Implementing and Scaling up Integrated Care through Collaboration

2014 ◽  
pp. 41-61
Author(s):  
George Crooks ◽  
Donna Henderson
Keyword(s):  
Integrated Care ◽  
Action Group ◽  
Care Services ◽  
Challenging Environment ◽  
Integration Of Services ◽  
Care Systems ◽  
Group Members ◽  
The Common ◽  
High Level ◽  
Developed World

Across the developed world, the majority of health and care systems are looking towards the integration of services within and across organisations to deliver efficiencies and enhance effectiveness and, by doing so, deliver service sustainability in an increasingly challenging environment, while a simple aspiration to articulate in reality the delivery of integrated care is proving challenging and in some cases elusive. In 2012, the European Innovation Partnership on Active and Healthy Ageing's B3 Integrated Care Action Group carried out a high-level survey of 27 B3 Action Group members from regions and delivery organisations across Europe to determine their state of readiness for the delivery of integrated care services. This chapter highlights the common bottlenecks and barriers identified, before moving on to explore the key components that support the successful integration of services, including incentives/levers for change and technology-enabled service solutions.

The Common Bond

2015 ◽  
pp. 19-29
Author(s):  
Anne Eyre ◽  
Pam Dix
Keyword(s):  
Support Groups ◽  
Legal Status ◽  
Common Bond ◽  
Action Group ◽  
Self Help ◽  
Group Members ◽  
The Common ◽  
Set Up ◽  
The Uk

This chapter discusses how those affected by a disaster often form an extraordinary common bond. Self-help support and action group members say that only with others from 'their' disaster can they open up completely, without fear of judgement, about the most difficult aspects of their experience. The examples in this chapter illustrate the kinds of support groups that grew out of those disasters of the 1980s, including the King's Cross Families Action Group, the Herald Families Association, the UK Families Flight 103, the Marchioness Action Group, the Stairway to Heaven Memorial Trust, and the MV Derbyshire Families Association. There are a number of different options for the structure of family and survivor groups in terms of membership, legal status, and management. Some groups have set up unincorporated associations, while a few have chosen to apply for charitable status. Ultimately, representatives from the groups of the 1980s, as well as individual survivors and bereaved people, went on to form, join, and develop Disaster Action.

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 Achieving integrated care through commissioning of primary care services in the English NHS: a qualitative analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e027622 ◽  
Author(s):  
Imelda McDermott ◽  
Kath Checkland ◽  
Valerie Moran ◽  
Lynsey Warwick-Giles
Keyword(s):  
Primary Care ◽  
Integrated Care ◽  
Case Studies ◽  
Models Of Care ◽  
Telephone Surveys ◽  
Care Services ◽  
Primary Care Services ◽  
Combining Data ◽  
Care Systems ◽  
The Impact

ObjectivesSince April 2015, Clinical Commissioning Groups (CCGs) have taken on the responsibility to commission primary care services. The aim of this paper is to analyse how CCGs have responded to this new responsibility and to identify challenges and factors that facilitated or inhibited achievement of integrated care systems.DesignWe undertook an exploratory approach, combining data from interviews and national telephone surveys, with analysis of policy documents and case studies in four CCGs. Data were analysed using thematic content analysis.Setting/participantsWe reviewed 147 CCG application documents and conducted two national telephone surveys with CCGs (n=49 and n=21). We interviewed 6 senior policymakers and 42 CCG staff who were involved in primary care co-commissioning (general practitioners and managers). We observed 74 primary care commissioning committee meetings and their subgroups (approx. 111 hours).ResultsCCGs in our case studies focused their primary care commissioning activities on developing strategic plans, ‘new’ primary care initiatives, and dealing with legacy work. Many plans focused on incentivising and supporting practices to work together and provide a broad range of services. There was a clear focus on ensuring the sustainability of general practice. Our respondents expressed mixed views as to what new collaborative service models, such as the new models of care and sustainability and transformation partnerships (STPs), would mean for the future of primary care and the impact they could have on CCGs and their members.ConclusionsThere is a disconnect between locally based primary care and the wider system. One of the major challenges we identified is the lack of knowledge and expertise in the field of primary care at STP level. While primary care commissioning by CCGs seems to be supporting local collaborations between practices, there is some way to go before this is translated into broader integration initiatives across wider footprints.

A Cooperative Species

2011 ◽  
Author(s):  
Samuel Bowles ◽  
Herbert Gintis
Keyword(s):  
Common Good ◽  
Cooperative Groups ◽  
Social Emotions ◽  
Large Numbers ◽  
Group Competition ◽  
Self Interest ◽  
Shame And Guilt ◽  
Group Members ◽  
The Common ◽  
Ethnographic Data

Why do humans, uniquely among animals, cooperate in large numbers to advance projects for the common good? Contrary to the conventional wisdom in biology and economics, this generous and civic-minded behavior is widespread and cannot be explained simply by far-sighted self-interest or a desire to help close genealogical kin. This book shows that the central issue is not why selfish people act generously, but instead how genetic and cultural evolution has produced a species in which substantial numbers make sacrifices to uphold ethical norms and to help even total strangers. The book describes how, for thousands of generations, cooperation with fellow group members has been essential to survival. Groups that created institutions to protect the civic-minded from exploitation by the selfish flourished and prevailed in conflicts with less cooperative groups. Key to this process was the evolution of social emotions such as shame and guilt, and our capacity to internalize social norms so that acting ethically became a personal goal rather than simply a prudent way to avoid punishment. Using experimental, archaeological, genetic, and ethnographic data to calibrate models of the coevolution of genes and culture as well as prehistoric warfare and other forms of group competition, the book provides a compelling and novel account of human cooperation.

Negotiations over Accounting Issues: The Congruency of Audit Partner and Chief Financial Officer Recalls

2005 ◽  
Vol 24 (s-1) ◽  
pp. 171-193 ◽  
Author(s):  
Michael Gibbins ◽  
Susan A. McCracken ◽  
Steven E. Salterio
Keyword(s):  
Negotiation Process ◽  
Chief Financial Officers ◽  
Chief Financial Officer ◽  
Relative Importance ◽  
Common Elements ◽  
Contextual Features ◽  
Large Numbers ◽  
The Common ◽  
High Level ◽  
Two Sides

Much of what takes place in auditor-client management negotiations occurs in unobservable settings and normally does not result in publicly available archival records. Recent research has increasingly attempted to probe issues relating to accounting negotiations in part due to recent events in the financial world. In this paper, we compare recalls from the two sides of such negotiations, audit partners, and chief financial officers (CFOs), collected in two field questionnaires. We examine the congruency of the auditors' and the CFOs' negotiation recalls for all negotiation elements and features that were common across the two questionnaires (detailed analyses of the questionnaires are reported elsewhere). The results show largely congruent recall: only limited divergences in recall of common elements and features. Specifically, we show a high level of congruency across CFOs and audit partners in the type of issues negotiated, parties involved in resolving the issue, and the elements making up the negotiation process, including agreement on the relative importance of various common accounting contextual features. The analysis of the common accounting contextual features suggests that certain contextual features are consistently important across large numbers of negotiations, whether viewed from the audit partner's or the CFO's perspective, and hence may warrant future study. Finally, the comparative analysis allows us to identify certain common elements and contextual features that may influence both audit partners and CFOs to consider the accounting negotiation setting as mainly distributive (win-lose).

Can Groups Assert That P?

2019 ◽  
pp. 326-344
Author(s):  
Deborah Tollefsen
Keyword(s):  
Common Ground ◽  
Speech Act ◽  
Single Individual ◽  
Constitutive Rule ◽  
The Past ◽  
Group Members ◽  
The Common ◽  
Declarative Statement ◽  
John Macfarlane

When a group or institution issues a declarative statement, what sort of speech act is this? Is it the assertion of a single individual (perhaps the group’s spokesperson or leader) or the assertion of all or most of the group members? Or is there a sense in which the group itself asserts that p? If assertion is a speech act, then who is the actor in the case of group assertion? These are the questions this chapter aims to address. Whether groups themselves can make assertions or whether a group of individuals can jointly assert that p depends, in part, on what sort of speech act assertion is. The literature on assertion has burgeoned over the past few years, and there is a great deal of debate regarding the nature of assertion. John MacFarlane has helpfully identified four theories of assertion. Following Sandy Goldberg, we can call these the attitudinal account, the constitutive rule account, the common-ground account, and the commitment account. I shall consider what group assertion might look like under each of these accounts and doing so will help us to examine some of the accounts of group assertion (often presented as theories of group testimony) on offer. I shall argue that, of the four accounts, the commitment account can best be extended to make sense of group assertion in all its various forms.

Caged-electron States and Split-electron States in Endohedral Alkali C60

2021 ◽  
Author(s):  
yifan yang ◽  
Lorenz S Cederbaum
Keyword(s):  
State Of The Art ◽  
Electronic States ◽  
Electron States ◽  
The Common ◽  
High Level

The low-lying electronic states of neutral X@C60(X=Li, Na, K, Rb) have been computed and analyzed by employing state-of-the-art high level many-electron methods. Apart from the common charge-separated states, well known...

scholarly journals Referrals to Urgent Dental Centres During the COVID-19 Pandemic: A Multi-Site Analysis Research Project

2021 ◽  
Vol 10 (1) ◽  
pp. 40-45
Author(s):  
Adam Shathur ◽  
Samuel Reeves ◽  
Faizal Sameja ◽  
Vishal Patel ◽  
Allan Jones
Keyword(s):  
Primary Care ◽  
Secondary Care ◽  
Easy Access ◽  
Dental Services ◽  
Care Services ◽  
Dental Practitioners ◽  
Consultation And Referral ◽  
Care Systems ◽  
Access To Primary Care ◽  
The Uk

Introduction: The COVID-19 pandemic enforced the cessation of routine dentistry and the creation of local urgent dental care systems in the UK. General dental practices are obligated by NHS guidance to remain open and provide remote consultation and referral where appropriate to patients having pain or problems. Aims: To compare two urgent dental centres with different triage and referral systems with regard to quality and appropriateness of referrals, and patient management outcomes. Methods: 110 consecutive referrals received by a primary care urgent dental centre and a secondary care urgent dental centre were assessed. It was considered whether the patients referred had access to remote primary care dental services, fulfilled the criteria required to be deemed a dental emergency as mandated by NHS guidance, and what the outcomes of referrals were. Results: At the primary care centre, 100% of patients were referred by general dental practitioners and had access to remote primary care dental services. 95.5% of referrals were deemed appropriate and were seen for treatment. At the secondary care site, 94.5% of referrals were direct from the patient by contacting NHS 111. 40% had received triaging to include ‘advice, analgesia and antimicrobial’ from a general dental practitioner, and 25.5% were deemed appropriate and resulted in treatment. Conclusion: Urgent dental centres face many issues, and it would seem that easy access to primary care services, collaboration between primary care clinicians and urgent dental centres, and training of triaging staff are important in operating a successful system.

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