Coordination of health and social care for children with complex health needs across the EU/EEA: a case scenario approach exploring care coordination for an adolescent with an Acquired Brain Injury

Introduction: The use of link workers for social prescribing and health and social care coordination is increasing, but there is insufficient data to demonstrate their effectiveness or for whom they work best. Multimorbidity is increasing in prevalence and affects those living in deprived areas ten years earlier than affluent areas. This systematic review aims to examine the evidence for the effectiveness and costs of link workers in improving health outcomes. We will also look for evidence for the use of link workers specifically for people living with multimorbidity and in deprived areas. Methods: Databases of published and grey literature will be searched for randomised and non-randomised controlled trials examining use of link workers based in primary care for community dwelling adults compared to usual care. Primary outcomes will be health related quality of life and mental health. Data on costs will be extracted. Studies will be selected for inclusion by title and abstract review by two reviewers. A Preferred Reporting Items for Systematic Reviews (PRISMA) flow diagram will document the selection process. A standardised form will be used to extract data. Data quality will be assessed using the Cochrane Risk of Bias tool for randomised controlled trials, a narrative synthesis will be completed and the GRADE assessment tool used to comment on evidence quality. A meta-analysis of effect size of primary outcomes and subgroup analysis for multimorbidity and social deprivation will be performed if there are sufficient comparable data. Conclusion: This systematic review will give an important overview of the evidence for the use of link workers providing social prescribing and health and social care coordination in primary care. This will help inform intervention development and guide policy makers on whether these interventions are cost effective and which groups stand to benefit most. Prospero registration: CRD42019134737 (04/07/2019)

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International experiments with different models of allocating funds to facilitate integrated care: a scoping review protocol

BMJ Open ◽

10.1136/bmjopen-2017-021374 ◽

2018 ◽

Vol 8 (11) ◽

pp. e021374

Author(s):

Akram Khayatzadeh-Mahani ◽

Ellen Nolte ◽

Jason Sutherland ◽

Pierre-Gerlier Forest

Keyword(s):

Integrated Care ◽

Scoping Review ◽

Care Coordination ◽

Social Care ◽

Service Providers ◽

Research Question ◽

Major Barrier ◽

Health And Social Care ◽

Wide Range ◽

Care Systems

IntroductionIntegrated care is viewed widely as a potential solution to some of the major challenges faced by health and social care systems, such as those posed by service duplication, fragmentation and poor care coordination, and associated impacts on the quality and cost of services. Fragmented models of allocating funds to and across sectors, programmes and providers are frequently cited as a major barrier to integration and countries have experimented with different models of allocating funds to enhance care coordination among service providers and to reduce ineffective care and avoid costly adverse events. This scoping review aims to assess published international experiences of different models of allocating funds to facilitate integration and the evidence on their impacts.Methods and analysisWe will adopt a scoping review methodology due to the potentially vast and multidisciplinary nature of the literature on different models of allocating funds in health and social care systems, as well as the scarcity of existing knowledge syntheses. The framework developed by Arksey and O’Malley will be followed that entails six steps: (1) identifying the research question(s), (2) searching for relevant studies, (3) selecting studies, (4) charting the data, (5) collating, summarising and reporting the results and (6) and conducting consultation exercises. These steps will be conducted iteratively and reflexively, making adjustments and repetitions when appropriate to make sure the literature has been covered as comprehensively as possible. To ensure comprehensiveness of our literature review, we also search a wide range of sources.Ethics and disseminationAn integrated knowledge translation strategy will be pursued by engaging our knowledge users through all stages of the review. We will organise two workshops or policy roundtables/policy dialogues in Alberta and British Columbia with participation of diverse knowledge users to discuss and interpret the findings of our review and to draw out policy opportunities and lessons that can be applied to the context of these two provinces.

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The Development of the Health and Social Care Sector in the Regions of the Czech Republic in Comparison with other EU Countries

Social Sciences ◽

10.3390/socsci8060170 ◽

2019 ◽

Vol 8 (6) ◽

pp. 170 ◽

Cited By ~ 1

Author(s):

Erika Urbánková

Keyword(s):

Czech Republic ◽

Healthcare Workers ◽

Social Care ◽

Secondary Data ◽

The European Union ◽

The Czech Republic ◽

Health And Social Care ◽

The Given ◽

Nurses And Midwives ◽

The Eu

In this paper, the quantitative status of employees in the Health and Social Care sector in the Czech Republic is assessed, and the future development of the sector is predicted both for the Czech Republic as a whole, and for individual regions according to the NUTS3 classification. At present, labor market prognoses are created using the ROA-CERGE model, which includes the main professions in the Health and Social Care sector. This article expands the predictions by adding the regional level and using extrapolation of time series, and it identifies the regions important for the given sector and the labor force. The position of the Czech Republic with regard to selected professions in comparison with other countries of the European Union, i.e., its qualitative status, is also assessed in the paper. The following professions are assessed: general nurses and midwives (both with and without a specialization), physicians, and professional assistants. Healthcare workers do not manifest geographical mobility between regions and work primarily in the region where they live. Since the Czech Republic’s accession to the EU, staff working in key professions have been able to work under comparable conditions in any of the member states. The workforce flow depends, among other things, on its qualitative representation in the given country. To find groups of European countries with similar characteristics of quantitative coverage in selected professions in the Health and Social Care sector, cluster analysis is used to identify homogeneous clusters of countries, as of 2016. Secondary data was obtained from the Czech Statistical Office (CZSO) and the Information System (ISA+) of the National Institute of Education (NIE).

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Operationalising the Deprivation of Liberty Safeguards (DoLS) in support of brain injury survivors – views from practice

The Journal of Adult Protection ◽

10.1108/jap-02-2021-0006 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Jade Scott ◽

Stephen Weatherhead ◽

Jill Manthorpe

Keyword(s):

Decision Making ◽

Brain Injury ◽

Social Care ◽

Legal Framework ◽

Content Type ◽

Health And Social Care ◽

Mental Capacity Act 2005 ◽

Decision Making Styles ◽

Tentative Explanation ◽

Mental Capacity Act

Purpose Deprivation of Liberty Safeguards (DoLS), as part of the Mental Capacity Act 2005 (DoLS, 2007), was established to provide a legal framework for decision-making in respect of adults who lack capacity to make decisions in relation to their care and residence in England and Wales. The purpose of this study was to explore the DoLS decision-making process from the perspectives of health and social care practitioners when working with individuals with an acquired brain injury (ABI). Design/methodology/approach A total of 12 health and social care practitioners were interviewed in 2019–2020 about their experiences of using and making or supporting decisions in the DoLS framework with ABI survivors. Data were analysed, and a tentative explanation of variations in DoLS decision-making was developed. Findings Three distinct approaches emerged capturing different decision-making styles (risk-averse, risk-balancing and risk-simplifying) which appeared to influence the outcome of DoLS assessments. A range of mediating factors seemed to account for the variability in these styles. The wider contextual challenges that impact upon practitioners’ overall experiences and use of DoLS processes in their ABI practice were noted. Research limitations/implications The findings highlight a need for changes in practice and policy in relation to how DoLS or similar processes are used in decision-making practice with ABI survivors and may be relevant to the implementation of the Liberty Protection Safeguards that are replacing the DoLS system. Originality/value To the best of the authors’ knowledge, this is the first study to explore accounts of DoLS decision-making practices in ABI service.

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A response to “A preventable death? A family’s perspective on an adult safeguarding review regarding an adult with traumatic brain injury”

The Journal of Adult Protection ◽

10.1108/jap-01-2017-0002 ◽

2017 ◽

Vol 19 (1) ◽

pp. 4-9 ◽

Cited By ~ 2

Author(s):

Pete Morgan

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Support Services ◽

Brain Injuries ◽

Social Care ◽

Discharge Planning ◽

Community Support ◽

Content Type ◽

Care Services ◽

Health And Social Care

Purpose To reflect on the particular case from a professional’s perspective to provide, in conjunction with the original article, a more holistic overview of some of its implications for safeguarding practice and, by definition, for the provision of health and social care support services to individuals with a traumatic brain injury and their families. The paper aims to discuss these issues. Design/methodology/approach A response to an already published article. Findings That a lack of “professional curiosity” on the part of practitioners across a range of professions and agencies led to a failure to initiate safeguarding processes and procedures appropriately, resulting in avoidable damage to the subject of the article, the author’s partner and their families. Practical implications There is a need for a greater awareness and understanding of the implications of traumatic brain injuries across health and social care services: that hospital discharge planning and community support services need to be more flexible in identifying and meeting the needs of patients with traumatic brain injury, that there is no substitute for “professional curiosity” in ensuring that assessments are holistic, and that services are appropriate and multi-agency working is effective. Originality/value This is a response to an existing publication.

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