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Whose agenda is it anyway?
- Authors:
- HAM Chris, GLASBY Jon
- Journal article citation:
- Community Care, 23.02.06, 2006, pp.34-35.
- Publisher:
- Reed Business Information
The authors debate how central social care is to the white paper 'Out Health, Our Care, Our Say' and discuss whether it matters that health wins the lion's share of attention in the plans.
The future of adult social care: lessons from previous reforms
- Author:
- GLASBY Jon
- Journal article citation:
- Research Policy and Planning, 23(2), 2005, pp.61-70.
- Publisher:
- Social Services Research Group
In 2005, the adult social care Green Paper, 'Independence, Well-being and Choice', set out a 'new vision' for the future of social care in England. Throughout the document there was a strong emphasis on greater choice and control for service users, a more strategic, preventative approach, working with other service and promoting independence, well-being and inclusion. As the formal consultation process closes (in July 2005), this paper reviews three previous reforms (The Seebohm Report, The Barclay Report, and The community care reforms) - all of which set out very similar ideas and demonstrate considerable continuity in thinking over time. Given that the Green Paper feels that a 'new vision' is need for adult social care, this paper questions the extent to which any of these proposals are indeed 'new' and questions how these changes are expected to work when previous reforms are perceived not to have delivered desired outcome.
Integrated health and social care in England: ten years on
- Authors:
- MILLER Robin, GLASBY Jon, DICKINSON Helen
- Journal article citation:
- International Journal of Integrated Care, 21(S2), 2021, p.6. Online only
- Publisher:
- International Foundation for Integrated Care
Introduction: As part of major policy reforms begun in 2010, England introduced a wave of initiatives to encourage more integrated care between health and social care. These built on previous attempts which sought to achieve similar objectives through a focus on better partnership working. This article provides an overview and critical commentary on integrated care policy in England from 2010–2020 based on reviews by regulators, parliamentary committees and the national audit office. Overview of Policy: Integrated care became a priority through the work of the Future Forum, a group of leading stakeholders established due to concerns about greater competition in public health care. This led to a public statement of shared commitment to integrated care by national health and social care bodies. Early mechanisms included a pooled fund to achieve nationally set objectives, the creation of local authority led partnership boards, and high profile innovation programmes. Later in the 2010’s, new health led partnerships became more dominant vehicles to achieve integrated care at regional level. Impact of Policy: Despite progress within a few local areas, and reduction in delayed discharges from hospital the overall picture from national reviews was that expected improvements were not achieved. Emergency admissions to hospital continued to grow, patients within primary care reported being less involved in their care, and health inequalities worsened. The initial response to COVID-19 was health-centric contributing to outbreaks in care homes and inadequate supplies of protective personal equipment. The ability of leaders to look beyond their organisations’ interests was reported as vital for local progress. National government performance frameworks discouraged system based working and chronic underfunding of social care led to major capacity and workforce challenges. Conclusion: The experience of England suggests that greatest progress is made when integrated care focusses on tangible issues and when there is a clear understanding of how success will be measured. Even with considerable investment and intent progress should be expected to be slow and difficult. Layering of numerous policy initiatives provides confusion and can distract from the important work of relationship building. And ultimately, integrated care cannot by itself address major inadequacies in the underlying resources and structural inequalities. (Edited publisher abstract)
Together we are better? Strategic needs assessment as a tool to improve joint working in England
- Authors:
- ELLINS Jo, GLASBY Jon
- Journal article citation:
- Journal of Integrated Care, 19(3), 2011, pp.34-41.
- Publisher:
- Emerald
The launch of the Health and Social Care Bill will change the relationships between the NHS and local government. However, set against large public spending cuts, partnership working between health and social care can be expected to be harder, but more important, than ever before. A national survey explored preparations by local authorities and primary care trusts (PCT) for the duty to conduct a joint strategic needs assessment (JSNA). It explores the key barriers and enablers and the implications for future policy. The authors contacted all PCT chief executives, directors of adult social services and public health in England (a total of 459 people). A qualitative survey was e-mailed in February 2008 at the time when health and social care communities were preparing to implement the new duty. The completed surveys (87 responses) were evaluated using thematic content analysis. Although respondents felt that it was very early days, they had a number of aspirations for JSNA and identified some potential impacts and implications. Most importantly, they felt that JSNA had scope to raise the profile of the importance of jointly agreed approaches to needs assessment and to partnership working more generally. However, many respondents pointed out that the extent to which JSNA is able to realise this potential depends on it being seen as a means to an end, rather than an end in itself.
The care trust pilgrims
- Authors:
- MILLER Robin, DICKINSON Helen, GLASBY Jon
- Journal article citation:
- Journal of Integrated Care, 19(4), 2011, pp.14-21.
- Publisher:
- Emerald
Using the analogy of the pilgrim fathers and their journey into new territory based on hope, this article reflects on the development and work of English care trusts, the first of which were launched in 2002. The introduction of care trusts was designed to improve partnership working between health and social care by integrating health and social care into a single organisation. Current care trust chief executives were invited to participate in semi-structured interviews exploring their experiences, and the article brings together themes from the interviews with findings from literature and policy review. It summarises the background to care trusts and lists pilots and trusts. It discusses the strengths and weaknesses of the care trust model and looks at future directions in the light of the restructuring of the health care system in England.
Partnership working in England: where we are now and where we've come from
- Authors:
- GLASBY Jon, DICKINSON Helen, MILLER Robin
- Journal article citation:
- International Journal of Integrated Care, 11(1), 2011, Online only
- Publisher:
- International Foundation for Integrated Care
Joint working between health and social care has long been a policy priority in England. Against this background, this paper reviews lessons from current and previous partnership initiatives, summarising some of the key approaches adopted and exploring key underlying concepts and frameworks. Despite a tendency to focus on structural ‘solutions’, evidence and experience suggests a series of more important processes, approaches and concepts that might help to promote more effective inter-agency working. This includes a focus on outcomes, consideration of the depth and breadth of relationship required and the need to work together on different levels.
Integrated care in a cold climate
- Author:
- GLASBY Jon
- Journal article citation:
- International Journal of Integrated Care, 10(1), 2010, Online only
- Publisher:
- International Foundation for Integrated Care
Following a global recession, public services in many countries including the UK are facing substantial cuts in terms of future public spending. At a time when the population is ageing and demand increasing, services may find themselves having to meet ever greater need with less and less resource. Because of the political necessity to protect the NHS as much as possible, other services—such as adult social care—could be hit to an even greater extent. Local care services may be tempted to respond to the crisis by retreating behind their traditional organisational boundaries. However, integrated care may be the best approach to maximising the benefit of scarce public resources, enabling agencies to work together for better patient outcomes and safer, more effective care.
The Controversies of Choice and control: why some people might be hostile to English social care reforms
- Author:
- GLASBY Jon
- Journal article citation:
- British Journal of Social Work, 44(2), 2014, pp.252-266.
- Publisher:
- Oxford University Press
With successive English governments extolling the virtues of greater choice and control within welfare services, there is growing debate about concepts such as direct payments and personal budgets (in the UK and in many developed countries). With the evidence base inevitably patchy and incomplete, there have been increasing criticisms of these approaches from the social care trade press and from academic policy commentators alike. Against this background, this paper reviews the concerns that are emerging and explores some of the limitations of current debates—many of which make an implicit appeal to ‘the evidence’ in order to justify increasingly polarised views. In particular, the paper argues that many current accounts are based on an imperfect understanding of the principles at stake; on a failure to apply the same burden of proof to the old system as well as the new; on prior attitudes to state services and to current social care; and on a potentially limited adherence to more traditional forms of evidence-based practice. (Publisher abstract)
Mental health policy and practice
- Authors:
- LESTER Helen, GLASBY Jon
- Publisher:
- Palgrave Macmillan
- Publication year:
- 2010
- Pagination:
- 304p.
- Place of publication:
- Basingstoke
- Edition:
- 2nd ed.
The revised edition provides a comprehensive overview of recent UK mental health policy. It includes ideas from a wide spectrum of mental health services, examples of successful evidence-based practice and analyses the impact of the 'modernisation agenda'. It examines role of health and social care policy in the development of mental health care and treatment. Individual chapters are included on Mental Health Policy; Primary Care and Mental Health; Community Mental Health Services; Acute Mental Health Services; Forensic Mental Health Services; Partnership Working; User Involvement; Anti-Discriminatory Practice; Carers. Each chapter contains key points highlighted at the beginning, a series of reflective exercises and suggestions for further reading. The appendix includes a mental health policy chronology 1975-2009. The publication is ideal for students at both undergraduate and postgraduate levels.
Personalisation and the social care 'revolution': future options for the reform of public services
- Authors:
- DUFFY Simon, WATERS John, GLASBY Jon
- Publisher:
- University of Birmingham. Health Services Management Centre
- Publication year:
- 2010
- Pagination:
- 8p., bibliog.
- Place of publication:
- Birmingham
The first part of this policy paper provides a brief overview of the development of adult social care in order to place the introduction of personal budgets in their historical and policy context. The second part introduces the potentially new concept of personal budgets as a form of 'conditional resource entitlement', suggesting this as a possible framework within which to consider future options for welfare reform. The aim is to explore the concept of the 'conditional resource entitlement' in more detail.