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Multiagency working between children's social care and schools during COVID-19: case study experiences from English local authorities and international reflections
- Authors:
- BAGINSKY Mary, MANTHORPE Jill
- Journal article citation:
- Journal of Integrated Care, 30(2), 2022, pp.134-145.
- Publisher:
- Emerald
Purpose: A multiagency approach to supporting and enhancing child welfare lies at the heart of policies and practice in England and many other countries. The assumption is that if professionals together from different disciplines share their knowledge and skills this will lead to better outcomes for children and their families. The COVID-19 pandemic interrupted the "normal practice" of such arrangements. This research explored how the pandemic's disruption led to new ways of communicating and professional behaviour, while exploring the potential for longer-term impact in England and other jurisdictions. Design/methodology/approach: Case studies were conducted in 2020 in five English local authorities to explore how schools worked with Children's Social Care and other professionals during the COVID-19 period. It was supplemented by a survey of schools and discussions with and reflections from those with relevant experience in five other countries. Findings: Many schools played an extended role in supporting vulnerable and "in need" families during this period. Children's Social Care recognised their contributions and the improved communication achieved, although schools were divided over whether relationships had improved. Most communication and meetings were online; while benefits were noted there were concerns for families who were digitally disadvantaged. Originality/value: The work provides a contemporary picture of multiagency work during the 2020 pandemic and identifies factors which may shape this work in the future in England and internationally. (Edited publisher abstract)
Challenges and chances for local health and social care integration - lessons from Greater Manchester, England
- Author:
- CHANG Ming-Fang
- Journal article citation:
- Journal of Integrated Care, 30(2), 2022, pp.146-159.
- Publisher:
- Emerald
Purpose: Sustainability and transformation partnerships (STPs) were introduced to England, asking 44 local areas to submit their health and social care plans for the period from October 2016 to March 2021. This study aims to offer a deeper understanding of the complex structure in the local practice, and to discuss the associated challenges and chances. Design/methodology/approach: Documentary analysis, qualitative interviews and questionnaire survey are used for this study. Findings have been compared and analysed thematically. Findings: The study participants reported that apart from pooled budgets, past collaborative experience and local leadership are crucial elements for transforming health and social care integration in Greater Manchester (GM). Also, this study provides policy recommendations to promote effective collaborative partnerships in local practices and mitigate local inequity of funding progress. Research limitations/implications: The findings of this paper cannot be extrapolated to all stakeholders due to the limited samples. Meanwhile, some of the discussions about the case of GM may not be transferrable to other STPs. Originality/value: This study argues that the success of pooled budgets is the result, rather than the cause, of effective negotiations between various stakeholders; and therefore, there is no evidence suggesting that pooled budgets can resolve the discoordination of health and social care. Moreover, due to the bottom-up approach adopted by STPs, more effective boroughs tend to receive additional funding, resulting in an increasing gap of development between effective and ineffective boroughs. (Edited publisher abstract)
Sexual assault of older people by hospital staff in England
- Author:
- WARBURTON-WYNN Amanda
- Journal article citation:
- Journal of Adult Protection, 24(1), 2022, pp.54-56.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to highlight the findings of this research. A research paper was published in October 2021 highlighting results of freedom of information (FOI) requests sent to National Health Service (NHS) Trusts in England. The FOI requests asked for the number of incidents of sexual assault reported by hospitals where the victim was aged over 60 and the alleged perpetrator was a member of staff. Design/methodology/approach: The methodology involved sending FOI requests to all 206 NHS hospital Trusts in England requesting information on reported incidents of sexual assault against patients over 60 years old from 2016/17 to 20/21, where the alleged perpetrator was a member of staff (including agency staff). Along with the number of reports, the FOI request also asked for the sex of the victim and alleged perpetrator, whether the incident was reported to police, the outcome of the police investigation and whether any internal disciplinary processes were followed. Findings: Of the hospitals that responded with some data (others were nil return), 56 individual reports meeting the criteria of the FOI were identified. A further 19 hospitals advised that they held reports of such incidents but, under general data protection regulations, they were unable to disclose exact numbers, but they were less than 5, some hospitals said less than 10, so the research can only count one for each of these. The resulting findings are that there were at least 75 reports of sexual assault on patients over 60 by hospital staff in the past five years. The findings also show that whilst the majority of victims were female, 30% were male and that a disappointing number were reported to police - only 16. Of these, 14 were closed as "No Further Action" by the police. Originality/value: Whilst there has been some research into sexual violence against older people, most notably by Dr Hannah Bows, the issue of sexual assault happening whilst in hospital perpetrated by hospital staff has not been studied. (Edited publisher abstract)
"Just because people are old, just because they're ill..." dignity matters in district nursing
- Authors:
- STEVENS Emma, PRICE Liz, WALKER Liz
- Journal article citation:
- Journal of Adult Protection, 24(1), 2022, pp.3-14.
- Publisher:
- Emerald
Purpose: This paper aims to explore the concept and practice, of dignity as understood and experienced by older adults and district nursing staff. The paper adds a new, nuanced, understanding of safeguarding possibilities in the context of district nursing care delivered in the home. Design/methodology/approach: The research used an ethnographic methodology involving observations of care between community district nursing clinicians and patients (n = 62) and semi-structured interviews with nursing staff (n = 11) and older adult recipients of district nursing care (n = 11) in England. Findings: Abuse is less likely to occur when clinicians are maintaining the dignity of their patients. The themes of time and space are used to demonstrate some fundamental ways in which dignity manifests. The absence of dignity offers opportunities for abuse and neglect to thrive; therefore, both time and space are essential safeguarding considerations. Dignity is influenced by time and how it is experienced temporally, but nurses are not allocated time to "do dignity", an arguably essential component of the caregiving role, yet one that can become marginalised. The home-clinic exists as a clinical space requiring careful management to ensure it is also an environment of dignity that can safeguard older adults. Practical implications: District nurses have both a proactive and reactive role in ensuring their patients remain safeguarded. By ensuring care is delivered with dignity and taking appropriate action if they suspect abuse or neglect, district nurses can safeguard their patients. Originality/value: This paper begins to address an omission in existing empirical research regarding the role of district nursing teams in delivering dignified care and how this can safeguard older adults. (Edited publisher abstract)
Challenges and chances for local health and social care integration - Lessons from Greater Manchester, England
- Author:
- CHANG Ming-Fang
- Journal article citation:
- Journal of Integrated Care, early cite December 2021,
- Publisher:
- Emerald
Purpose: Sustainability and transformation partnerships (STPs) were introduced to England, asking 44 local areas to submit their health and social care plans for the period from October 2016 to March 2021. This study aims to offer a deeper understanding of the complex structure in the local practice, and to discuss the associated challenges and chances. Design/methodology/approach: Documentary analysis, qualitative interviews and questionnaire survey are used for this study. Findings have been compared and analysed thematically. Findings: The study participants reported that apart from pooled budgets, past collaborative experience and local leadership are crucial elements for transforming health and social care integration in Greater Manchester (GM). Also, this study provides policy recommendations to promote effective collaborative partnerships in local practices and mitigate local inequity of funding progress. Research limitations/implications: The findings of this paper cannot be extrapolated to all stakeholders due to the limited samples. Meanwhile, some of the discussions about the case of GM may not be transferrable to other STPs. Originality/value: This study argues that the success of pooled budgets is the result, rather than the cause, of effective negotiations between various stakeholders; and therefore, there is no evidence suggesting that pooled budgets can resolve the discoordination of health and social care. Moreover, due to the bottom-up approach adopted by STPs, more effective boroughs tend to receive additional funding, resulting in an increasing gap of development between effective and ineffective boroughs. (Edited publisher abstract)
Enablers and barriers in adopting a reablement model of domiciliary care
- Authors:
- KING Erin, YOUNG Alys
- Journal article citation:
- Journal of Integrated Care, early cite February 2021,
- Publisher:
- Emerald
Purpose: The purpose of this paper is to explore the effectiveness of reablement as an outcome-focussed commissioning model within the English domiciliary care market from the perspective of two private domiciliary care agency (PDCA) managers/owners within one local authority (LA) in the North West of England. Specifically, it focusses on owner/managers' perceived ability to effect change from a dependency to a reablement model within the English domiciliary care market. Design/methodology/approach: Qualitative interviews with two contrasting owners/managers of PDCAs within one LA in the North West of England were carried out. Explorative analysis followed a constructionist grounded theory methodology. Findings: Findings revealed how two main factors interacted to effect change from a dependency model to a reablement model of domiciliary care: internal organisational structure and individual emotional investment of the owners/managers. Additionally, fiscal and external organisational systems impact on these drivers, and are perceived to act as potential barriers to the adoption of a reablement model of domiciliary care by PDCAs. Originality/value: Although based on only two idiographic accounts, the findings shed light on the policy and practice of commissioning models of domiciliary care within England and suggest further studies in this area of practice. (Edited publisher abstract)
The recruitment, retention and development of an integrated urgent care telephone triage workforce: a small-scale study
- Authors:
- SNELL Laura, GRIMWOOD Tom
- Journal article citation:
- Journal of Integrated Care, 30(1), 2022, pp.20-27.
- Publisher:
- Emerald
Purpose: NHS 111 is a non-emergency telephone triage service that provides immediate access to urgent care 24 h a day. This study explored the recruitment, retention and development of one integrated urgent care (IUC) workforce in England, specifically the NHS 111 service and Clinical Hub. Design/methodology/approach: An online survey was distributed to the NHS 111 and Clinical Hub workforce. The data from 48 respondents were summarised and analysed thematically. Findings: The survey respondents held a variety of clinical and non-clinical roles within NHS 111 and the Clinical Hub. The findings indicate that the IUC workforce is motivated to care for their patients and utilise a range of communication and cognitive skills to undertake their telephone triage roles. In total, 67% of respondents indicated that their work was stressful, particularly the volume and intensity of calls. Although the initial training prepared the majority of respondents for their current roles (73%), access to continuing professional development (CPD) varied across the workforce with only 40% being aware of the opportunities available. A total of 81% of respondents stated that their shifts were regularly understaffed which indicates that the retention of IUC staff is problematic; this can put additional pressure on the existing workforce, impact on staff morale and create logistical issues with managing annual leave entitlements or scheduling time for training. Originality/value: This small-scale study highlights some of the complexities of telephone triage work and demonstrates the challenges for IUC service providers in retaining an appropriately skilled and motivated workforce. (Edited publisher abstract)
The shift to collaborative working and integration in the English NHS: developing shared leadership in primary care networks
- Authors:
- WILLCOCKS Steve, CONWAY Tony
- Journal article citation:
- Journal of Integrated Care, 30(1), 2022, pp.28-41.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to explore leadership in the context of the policy shift to collaborative working and integration currently being pursued in the UK NHS. As ways of integrating care are being explored in other countries it can be argued that this topic may have wider policy significance. This paper is particularly concerned with leadership in Primary Care Networks in the English NHS. Design/methodology/approach: This paper is a conceptual paper using literature relating to the antecedents of shared leadership and relevant policy documents pertaining to the English NHS. The paper is informed, theoretically by the conceptual lens of shared leadership. A conceptual framework is developed identifying the antecedents of shared leadership that help to explain how shared leadership may be developed. Findings: The paper identifies the challenges that may be faced by policymakers and those involved in Primary Care Networks in developing shared leadership. It also reveals the implications for policymakers in developing shared leadership. Research limitations/implications: The paper is conceptual. It is acknowledged that this is a preliminary study and further work will be required to test the conceptual framework empirically. Practical implications: The paper discusses the policy implications of developing leadership in primary care networks. This has relevance to both the NHS and other countries. Originality/value: There is limited research on the antecedents of shared leadership. In addition, the conceptual framework is applied to a new policy initiative. (Edited publisher abstract)
Reflections on systemic barriers for ethnic minorities in accessing community-based forensic services for people with intellectual disabilities and autism
- Author:
- COLEMAN Mercedez
- Journal article citation:
- Journal of Intellectual Disabilities and Offending Behaviour, 13(1), 2022, pp.12-19.
- Publisher:
- Emerald
Purpose: Community-based forensic support services (CBFSSs) were commissioned nationally by National Health Service (NHS) England in 2017 in response to “Building the Right Support” (NHS England, 2015). CBFSSs provide multidisciplinary support to adults with intellectual disabilities and/or autism who are in (or at risk of) contact with the criminal justice system and those transitioning from inpatient secure care. This paper aims to highlight potential systemic barriers to accessing community forensic services for people from an ethnic minority background. in one CBFSSs in Northern England. Design/methodology/approach: This paper provides preliminary reflections on potential systemic barriers within the criminal justice system and health-care services that have implications for service users from ethnic minority backgrounds accessing CBFSSs. Findings: There is a paucity of data, policy and literature that focuses on people with intellectual disabilities and autism with forensic needs from ethnic minority backgrounds. This lack of data obstructs further reforms to meet the needs of this population. Originality/value: CBFSSs are commissioned across England. While some regional variation is to be expected, services should be aware of the systemic barriers people from ethnic minority backgrounds within their region face. These barriers should be considered and addressed when evaluating service efficacy and delivery. Recommendations are made to review and address issues of under-representation of ethnic minorities within CBFSSs. (Edited publisher abstract)
Ethnic disparity in mental health legislation at the point of inpatient entry: pilot review in detained adolescents with developmental disorders
- Authors:
- MORRIS Deborah J., et al
- Journal article citation:
- Journal of Forensic Practice, 23(3), 2021, pp.240-253.
- Publisher:
- Emerald
Purpose: Ethical concerns about the use of the Mental Health Act (MHA) have led to calls for developmental disorders to be removed from the list of mental disorders for which individuals can be detained. In parallel, there are long-standing concerns of ethnic disparity in the application of the MHA. Nonetheless, the impact of the intersections of developmental disorder diagnosis, adolescence and ethnicity on the application of the MHA is unknown. This study aims to explore ethnic differences in MHA sections and the factors accounting for this, in an adolescent inpatient developmental disorder service. Design/methodology/approach: File reviews were conducted to explore differences in MHA status, as well as demographic, clinical and risk factors that may account for this, between 39 white British and ethnic minority adolescents detained to a specialist inpatient developmental disorder service. Findings: Consistent with adult literature, adolescents of an ethnic minority were overrepresented in the sample and were significantly more likely to be detained on Part III or “forensic” sections of the MHA than White British counterparts, with five times greater risk. Analyses revealed no significant differences between ethnic minority and white British participants on demographic variables, clinical needs, risk behaviours, risk measures nor application of restrictive practices and safeguarding procedures. Practical implications: National audits exploring patterns of detention under the MHA across adolescent developmental disorder populations need to include analysis of intersections to ensure that the MHA is used as a means of last resort and in an equitable manner. Originality/value: To the best of the authors’ knowledge, this paper is the first comprehensive exploration of the impact of ethnicity on detention patterns in ethnic minority and White British populations. (Edited publisher abstract)