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Implementing integrated care: a synthesis of experiences in three European countries
- Authors:
- NOLTE Ellen, et al
- Journal article citation:
- International Journal of Care Coordination, 19(1-2), 2016, pp.5-19.
- Publisher:
- Sage
Many countries are experimenting with new models to better integrate care; yet, innovative care models are often implemented as time-limited, localised projects with limited impact on service delivery more broadly. This paper seeks to understand the processes behind successful projects that achieved some form of ‘routinisation’ and informed system-wide integrated care strategies. It draws on detailed case studies of three integrated care experiments: the ‘Integrated effort for people living with chronic diseases’ project in Denmark; the Gesundes Kinzigtal network in Germany; and Zio, a care group in the Maastricht region in the Netherlands. It explores how they were developed, implemented and sustained, and how they impacted the wider system context. All three models implicitly or explicitly adopted processes shown to be conducive to the dissemination of innovations, including dedicated time and resources, support and advocacy, leadership and management, stakeholder involvement, communication and networks, adaptation to local context and feedback. Each showed robust evidence of improvements on a number of service and patient outcomes and these findings were central to their wider impacts, shaping country-wide integrated care polices. However, the wider dissemination of projects occurred in an incremental and somewhat haphazard way. To further redesign health and social care a more formal strategy, alongside resources, may thus be needed to provide funders and providers with genuine incentives to invest in new business models of care. There remains a crucial need for better understanding of specific local conditions that influence implementation and sustainability to enable translation to other contexts and settings. (Publisher abstract)
Evaluation of the 1991 homelessness code of guidance
- Authors:
- MULLINS David, et al
- Publisher:
- HMSO/Great Britain. Department of the Environment
- Publication year:
- 1996
- Pagination:
- 130p.,tables,bibliog.
- Place of publication:
- London
Research study evaluating the effects of the 3rd edition of the Homelessness Code of Guidance issued in August 1991 to local authorities to help them discharge their duties under Part II of the Housing Act 1985.
Reducing unnecessary delay in care and supervision proceedings: Local Performance Improvement Groups: guidance
- Authors:
- GREAT BRITAIN. Ministry of Justice, et al
- Publisher:
- Great Britain. Ministry of Justice
- Publication year:
- 2010
- Pagination:
- 26p.
- Place of publication:
- London
Over the last 20 months there has been an unprecedented rise in the level of care order applications which has put pressure on all agencies involved in care proceedings. Too many public law cases are taking over a year to resolve. Excessive delay has been shown to have a detrimental effect upon those children who are awaiting a permanent outcome. It also increases the level of resources used across all parts of the system, including Cafcass, local authority Children’s Services, legal aid and the courts. Reducing delay will mean better outcomes for children as well as a more efficient use of resources. This guidance is intended to assist practitioners and front line managers working in Her Majesty’s Courts Service, local authorities, Cafcass, and the Legal Services Commission in their joint efforts to reduce unnecessary delay in care and supervision proceedings. The guidance proposes a basic operating framework which groups can adapt and build on, including a set of core performance measures which groups may wish to use to inform their monitoring and improvement action.
The right to choose: multi-agency statutory guidance for dealing with forced marriage
- Authors:
- GREAT BRITAIN. Foreign and Commonwealth Office, et al
- Publisher:
- Great Britain. Foreign and Commonwealth Office
- Publication year:
- 2008
- Pagination:
- 26p.
- Place of publication:
- London
In forced marriages, one or both spouses do not (or, in the case of some vulnerable adults, cannot) consent to the marriage and duress is involved. Duress can include physical, psychological, financial, sexual and emotional pressure. This statutory guidance is issued under the Forced Marriage (Civil Protection) Act 2007 and came into force on 25 November 2008. It sets out the processes that agencies must have in place when exercising public functions in relation to safeguarding children and vulnerable adults in cases of forced marriage. This guidance describes the responsibilities of Chief Executives, directors and senior managers regarding developing and maintaining local procedures and practice arrangements to enable their front-line practitioners to handle cases of forced marriage effectively.
When to share information: best practice guidance for everyone working in the youth justice system
- Authors:
- GREAT BRITAIN. Department of Health, et al
- Publisher:
- Great Britain. Department of Health
- Publication year:
- 2008
- Pagination:
- 70p.
- Place of publication:
- London
This guidance has been developed as a cross-governmental initiative on behalf of Department of Health, Department for Children, Schools and Families, the Youth Justice Board and the Prison Service. The guidance is set out in a pathway approach, with best practice case studies used to identify when, what, where and how information needs to be shared to ensure improved outcomes for children and young people, as outlined in Every Child Matters: Change for Children.
Homelessness code of guidance for local authorities
- Authors:
- GREAT BRITAIN. Department of the Environment, et al
- Publisher:
- Her Majesty's Stationery Office
- Publication year:
- 1994
- Pagination:
- 82p.
- Place of publication:
- London
- Edition:
- 3rd. (rev.).
This is the third edition of the Code since Parliament passed the homelessness legislation in 1977. Wider in scope than previous editions, containing guidance on all aspects of the assessment procedure, its main aim is to secure fair, consistent and good practice amongst housing authorities in England and Wales. The Code's three main sections cover: a guide to legislative requirements of the Act, assessment of applications and prevention, and an outline of how an authority should discharge its duties to applicants who are accepted as homeless.
Achieving best evidence in criminal proceedings: guidance for vulnerable or intimidated witnesses, including children
- Authors:
- GREAT BRITAIN. Home Office, et al
- Publisher:
- Great Britain. Home Office. Communication Directorate
- Publication year:
- 2002
- Pagination:
- 3 booklets.
- Place of publication:
- London
The principal areas, which require attention if the needs of vulnerable witnesses whether adults or children are to be met, are: the recognition and subsequent reporting of crime; the identification of vulnerabilities; and putting effective measures to address these into place during investigation, pre-trial preparation and during and after any criminal trial. Children are defined as vulnerable by reason of their age. The Youth Justice and Criminal Evidence Act 1999 acknowledges that all children under 17 years of age, appearing as defence or prosecution witnesses in criminal proceedings, are eligible for Special Measures to assist them in providing their evidence and having their evidence heard at court. Early identification of the individual abilities as well as disabilities of each vulnerable adult is important in order to guide subsequent planning. An exclusive emphasis upon disability ignores the strengths and positive abilities which a vulnerable individual possesses. Vulnerable witnesses may have had social experiences which may have implications for the investigation and any subsequent court proceedings. Research suggests that sexual offences, assaults, and those offences where the victim knew the offender are particularly likely to lead to intimidation of witnesses. It seems likely that crimes which involved repeated victimisation such as stalking and racial harassment are also particularly likely to lead to intimidation. In addition, some witnesses to other crimes may be under fear and distress and may require safeguarding and support in order to give their best evidence.
Early special measures meetings between the police and the Crown Prosecution Service and meetings between the Crown Prosecution Service and vulnerable or intimidated witnesses: practice guidance
- Authors:
- GREAT BRITAIN. Home Office, et al
- Publisher:
- Great Britain. Home Office. Communication Directorate
- Publication year:
- 2002
- Pagination:
- 36p.
- Place of publication:
- London
An early special measures meeting is an opportunity for the investigating police officer and CPS prosecutor to discuss the needs of prosecution witnesses who may be considered vulnerable or intimidated. In particular, the eligibility of witnesses to benefit from special measures will be discussed. A benefit of an early special measures meeting will be to ensure that any necessary application for special measures is made in an effective and timely manner. How will a Case involving a Vulnerable or Intimidated Witness be Identified? The police, during the course of an investigation, will have the responsibility for identifying those cases where an early special measures meeting is required, or may be desirable. It is essential that the police officer dealing with a vulnerable or intimidated witness does not raise unrealistic expectations on the part of the witness, since the decision whether to apply for special measures will be taken by the CPS and the decision whether to allow special measures rests with the court. Police officers will be trained to identify witnesses who may be vulnerable or intimidated and may thereby be eligible for special measures. This training will include a set of prompts to assist police officers identify both vulnerable and intimidated witnesses. For example, the prompts include a list of behavioural characteristics that may indicate that a witness is vulnerable.
Safeguarding children involved in prostitution: supplementary guidance to "Working together to safeguard children"
- Authors:
- GREAT BRITAIN. Department of Health, et al
- Publisher:
- Great Britain. Department of Health
- Publication year:
- 2000
- Pagination:
- 47p.,bibliog.
- Place of publication:
- London
Guidance setting out an inter agency approach, based on local protocols developed within the framework of 'Working together to safeguard children' to address the protection of children involved in, or at risk of becoming involved in, prostitution.
Working together to safeguard children: a guide to inter-agency working to safeguard and promote the welfare of children; consultation draft
- Authors:
- GREAT BRITAIN. Department of Health, et al
- Publisher:
- Great Britain. Department of Health
- Publication year:
- 1999
- Pagination:
- 143p.,bibliog.
- Place of publication:
- London
Guidance highlighting the shared responsibility of services, professionals and the wider community for safeguarding children and promoting their welfare. Emphasises the need for all services to focus on securing the best possible outcomes for children and young people. Takes account of lessons from research and experience since publication of the existing guidance, and of developments in policy and practice.