Clinical Engagement in Commissioning: Past and Present

Author(s):  
Kath Checkland ◽  
Anna Coleman ◽  
Imelda McDermott ◽  
Rosalind Miller ◽  
Stephen Peckham ◽  
...  
Keyword(s):  
2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Christos Begkos ◽  
Katerina Antonopoulou

PurposeThis study aims to investigate the hybridization practices that medical managers engage with to promote accounting and performance measurement in the hybrid setting of healthcare. In doing so, the authors explore how medical managers enact and become practitioners of hybridity.Design/methodology/approachThe authors adopt a practice lens to conceptualize hybridization as an emergent, situated practice and capture the micro-activities that medical managers engage with when they enact hybridity. The authors conducted semi-structured interviews with medical managers, business managers and coding professionals and collected documents at an English National Health Service (NHS) hospital over the course of five years.FindingsThe findings accentuate two emergent practices through which medical managers instill hybridity to individuals who are hesitant or resistant to hybridization. Medical managers engage in equivocalizing and de-stigmatizing practices to broaden the understandings, further diversify or reconcile the teleologies of clinicians in non-managerial roles. In doing so, the authors signal the merits of accounting in improving care outcomes and remove the stigma associated to clinical engagement with costs.Originality/valueThe study contributes to hybridization and practice theory literature via capturing how hybridity is enacted in practice in a healthcare setting. As medical managers engage with and promote accounting information and performance measurement technologies in their practice environment, they transcend professional boundaries and hybridize the professional spaces that surround them.


2008 ◽  
Vol 14 (5) ◽  
pp. 326-329 ◽  
Author(s):  
Annie Lau

‘Delivering race equality’ is a 5-year action plan for tackling race inequalities in mental healthcare in England and Wales, based on the main themes of improved services, better community engagement and better information. The perception is that clinical teams have not been sufficiently engaged with the plan and progress is slow. This article shares insights from the author's work across government departments over the past 2 years and explores the potential for linking up different initiatives across the patient care pathway in support of the plan's delivery. A summary of conclusions from a pilot survey of consultant psychiatrists, commissioned by the Department of Health in June 2007, addresses the main controversial areas in the action plan, with suggestions for improvement. Areas for clinical engagement are identified that exploit new funding, investment and policy initiatives. Examples of good practice are offered.


2018 ◽  
Vol 22 (1) ◽  
pp. 63-84
Author(s):  
John O'Connor

The art of psychotherapy has been defined as the capacity of the psychotherapist’s mind to receive the psyche of the patient, particularly its unconscious contents. This deceptively simple definition implies the enormously complex art of receiving the most disturbed, dissociated, maddening, often young and primitive, frightening, and fragmented aspects of the patient’s multiple ages and selves, in the hope perhaps that we might make available to our own mind, to the patient’s mind, and within the therapeutic relationship, whatever it is that we discover together, perhaps with the possibility that this may allow that these dissociated, fragmented, lost, and potentially transformative aspects of self might become more accessible to both therapist and patient. The complexity of this process is further intensified when cultural difference is an important aspect of therapeutic engagement. This paper will explore this rich and complex art. It will include exploration of psychoanalytic, relational, and transpersonal psychotherapeutic perspectives as they inform the potentials and mysteries of this deeply receptive process. The paper will consider the potential this receiving of the other might have for the growth of both the therapist and patient within the life span of clinical engagement and will include consideration of implications for cross cultural clinical work. Clinical vignettes illustrating and informing the ideas explored in this paper will be woven throughout the paper. Whakarāpopotonga Kua tautuhia te toi whakaora hinengaro ko te kaha o te hinengaro o te kaiwhakaora hinengaro ki te pupuri i te hinengaro o te tūroro, mātuatua nei ko ngā matū maurimoe. E tohu ana te tautuhinga ngāwari nei i te kaha uaua o te mahi pupuri i ngā maramara tirohanga, ngā tau, ngā whaiaro tini o ngā tūroro arā noa atu te wairangi, te noho wehe, te kārangirangi, he taiohi, he māori, whakawehiwehi, i runga i te wawata tērā pea ka tuwhera ki ō tātau ake hinengaro, ko tō te tūroro ki waenga hoki i te whakapiringa haumanu. E kene pea mā te mea ka kitea, e tuku ēnei tirohanga pūreirei, kongakonga, ngaro, ā, ngā tirohanga hurihanga whaiaro e whakamāmā ake ki te kaiwhakaora me te tūroro. Ka kaha ake te auatanga o tēnei hātepe i te mea ko te rerekētanga o te ahurea te wāhanga nui o te mahi haumanu. Ka wheraina e tēnei tuhinga te tirohanga toitaurea mōmona nei. Ka whakaurua te wherawherahanga o te wetewetenga hinengaro, te tātanga, me ngā tirohanga whakaoranga hinengaro wairua i te mea ko ēnei ngā kaiwhakamōhio i ngā pirikoko o tēnei hātepe toropupū tino hōhonu. Ka whakaarohia e te pepa nei te ēkene pea o te whakaurunga mai o tētahi kē atu mō te whakatipuranga o te kaihaumanu me te tūroro i roto i te wā huitahi ai. Ka whakaarohia ake anō hoki ngā hīkaro mō te mahi haumanu ahurea whakawhiti. Ka rarangahia ngā kōrero haumanu e whakaahua e whakaatu ana i ngā whakaaro tūhuraina i roto i tēnei tuhinga.


2019 ◽  
Author(s):  
Jessica D'Arcey ◽  
Joanna Collaton ◽  
Nicole Kozloff ◽  
Aristotle N Voineskos ◽  
Sean A Kidd ◽  
...  

BACKGROUND Individuals experiencing psychosis are at a disproportionate risk for premature disengagement from clinical treatment. Barriers to clinical engagement typically result from funding constraints causing limited access to and flexibility in services. Digital strategies, such as SMS text messaging, offer a low-cost alternative to potentially improve engagement. However, little is known about the efficacy of SMS text messaging in psychosis. OBJECTIVE This review aimed to address this gap, providing insights into the relationship between SMS text messaging and clinical engagement in the treatment of psychosis. METHODS Studies examining SMS text messaging as an engagement strategy in the treatment of psychosis were reviewed. Included studies were published from the year 2000 onward in the English language, with no methodological restrictions, and were identified using 3 core databases and gray literature sources. RESULTS Of the 233 studies extracted, 15 were eligible for inclusion. Most studies demonstrated the positive effects of SMS text messaging on dimensions of engagement such as medication adherence, clinic attendance, and therapeutic alliance. Studies examining the feasibility of SMS text messaging interventions found that they are safe, easy to use, and positively received. CONCLUSIONS Overall, SMS text messaging is a low-cost, practical method of improving engagement in the treatment of psychosis, although efficacy may vary by symptomology and personal characteristics. Cost-effectiveness and safety considerations were not adequately examined in the studies included. Future studies should consider personalizing SMS text messaging interventions and include cost and safety analyses to appraise readiness for implementation. CLINICALTRIAL


2021 ◽  
Vol 37 (S1) ◽  
pp. 34-34
Author(s):  
Neil Anand ◽  
Evan Campbell ◽  
Tracey Macgann ◽  
Joanna Kelly ◽  
Julie Calvert

IntroductionHealth Technology Assessment (HTA) is an important but time-consuming process to inform decision-making. Following requests from stakeholders in Scotland to provide advice on technologies that had recently undergone HTA in other jurisdictions, SHTG recognized a gap in their ‘product menu’. Colleagues within the SHTG team devised a mechanism through which an original HTA could be adapted for Scotland, taking into account local contextual factors.MethodsSHTG Adaptations comprise the following: i) assessment of the original HTA using the EUnetHTA HTA Adaptation Toolkit and checklist; ii) draft Adaptation using the outcome of the assessment and contextual information for Scotland; iii) consultation group of relevant Scottish clinicians is provided with the original HTA and draft SHTG Adaptation; iv) modified Delphi approach (max. three rounds of questioning) is used to ascertain the relevance of the original HTA to Scotland; v) the Adaptation is submitted to SHTG Council for endorsement.ResultsSHTG Adaptations have a timeline of 2–3 months, three have been published since this product was launched. The process has run smoothly with excellent clinical engagement from across NHS Scotland. Key learning focusses on the role of the SHTG Council (i.e. appraisal committee) in this process and in handling of expert opinion of evidence which has already been appraised by another agency.ConclusionsThe SHTG Adaptation is a new product which offers a timely assessment and utilization of an HTA from another agency.


2019 ◽  
Vol 64 (2) ◽  
pp. S42
Author(s):  
Carolyn A. McCarty ◽  
Madisen Barre-Hemingway ◽  
Elizabeth Parker ◽  
Deborah Ann Fandel ◽  
Adriana Cristina Arghira ◽  
...  

2014 ◽  
Vol 59 (1) ◽  
pp. 62-66 ◽  
Author(s):  
E Riches ◽  
B Robson
Keyword(s):  

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