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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)
Discourses of middle managers' cross-boundary collaboration in health and social care
- Authors:
- HUJALA Anneli, et al
- Journal article citation:
- Journal of Integrated Care, 30(2), 2022, pp.203-215.
- Publisher:
- Emerald
Purpose: In the implementation of integrated care, the role of managers is important and their mutual collaboration should be addressed more visibly. The purpose of this study was to investigate how cross-boundary collaboration is constructed in the discourse of middle-level managers in health and social care. Design/methodology/approach: The study was based on a discursive approach. Group discussions with three groups of Finnish middle managers (n = 39) were analyzed using discourse analysis. Findings: Five ways of talking about cross-boundary collaboration were identified, labeled "ideal", "structure", "defence", "money" and "support" discourses. In the ideal discourse, cross-boundary collaboration appeared as a "good thing" and is self-evident. Structural discourse defined managers as passive actors in self-sustaining entities. Defensive discourse highlighted the problems of cross-boundary collaboration and the hierarchy within the health and social sectors. Financial discourse constituted the ultimate obstacle to successful cross-boundary collaboration, and both strengthened and explained defensive discourse. Supportive discourse portrayed other managers as partners and as an important resource. Research limitations/implications: Cross-boundary collaboration can be experienced as a resource, helping managers cope with their workload. However, identification of and continuous attention to challenges at macro, meso and micro levels of integrated care is crucial for successful collaboration. Thus, critical discussion of collaboration needs to be given space. Originality/value: The study design and discursive approach highlights the power of language and give voice to middle managers who are key actors when implementing integrated care. (Edited publisher abstract)
Commentary on “Making the world a better place: achieving impact through innovation and an entrepreneurial ethos”
- Author:
- McGILL Peter
- Journal article citation:
- Tizard Learning Disability Review, 26(3), 2021, pp.157-159.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to provide a commentary on “Making the world a better place: achieving impact through innovation and an entrepreneurial ethos” written by John Pepin. Design/methodology/approach: The commentary considers the broader role of philanthropy especially with respect to learning disability and autism. Findings: The work of the Shirley Foundation is a good example of the contribution that can be made by philanthropy. Although philanthropy has many critics, it remains one way in which significant change can by supported. Originality/value: Partnerships between philanthropic and government funding may help both to address some of the concerns raised about philanthropy and maximise the potential for beneficial impacts. (Edited publisher abstract)
Building an initial realist theory of partnering across National Health Service providers
- Authors:
- AUNGER Justin Avery, et al
- Journal article citation:
- Journal of Integrated Care, 29(2), 2021, pp.111-125.
- Publisher:
- Emerald
Purpose: The National Health Service (NHS) is facing unprecedented financial strain. These significant economic pressures have coincided with concerns regarding the quality and safety of the NHS provider sector. To make the necessary improvements to performance, policy interest has turned to encouraging greater collaboration and partnership working across providers. Design/methodology/approach: Using a purposive search of academic and grey literature, this narrative review aimed (1) to establish a working typology of partnering arrangements for improvement across NHS providers and (2) inform the development of a plausible initial rough theory (IRF) of partnering to inform an ongoing realist synthesis. Findings: Different types of partnership were characterised by degree of integration and/or organisational change. A review of existing theories of partnering also identified a suitable framework which incorporated key elements to partnerships, such as governance, workforce, leadership and culture. This informed the creation of an IRF of partnerships, which proposes that partnership “interventions” are proposed to primarily cause changes in governance, leadership, IT systems and care model design, which will then go on to affect culture, user engagement and workforce. Research limitations/implications: Further realist evaluation, informed by this review, will aim to uncover configurations of mechanisms, contexts and outcomes in various partnering arrangements and limitations. As this is the starting point for building a programme theory, it draws on limited evidence. Originality/value: This paper presents a novel theory of partnering and collaborating in healthcare with practical implications for policy makers and practitioners. (Edited publisher abstract)
Does integrated health and care in the community deliver its vision? A workforce perspective
- Author:
- WAIN Linda Marie
- Journal article citation:
- Journal of Integrated Care, 29(2), 2021, pp.170-184.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to explore and capture workforce perceptions, experiences and insights of the phenomena of integrated care (IC) in a community health and care NHS trust in England; including whether there are any associated factors that are enablers, barriers, benefits or challenges; and the level of workforce engagement in the process of integrated health and care. Design/methodology/approach: A qualitative design based on an interpretivist research paradigm was used with a purposive sampling technique. Five in-depth semi-structured interviews were conducted with community nursing, social workers and allied health professionals. Colaizzi's (1978) descriptive phenomenological seven-step method was applied to analyse data, with the emergence of 170 significant statements, 170 formulated meanings and 8 thematic clustering of themes to reveal 4 emergent themes and 1 fundamental structure capturing the essential aspects of the structure of the phenomenon IC. Findings: This study revealed four interdependent emergent themes: (1) Insight of IC and collaboration: affording the opportunity for collaboration, shared goals, vision, dovetailing knowledge, skills and expertise. Professional aspirations of person-centred and strength-based care to improve outcomes. (2) Awareness of culture and professionalism: embracing inter-professional working whilst appreciating the fear of losing professional identity and values. Working relationships based on trust, respect and understanding of professional roles to improve outcomes. (3) Impact of workforce engagement: participants felt strongly about their differing engagement experience in terms of restructuring and redesigning services. (4) Impact of organisational structure: information technology (IT) highlighted a barrier to IC as differing IT platforms prevent interoperability with one system to one patient. Shared positivity of IC, embracing new ways of working. Originality/value: This study proposes considerations for future practice, policy and research from a local, national and global platform, highlighting the need for any IC strategy or policy to incorporate the uniqueness of the “voice of the workforce” as a key enabler to integration developments, only then can IC be a fully collaborative approach. (Edited publisher abstract)
Research watch: exclusion and health inequality in England and what can be done to reverse it – discussing the Marmot review 10 years on
- Author:
- HOLTTUM Sue
- Journal article citation:
- Mental Health and Social Inclusion, 25(1), 2021, pp.7-15.
- Publisher:
- Emerald
Purpose: This paper aims to summarise key messages from a major evidence review of health inequality in England since 2010 – “the Marmot Review 10 Years on”. Design/methodology/approach: Alongside “the Marmot Review 10 Years on”, which came out in February 2020, the author accessed the original Marmot review published in 2010, a 2020 article by Marmot, and Marmot’s online talk to the Royal Society of Physicians Edinburgh on 2nd of July 2020. The author drew out key messages from these sources. Findings: Although many local authorities have taken up the 2010 Marmot review recommendations, they have been working against budget cuts under the system known as austerity. This has reduced funding to already deprived areas and probably explains worsened health inequality in England compared to other European countries. There are examples of successful local partnerships that have improved lives, but they rely on temporary charity funding. Health services can work for change locally, but central government policies must help. This has become even more urgent since the pandemic. Originality/value: The original Marmot review and “the Marmot Review 10 Years on” are major evidence-based examinations of what causes and maintains health inequality, both physical and mental, and how this situation might be improved. It is impossible to study them and still believe that health is just about lifestyle choices. People need real options to choose from, and this is only possible if they live in places designed for human thriving from childhood to old age. As a nation, England can move towards this goal rather than further away from it. These reports show the way. (Edited publisher abstract)
Commentary on a “unified approach to behaviours that challenge”: implementing evidence-based practice – a clinician’s perspective
- Author:
- CARNABY Steven
- Journal article citation:
- Tizard Learning Disability Review, 25(3), 2020, pp.163-167.
- Publisher:
- Emerald
Purpose: This paper aims to provide a commentary on papers in this special edition concerning the implementation of evidence-based practice from a clinician’s perspective. Design/methodology/approach: The commentary makes a number of points drawing on both recent literature and the author’s own experience working as a clinician with children and adults with learning disabilities including those who are autistic whose behaviours can challenge themselves, their parents, carers and support networks. Findings: Effective implementation requires clinical expertise to operate within a context of collaboration and partnership working, where co-production with those who have lived experience ensures that what clinicians offer resonates and contributes to improvements in quality of life for all. Originality/value: The paper will be of value to clinicians working alongside children and adults with learning disabilities and their families, particularly clinical psychologists and behaviour specialists, and to other stakeholders wanting to enable and facilitate the development of high-quality support. (Edited publisher abstract)
Health-justice partnerships: innovation in service delivery to support mental health
- Authors:
- BEARDON Sarah, et al
- Journal article citation:
- Journal of Public Mental Health, 19(4), 2020, pp.327-332.
- Publisher:
- Emerald
Purpose: This paper aims to introduce the concept of “health-justice partnership” (HJP), the provision of legal assistance for social welfare issues in health-care settings. It discusses the role of these partnerships in supporting health and care for people with mental health issues. Design/methodology/approach: The authors describe an example of an HJP; discuss the rationale and evidence for this approach in relation to mental health; and reflect on implementation challenges and future directions in the UK. The authors draw on both health and legal literature to frame the discussion. Findings: Social welfare legal needs have negative impacts on mental well-being and are more likely to occur among people with mental health conditions. Integrating legal assistance with healthcare services can improve access to support for those with unmet need. High-quality research has demonstrated positive impacts for mental health and well-being as a result of HJP interventions. Both further research and wider strategies are required to support implementation of HJPs in practice. Originality/value: Legal assistance is rarely positioned as a health intervention, yet it is an effective tool to address social welfare issues that are harmful to mental health and to which people experiencing mental health are at greater risk. This paper highlights the importance of the HJP movement as an approach for supporting people with mental health issues. (Edited publisher abstract)
Gamechanger: harnessing football for social change
- Authors:
- FITZPATRICK Linda Irvine, et al
- Journal article citation:
- Journal of Integrated Care, 28(2), 2020, pp.87-98.
- Publisher:
- Emerald
The purpose of this paper is to present a case study of an intersectoral partnership that has taken place in Scotland (United Kingdom) entitled Gamechanger. The main idea of Gamechanger was for statutory, commercial and voluntary organisations to work in partnership to harness the power of football (soccer), to tackle health inequalities and social exclusion. The paper will detail how Gamechanger has been developed, with reference to the newly developed “Incite” model for effective intersectoral partnership working. Design/methodology/approach: This paper draws on the authors’ experiences of leading and evaluating intersectoral partnerships from 2015 to 2019. The report draws on the work which took place during that period, and the achievements in relation to Gamechanger. Findings: Gamechanger has led to significant innovations. It has encouraged sectors to work together, and develop new ways of responding to difficult societal problems. Originality/value: Gamechanger is believed to be the first initiative of its kind developed with a football club in Scotland.Conclusions: This work has been developed through robust community-informed efforts. The scope and scale of the projects to deliver community benefits is significant. Gamechanger has provided a means for football to take a different approach to how it works to benefit communities. (Edited publisher abstract)
Practitioner perspectives of multi-agency safeguarding hubs (MASH)
- Authors:
- SHORROCK Sarah, MCMANUS Michelle M., KIRBY Stuart
- Journal article citation:
- Journal of Adult Protection, 22(1), 2020, pp.9-20.
- Publisher:
- Emerald
Purpose: The challenges of transferring the theoretical requirements of an effective multi-agency partnership into everyday practices are often overlooked, particularly within safeguarding practices. Therefore, the purpose of this paper is to explore practitioner perspectives of working within a multi-agency safeguarding hub (MASH) and those factors that encourage or hinder a multi-agency approach to safeguarding vulnerable individuals. Design/methodology/approach: Semi-structured interviews with 23 practitioners from one MASH location in the North of England were conducted, with a thematic analysis being used to analyse findings. Findings: The interviews with practitioners illustrated the complexity of establishing a multi-agency approach to safeguarding. It was inferred that whilst information sharing and trust between agencies had improved, the absence of a common governance structure, unified management system, formalisation of practices and procedures and shared pool of resources limited the degree to which MASH could be considered a multi-agency approach to safeguarding. Practical implications: Establishing a multi-agency approach to safeguarding is complex and does not occur automatically. Rather, the transition to collaborative practices needs to be planned, with agreed practices and processes implemented from the beginning and reviewed regularly. Originality/value: Few studies have investigated the implementation of MASH into safeguarding practices, with this paper providing a unique insight into practitioner opinions regarding the transition to multi-agency practices. Whilst there is a focus on MASH, the challenges to arise from the research may be reflective of other multi-agency partnerships, providing a foundation for best practice to emerge. (Edited publisher abstract)