scholarly journals Commissioning for long-term conditions: hearing the voice of and engaging users – a qualitative multiple case study

2014 ◽  
Vol 2 (44) ◽  
pp. 1-204 ◽  
Author(s):  
Stephen Peckham ◽  
Patricia Wilson ◽  
Lorraine Williams ◽  
Jane Smiddy ◽  
Sally Kendall ◽  
...  
Keyword(s):  
Research Programme ◽  
Interactive Methods ◽  
Long Term Conditions ◽  
The Public ◽  
Patient Representatives ◽  
The Uk ◽  
The Impact ◽  
The Voice

BackgroundSome 15 million people in England have a long-term condition (LTC) but there is concern about whether or not the NHS meets their needs. To address this, consecutive governments have developed policies aimed at improving service delivery and patient and public engagement and involvement (PPEI). There has been little research that examines the impact or benefit of PPEI in commissioning. This project explored the role and impact of PPEI in commissioning for people with LTCs. The research was undertaken during a period of substantial change in the English NHS, which enabled us to observe how the NHS reforms in England impacted on approaches to PPEI.AimThe aim was to examine how commissioners enable voice and engagement of people with LTCs and identify what impact this has on the commissioning process and pattern of services. Our specific objectives were to (1) critically analyse the relationship between the public/patient voice and the impact on the commissioning process; (2) determine how changes in the commissioning process reshape local services; (3) explore whether or not any such changes in services impact on the patient experience; (4) identify if and how commissioners enable the voice and engagement of people with LTCs; and (5) identify how patient groups/patient representatives get their voice heard and what mechanisms and processes patients and the public use to make their voice heard.MethodsWe used a case study design examining the experience of PPEI in three LTC groups – diabetes, rheumatoid arthritis and neurological conditions – through three in-depth case studies. Our approach involved reviewing practice across the UK and then focusing on three geographical areas to examine practices of commissioning health care for people with LTCs, approaches to PPEI, patterns of services for people with LTCs and the activities of local patient and voluntary organisations for people with LTCs. The research had five phases and involved participatory and interactive methods of data collection and analysis.FindingsWe identified two key areas where improvements to practice in relation to PPEI can be made. The first relates to the framework or infrastructure arrangements for PPEI and how PPEI can be supported in the NHS and other organisations. To combat short-termism and the fragility of PPEI activities, sufficient resources need to be invested in developing shared understandings and sustaining relationships and infrastructures. The second area of action relates to the process for PPEI and how it should be undertaken.ConclusionAction needs to be taken by organisations at both national and local levels. PPEI is a circular process and, in itself, extremely fragile. This circular process can be ‘virtuous’– successful engagement leads to improved involvement and outcomes. However, where involvement is tokenistic or ends, patients and the public become disengaged and less involved and can be described as a ‘vicious circle’. In addition, we identified a number of key methodological issues and areas for further research that should be considered by research funders and researchers undertaking research in the area of PPEI, including a need for research on PPEI with young people.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

Back to basics: fighting fraud and austerity

2015 ◽  
Vol 22 (2) ◽  
pp. 219-227
Author(s):  
Kwabena Frimpong
Keyword(s):  
Public Sector ◽  
Financial Crime ◽  
Content Type ◽  
The Public ◽  
Reference Guide ◽  
Secondary Sources ◽  
The Uk ◽  
The Impact ◽  
Resource Capacity

Purpose – This article aims to focus on the impact of the current austerity measures on UK public sector anti-fraud and financial crime investigative resource capacity building initiative developed over the years to tackle fraud against the public purse. Design/methodology/approach – The article draws on secondary sources of data and available literature on fraud and financial crime. Findings – Fraud is a challenge in the UK public sector but the cut-back on anti-fraud and financial crime investigative resources, given the scale of public sector fraud, the growing emphasis on accountability and the time of austerity with public money more exposed to fraud is arguably a back-door/u-turn policy on zero-tolerance approach in tackling public sector fraud and financial crime. There is the potential of this encouraging more fraud and financial crime against the public sector in the long term if measures are not taken to devise strategies for enhancing anti-fraud and financial crime investigative resource capacity. Research limitations/implications – The research implication for this article is that it opens an avenue for future studies to examine post austerity strategies for strengthening public sector anti-fraud and financial crime investigative resource strategies to deal with emerging fraud threats to UK public sector. Practical implications – This article acts as a reference guide for policymakers to reflect on the long-term adverse impact of the austerity on anti-fraud and financial crime investigative resource capacity and capability in tackling fraud public sector fraud. Originality/value – The paper attempts to present an alternative lens to examining the scale of UK public sector fraud problem rather than relying on headline story of declining fraud in UK.

scholarly journals Impact of the UK COVID-19 pandemic on HbA1c testing and its implications for diabetes diagnosis and management

2020 ◽  
Author(s):  
David Holland ◽  
Adrian Heald ◽  
Mike Stedman ◽  
Lewis Green ◽  
Jonathan Scargill ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetes Diagnosis ◽  
Long Term Conditions ◽  
Diagnosis And Management ◽  
Increased Risk ◽  
Poor Outcomes ◽  
The Uk ◽  
The Impact

Our findings illustrate the widespread collateral impact of implementing measures to mitigate the impact of COVID-19 in people with, or being investigated for diabetes mellitus (DM). Ironically, failure to focus of the wider implications for people with DM and other groups with long-term conditions, may place them at increased risk of poor outcomes from SARS-CoV-2 infection itself, irrespective of the implications for their longer-term health prospects.

Evolution of public-private partnership: the UK perspective through a case study approach

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Marios Adamou ◽  
Niki Kyriakidou ◽  
Jon Connolly
Keyword(s):  
Public Private Partnership ◽  
Long Term Results ◽  
Private Partnership ◽  
Content Type ◽  
System Resilience ◽  
The Uk ◽  
The Impact

Purpose Since the 1990s, the National Health Service (NHS)advisory officers have developed considerable expertise in managing the process of specifying, procuring, contracting and running public–private partnership (PPP) projects. However, there has been a relatively consistent trajectory in the findings of studies and evaluation of PPP from its initial introduction in the health sector in 1992 to the present time. Therefore, the purpose of this study is to critically evaluate the PPP experience in the UK context using a case study in the NHS. Design/methodology/approach The partnership literature is primarily focussed on process issues, and the impact of partnerships on improving outcomes cannot be assumed. By conducting a critical review on most updated research studies and innovative approaches in this area, the literature as to the place of PPPs in health in the context of the UK is critically explored and whether they have a role in system resilience is examined. A case study has be used as well to describing the processes of a PPP arrangement. Findings Health-care PPP is one of the options relating to health system resilience. However, their contribution in the NHS has been mixed, with success noted in short-term clinical and services contracts while in the long-term the value for money argument has not been proven. In theory, the role of PPPs in bringing together ingredients supporting system resilience such as finance, management and innovation in the UK has not always been successful, and NHS providers have taken the approach to exit such arrangements. Research limitations/implications More research work is needed to capture the 21st-century challenges and critical success factors during its implementation. Practical implications The creation of strong partnerships is moving service delivery away from a project-by-project approach to one that includes strategic and policy developments for long-term results. Originality/value This is a fresh discussion in the role of PPP in system resilience in the UK perspective through a case study describing an exit from a PPP arrangement.

scholarly journals From Pilot to Scale - A Framework for Development Practitioners for Market Driven Vocational Training

2021 ◽  
Vol 22 (2) ◽  
pp. 653-674
Author(s):  
Jaime Moll de Alba ◽  
Virpi Stucki
Keyword(s):  
Industrial Development ◽  
Manufacturing Sector ◽  
System Development ◽  
Supply And Demand ◽  
Skills Acquisition ◽  
The Public ◽  
The Impact

Partnerships bringing together both the private and the public sector, as well as development actors might play an important role in facilitating the acquisition of skills and thereby support sustainable socio-economic development, notably in the manufacturing sector. The participation of the private sector in such partnerships contributes to enhance the adequacy between skills supply and demand and thereby spurs employability and economic activity. This paper makes use of the case study method to analyse the role of this kind of partnership in skills acquisition in five industrial development projects in Africa. We hypothesize that the Market System Development (MSD) approach offers potential to enhance the impact of skills acquisition partnerships. We conclude by proposing an innovative framework to support policymakers and development practitioners to conceptualise new skills development partnerships through the application of the MSD approach contributing to systemic change and long-term sustainability.

scholarly journals The Future of Our Seas: Marine scientists and creative professionals collaborate for science communication

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Laurence De Clippele ◽  
Madlaina Michelotti ◽  
Charlotte R. Findlay ◽  
Amy Cartwright ◽  
Qing Fang ◽  
...  
Keyword(s):  
Public Engagement ◽  
Science Communication ◽  
The Public ◽  
The Future ◽  
Effective Science ◽  
Collaborative Engagement ◽  
Development Support ◽  
The Impact

To increase awareness of the current challenges facing the marine environment, the Future of Our Seas (FOOS) project brought together the expertise of scientists, public engagement experts and creatives to train and support a group of marine scientists in effective science communication and innovative public engagement. This case study aims to inspire scientists and artists to use the FOOS approach in training, activity design and development support (hereafter called the ‘FOOS programme’) to collaboratively deliver novel and creative engagement activities. The authors reflect on the experiences of the marine scientists: (1) attending the FOOS communication and engagement training; (2) creating and delivering public engagement activities; (3) understanding our audience; and (4) collaborating with artists. The authors also share what the artists and audiences learned from participating in the FOOS public engagement activities. These different perspectives provide new insights for the field with respect to designing collaborative training which maximizes the impact of the training on participants, creative collaborators and the public. Long-term benefits of taking part in the FOOS programme, such as initiating future collaborative engagement activities and positively impacting the scientists’ research processes, are also highlighted.

scholarly journals Automated conflict resolution between multiple clinical pathways: a technology report

2018 ◽  
Vol 25 (3) ◽  
pp. 142-148 ◽  
Author(s):  
Ian Litchfield ◽  
Alice Turner ◽  
Ruth Backman ◽  
João Bosco Ferreira Filho ◽  
Phil Weber ◽  
...  
Keyword(s):  
Secondary Care ◽  
Fundamental Problem ◽  
Clinical Pathways ◽  
Software Tool ◽  
Care Pathways ◽  
Long Term Conditions ◽  
Type Method ◽  
The Uk

BackgroundThe number of people in the UK with three or more long-term conditions continues to grow and the management of patients with co-morbidities is complex. In treating patients with multimorbidities, a fundamental problem is understanding and detecting points of conflict between different guidelines which to date has relied on individual clinicians collating disparate information.ObjectiveWe will develop a framework for modelling a diverse set of care pathways, and investigate how conflicts can be detected and resolved automatically. We will use this knowledge to develop a software tool for use by clinicians that can map guidelines, highlight root causes of conflict between these guidelines and suggest ways they might be resolved.MethodOur work consists of three phases. First, we will accurately model clinical pathways for six of the most common chronic diseases; second, we will automatically identify and detect sources of conflict across the pathways and how they might be resolved. Third, we will present a case study to prove the validity of our approach using a team of clinicians to detect and resolve the conflicts in the treatment of a fictional patient with multiple common morbidities and compare their findings and recommendations with those derived automatically using our novel software.DiscussionThis paper describes the development of an important software-based method for identifying a conflict between clinical guidelines. Our findings will support clinicians treating patients with multimorbidity in both primary and secondary care settings.

scholarly journals Nutrient retention behind a tropical mega-dam: a case study of the Sardar Sarovar Dam, India

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Harish Gupta ◽  
S. Kiran Kumar Reddy ◽  
Mounika Chiluka ◽  
Vamshikrishna Gandla
Keyword(s):  
Arabian Sea ◽  
Inorganic Nitrogen ◽  
Nutrient Retention ◽  
Significant Loss ◽  
N Removal ◽  
Narmada River ◽  
Sardar Sarovar ◽  
The Impact

AbstractIn this study, we demonstrate the impact of the construction of a mega-dam on the nutrient export regime of a large tropical river into the Arabian Sea. Long-term (11 years) fortnight nutrient parameters, upstream and downstream to Sardar Sarovar (SS) Dam, were examined to determine the periodical change in nutrient fluxes from the Narmada River, India. During this 11-year period, the average discharge of the Narmada River upstream to Rajghat (35.3 km3 year−1) was higher than that of downstream at Garudeshwar (33.9 km3 year−1). However, during the same period, the suspended sediment load was reduced by 21 million tons (MT) from 37.9 MT at Rajghat to 16.7 MT at Garudeshwar. Similarly, mean concentrations of dissolved silica (DSi) reduced from 470 (upstream) to 214 µM (downstream), dissolved inorganic phosphate (DIP) from 0.84 to 0.38 µM, and dissolved inorganic nitrogen (DIN) from 43 to 1.5 µM. It means that about 54%, 55%, and 96% flux of DSi, DIP, and DIN retained behind the dam, respectively. The estimated denitrification rate (80,000 kg N km−2 year−1) for the reservoir is significantly higher than N removal by lentic systems, globally. We hypothesize that processes such as biological uptake and denitrification under anoxic conditions could be a key reason for the significant loss of nutrients, particularly of DIN. Finally, we anticipated that a decline in DIN fluxes (by 1.13 × 109 mol year−1) from the Narmada River to the Arabian Sea might reduce the atmospheric CO2 fixation by 7.46 × 109 mol year−1.

scholarly journals Evaluation of the Impact of Timber Truck Configuration and Tare Weight on Payload Efficiency: An Australian Case Study

Forests ◽  
2021 ◽  
Vol 12 (7) ◽  
pp. 855
Author(s):  
Mark W. Brown
Keyword(s):  
Load Management ◽  
Vehicle Design ◽  
Forest Industry ◽  
Post Operation ◽  
Gross Vehicle Weight ◽  
Australian Case ◽  
Trends Over Time ◽  
The Impact

The forest industry tends to plan, and model transportation costs based on the potential payload benefits of increased legal gross vehicle weight (GVW) by deploying different configurations, while payload benefits of a configuration can be significantly influenced by the vehicle design tare weight. Through this research the relative benefit of increased legal GVW of different configurations is compared across Australia over a 13-year period from 2006 to 2019, by examining data collected post operation across multiple operations. This approach is intended to offer realistic insight to real operations not influenced by observation and thus reflect long-term operating behaviour. The inclusion of the three most common configuration classes in Australian forestry over a 13-year period has also allowed the exploration of load management between configurations and potential trends over time. When considering the legal GVW and the tare weight impacts across the fleets, the semi-trailer has an 8 t payload disadvantage compared to B-Doubles and 19.6 t disadvantage compared to road trains.

scholarly journals Storm Driven Migration of the Napatree Barrier, Rhode Island, USA

Geosciences ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 330
Author(s):  
Bryan A. Oakley
Keyword(s):  
Rhode Island ◽  
Shoreline Change ◽  
Aerial Photographs ◽  
Tropical Storms ◽  
Lower Intensity ◽  
Storm Activity ◽  
The Impact ◽  
Washover Fan

Napatree Point, an isolated barrier in southern Rhode Island, provides a case study of barrier spit migration via storm driven overwash and washover fan migration. Documented shoreline changes using historical surveys and vertical aerial photographs show that the barrier had little in the way of net change in position between 1883 and 1939, including the impact of the 1938 hurricane. The barrier retreated rapidly between 1945 and 1975, driven by both tropical and extra-tropical storms. The shoreline position has been largely static since 1975. The removal of the foredune during the 1938 hurricane facilitated landward shoreline migration in subsequent lower intensity storms. Dune recovery following the 1962 Ash Wednesday storm has been allowed due to limited overwash and barrier migration over the last several decades. Shoreline change rates during the period from 1945–1975 were more than double the rate of shoreline change between 1939 and 2014 and triple the rate between 1883 and 2014, exceeding the positional uncertainty of these shoreline pairs. The long-term shoreline change rates used to calculate coastal setbacks in Rhode Island likely underestimate the potential for rapid shoreline retreat over shorter time periods, particularly in a cluster of storm activity. While sea-level rise has increased since 1975, the barrier has not migrated, highlighting the importance of storms in barrier migration.

scholarly journals The Impact of COVID-19 on Hospitality Industry in Greece and Its Treasured Santorini Island

2021 ◽  
Vol 13 (14) ◽  
pp. 7906
Author(s):  
Nikola Medová ◽  
Lucie Macková ◽  
Jaromir Harmacek
Keyword(s):  
Social Impact ◽  
Tourism Sector ◽  
Challenges And Opportunities ◽  
Multiple Variables ◽  
Hospitality Sector ◽  
Tourism And Hospitality ◽  
The Impact ◽  
Further Development

This paper focuses on the dynamic of the recent upheaval in the tourism and hospitality sector due to the COVID-19 epidemic in Greece and Santorini island. It uses the case study of a country one-fourth of whose GDP consists of tourism. We compare the available statistical data showing the change in variables in the previous years with 2020 and look into the new challenges and opportunities posed by the drop in the numbers of visitors and flights. We focus mainly on the economic and social impact on the destination and possible future scenarios for further development in the area. Data show a significant effect of the pandemic on multiple variables, such as the long-term trend of the importance of tourism sector in GDP in Greece, the number of flights and visitors to Greece and Santorini island, and the contribution of tourism and travel to GDP. Based on the available data, we also construct three foresight scenarios that describe the possible futures for Santorini island in terms of the pandemic evolution. These scenarios may help various stakeholders and policymakers to be better prepared for different developments that may appear.

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