants: A hundred individuals participated in the survey, of those 32% were living on the streets whilst 68% were living in temporary accommodation such as a charity home, shelter or a hotel paid for by the local authority. In addition, 16 participated in either a focus group or one-to-one interview Methods: The quantitative component consisted of a paper-based questionnaire whilst the qualitative aspect was focus groups/one-to-one interviews. The COREQ criteria were used in the report of the qualitative aspects of the study. Results: Quantitative data identified poor health in 90% of the sample. Access to both healthcare and wider wellbeing services (housing and food) was problematic and support for this was largely through third sector charity organisations. Qualitative data identified numerous systemic, individual and cultural obstacles, leaving difficulty for people in terms of knowing who to contact and how to access services, largely relying on word of mouth of other people who are homeless. Conclusions: In order to address health inequities experienced by people who are homeless, there is a need to review how information regarding local health and wider wellbeing services is provided in local communities.

Prevent rough sleeping; create a psychologically informed environment

2015 ◽  
Vol 36 (1) ◽  
pp. 36-42 ◽  
Author(s):  
Claire Ritchie
Keyword(s):  
Design Methodology ◽  
Mental Distress ◽  
Social Care ◽  
Good Practice ◽  
Psychological Needs ◽  
Personal Accomplishment ◽  
Content Type ◽  
Health And Wellbeing ◽  
Care Services ◽  
Health And Social Care

Purpose – The purpose of this paper is to inspire services to create Psychologically Informed Environments (PIEs) to support people experiencing homelessness, complex trauma and multiple exclusion. Design/methodology/approach – It outlines key elements of PIEs and how these have been implemented at the Waterloo Project; a 19 bed hostel and integrated health and social care partnership in Lambeth. It considers the importance of meeting individuals emotional and psychological needs to support them out of homelessness. Findings – The service review found a reliable reduction in residents’ mental distress and improved health and wellbeing. Repeat homelessness, anti-social and self-harming behaviour decreased whilst engagement with services, self-care and esteem increased. There are early indications of cost benefits to health and social care services. Staff reported professional development and an increase in their sense of personal accomplishment. Originality/value – The paper aims to share learning, good practice and the outcomes of a psychologically informed approach to working with individuals who have not had their needs met by existing services. It illustrates the actual and potential social and economic impact and value on both individuals and public services.

Integrated care nursing in Canterbury, New Zealand

2016 ◽  
Vol 24 (3) ◽  
pp. 150-160 ◽  
Author(s):  
Lynne Wigens
Keyword(s):  
Integrated Care ◽  
Social Care ◽  
Health Care Systems ◽  
Positive Culture ◽  
Content Type ◽  
Nurse Leadership ◽  
Care Services ◽  
Health And Social Care ◽  
Care Systems ◽  
Travel Scholarship

Purpose – The purpose of this paper is to outline how nursing has contributed to the development of integrated care in an internationally recognised centre of excellence (Timmins and Ham, 2013). Design/methodology/approach – During a three-week travel scholarship the author undertook interviews, focus groups and observation and has reflected on this through three themes. These are: system working, nursing leadership and examples of integrated care in action. Findings – Elements of the Canterbury approach could have implications for other health care systems, e.g. New Care Models within England. Time was spent on developing the vision, involving many staff. Stability in the senior leadership team allowed decisions to be made in a collective, transformational way. Nurse leadership authenticity meant nursing staff saw integrated decision making being role modelled at a senior level and this appeared to empower them to operate in a similar way. Time was invested in redesign. Creating a positive culture where innovation was tried, without staff feeling the risks and challenges would not be supported by their leaders. Originality/value – This system worked most effectively where there was cohesion between health and social care, and strong relationships developed between leaders and staff working for different providers. The reflection includes practice examples of integrated care services in action. There is potential to inform integrated care developments within other health and social care systems, e.g. Vanguards within England.

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.

Context: commissioning in the English NHS

2020 ◽  
pp. 15-34
Author(s):  
Imelda McDermott ◽  
Pauline Allen ◽  
Valerie Moran ◽  
Anna Coleman ◽  
Kath Checkland ◽  
...  
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Social Care ◽  
Local Health ◽  
Health And Wellbeing ◽  
Short Summary ◽  
Health Authorities ◽  
Health And Social Care ◽  
The Creation ◽  
Expected Benefits

Chapter 2 provides the context, setting out the organisation and governance of commissioning in the NHS. It includes a short summary of the architecture of commissioning pre-Health and Social Care Act (HSCA12), and highlights the important changes which were brought about by the Act, including the abolition of Primary Care Trusts and Strategic Health Authorities, the establishment of Clinical Commissioning Groups (CCGs), the creation of NHS England, transfer of commissioning responsibilities to different bodies (e.g. public health) and the setting up of local Health and Wellbeing Boards. The chapter also highlights the programme theories underlying the HSCA12, in particular the commitment to competition as a means of improving services and the expected benefits of greater clinical involvement in commissioning.

Off the Radar? Addressing housing disrepair to improve health in later life

2017 ◽  
Vol 21 (4) ◽  
pp. 224-228 ◽  
Author(s):  
Susan Marie Adams
Keyword(s):  
Private Sector ◽  
Older People ◽  
Social Care ◽  
Housing Stock ◽  
Local Level ◽  
Later Life ◽  
Content Type ◽  
Health And Wellbeing ◽  
Health And Social Care ◽  
Housing Services

Purpose The purpose of this paper is to highlight the pivotal role of initiatives that address housing disrepair, home improvements and adaptations as a way of improving health, independence and quality of life in older age. Design/methodology/approach The author uses data from housing and health, combined with the author’s experience of policy formulation as well as working with older people and developing practical services, particularly those which address private sector housing stock condition. Findings As well as its massive economic impact, housing greatly affects people’s health and wellbeing, not only in later life but across the life course. In England, there is a long history of systematic, government backed action to improve and maintain housing stock condition. There are significant economic and social gains from a coherent national response to addressing private sector housing disrepair, including creation of employment opportunities, economic stimulus through enabling best use of assets, as well as health and social care gains. In addition to increasing housing supply through building much needed new homes, existing housing stock disrepair needs once again to be “on the radar” of policy makers operating across health, social care and housing. Concerted action to make homes safe, healthy places to live in later life, whatever an older person’s tenure, requires vision and innovation and is an essential element in the integration of health, social care – and housing. With significant funding constraints in local authorities, especially for adult social care, and in the context of growing pressures on the NHS, sustaining good health in later life is more important than ever. There is a compelling case for cross-sector action to reduce health hazards in ordinary, private housing, given that 79 per cent of older people who live in non-decent homes are owner occupiers. This is an opportune moment for Health and Wellbeing Boards to take a lead on this issue at a local level, as well as time to put housing stock condition back “On the Radar” of national government policy. Social implications There is a need to embed practical housing services in the emerging integrated health and care systems in order to extend healthy later life for the majority of older people who live in mainstream housing. Originality/value The author draws on over 30 years’ experience of innovation, development and evaluation of older people’s housing, services and policy development to provide a vision for greater integration across health, care and housing.

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 Occupational therapists’ experiences of enabling people to participate in sport

2020 ◽  
pp. 030802262097394
Author(s):  
Deborah Bullen ◽  
Channine Clarke
Keyword(s):  
Qualitative Study ◽  
Occupational Therapy ◽  
Thematic Analysis ◽  
Social Care ◽  
Occupational Therapists ◽  
Phenomenological Approach ◽  
Scope Of Practice ◽  
Local Populations ◽  
Care Services ◽  
Health And Social Care

Introduction In response to growing demands on health and social care services there is an emphasis on communities addressing the needs of local populations to improve lives and reduce inequalities. Occupational therapists are responding to these demands by expanding their scope of practice into innovative settings, such as working with refugees, the homeless and residents of nursing homes, and within sport and leisure environments. The benefits of sport are widely acknowledged, and this paper argues that occupational therapists could play a pivotal role in enabling people to participate. Method This qualitative study drew on a phenomenological approach and used interviews and thematic analysis to explore five occupational therapists’ experiences of enabling people to participate in sport. Findings Findings revealed that participants demonstrated the uniqueness of occupational therapy when enabling people to participate in sport and practised according to their professional philosophy. There were opportunities to reach wider communities and promote the value of occupational therapy by collaborating with organisations, but there were also challenges when working outside of traditional settings. Conclusion The study emphasises the unique skills occupational therapists can bring to this setting. It highlights opportunities to expand their practice, to forge new partnerships in sports and leisure environments, and to address the national inactivity crisis.

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.

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