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Personal reflections on the development of an integrated service delivery for child and adolescent mental health services
- Authors:
- ALLISON Sam, et al
- Journal article citation:
- Child Care in Practice, 13(1), January 2007, pp.67-74.
- Publisher:
- Taylor and Francis
This paper explores the issue of how to develop a greater level of integration across the continuum services to young people with mental health difficulties. Reference is made to the strategic guidance offered by key documents and a pilot project is described, which attempted to link services across providers including a specialist Child and Adolescent Mental Health Teams, Paediatricians, a Family Centre, a schools’ counselling service, the voluntary sector and the Youth Justice agency. The achievements of the pilot are noted, as are some of the difficulties encountered. The potential for further development is also considered.
Super for some
- Author:
- CALLAGHAN David
- Journal article citation:
- Community Care, 26.10.06, 2006, pp.30-31.
- Publisher:
- Reed Business Information
Once regarded as a model for the UK to follow, the system of integrated health and social services in Northern Ireland is to be completely rebuilt. The author looks at the changes, and highlights some of the advantages and disadvantages identified.
Care management for older people: does integration make a difference?
- Authors:
- CHALLIS David, et al
- Journal article citation:
- Journal of Interprofessional Care, 20(4), August 2006, pp.335-348.
- Publisher:
- Taylor and Francis
England and Northern Ireland provide examples of different degrees of integration of health and social care within broadly similar administrative and funding frameworks. This paper examines whether integrated structures appear to impact upon the operation of care management, a key approach to providing coordinated care for vulnerable older people. It draws on a study undertaken by the Personal Social Services Research Unit (PSSRU) and funded by the Department of Health to evaluate the different forms and types of care management that have emerged since the NHS and Community Care Act for two user groups: older people and people with mental health problems. Results found there appeared to be more evidence of integrated practice between health and social care in Northern Ireland than England, although some key features, such as intensive care management, were no more evident. It is concluded that further investigation is required as to the extent to which integrated structures have impacted upon patterns of professional working and underlying beliefs about roles.
The promised land
- Author:
- PHILPOT Terry
- Journal article citation:
- Community Care, 8.3.01, 2001, pp.22-23.
- Publisher:
- Reed Business Information
Northern Ireland's integrated services offer the government a model for England's health and social care. Asks whether integration is actually delivering.
Integrated care in Northern Ireland, Scotland and Wales: lessons for England
- Authors:
- HAM Chris, et al
- Publisher:
- Kings Fund Centre
- Publication year:
- 2013
- Pagination:
- 82
- Place of publication:
- London
At a time when policy-makers in England have made a commitment to bring about closer integration of care both within the NHS and between health and social care, what can the health and social care system in England learn from the experiences of the other countries of the United Kingdom? This paper examines the context in which health and social care is provided; identifies policy initiatives that promote integrated care and the impact of these initiatives; and considers the barriers and challenges to achieving integrated care. (Publisher abstract)
Implementing the Transforming Your Care agenda in Northern Ireland within integrated structures
- Authors:
- BIRRELL Derek, HEENAN Deirdre
- Journal article citation:
- Journal of Integrated Care, 20(6), 2012, pp.359-366.
- Publisher:
- Emerald
The Transforming Your Care (2011) review of health and social care in Northern Ireland included proposals for integrated care, working together, and a shift in provision and resources from services in hospital to services in the community. This paper aims to assess the recommendations and proposals in the review in the context of existing integrated structures, and to explore the implications of the proposed reconfiguration of health and social care. It discusses integrated structures in Northern Ireland, the proposal for integrated care partnerships for health and social care services, current initiatives in integrated working, and difficulties for the integration of social care posed by new structures. It includes a brief summary of a case study of integration in action at a multi-disciplinary Rapid Access Clinic. The article reports that since 2007 the system in Northern Ireland has developed into a comprehensive model of structural integration. The authors argue that this integrated system is now challenged, that there are concerns about the capacity of the social care workforce to deliver services, and that the planned shift from hospital care to community-based health provision and social care could have adverse consequences.
Transforming your care: a review of health and social care in Northern Ireland
- Author:
- HEALTH AND SOCIAL CARE BOARD
- Publisher:
- Health and Social Care Board
- Publication year:
- 2011
- Pagination:
- 142p., appendices
- Place of publication:
- Belfast
This review undertook consultation with the public, political representative and clinical and professional leaders to examine the quality and accessibility of health and social care services in Northern Ireland. It also examined the extent to which the needs of patients, clients, carers and communities are being met. The report begins by outlining the reasons why the health and social care system needs to change, based on the evidence collected. It the identifies 11 key reasons which support the need for change and provides a model for integrated health and social care to drive the future shape and direction of the service. The report details the impact of the new model across 10 areas of care (population health and wellbeing, older people, long-term conditions, physical disabilities, maternity and child health, family and child care, mental health services, learning disabilities, acute care and palliative and end of life care). It then describes the implications for the health and social care system, and explains who these changes will be implemented over a five year period. Appendices include a summary of online survey results and details of attendance at engagement events.
Integrated commissioning and structural integration: the experience of Northern Ireland
- Authors:
- GRAY Ann Marie, BIRRELL Derek
- Journal article citation:
- Journal of Integrated Care, 24(2), 2016, pp.67-75.
- Publisher:
- Emerald
Purpose: Across the UK integrated commissioning is seen as important to achieving integrated care. In Great Britain this has largely meant separate health and social care agencies coming together to assess need and the planning and delivery of services. Achieving integrated commissioning has proved difficult in the context of different funding systems and different organisational and professional values and cultures. Northern Ireland is the only part of the UK to have a system of total structural integration of all health and social care. The purpose of this paper is to examine the challenges of operationalising integrated commissioning in Great Britain and to assess whether the Northern Ireland model of structural integration has resolved such difficulties. Design/methodology/approach: The paper reviews how integrated commissioning is working through analysis of published research. The authors draw on policy documents to assess and evaluate the structure and process of integrated commissioning in Northern Ireland. Findings: It is concluded that structural integration is not a pre-requisite for integrated care and that there may be risks to social care in moving toward structural integration. While there is a rhetorical commitment to integrated care across the UK this is not followed through in commissioning practice. Originality/value: The paper presents an original assessment of the operation of integrated commissioning in Northern Ireland that has relevance for debates in Britain about the integration of health and social care. (Publisher abstract)
Enablers and barriers to integrated care and implications for Monitor: a report prepared for Monitor
- Author:
- FRONTIER ECONOMICS
- Publisher:
- Frontier Economics
- Publication year:
- 2012
- Pagination:
- 82
- Place of publication:
- London
This report gives an overview of what integrated care is, describes the evidence for the benefits from integrated care and develops a framework for thinking about the barriers to integrated care. In addition, it makes recommendations for how Monitor can carry out its duty to enable integrated care. The report draws on a literature review and the proceedings of workshops with stakeholders. Integrated care is defined as a model that seeks to improve the quality and cost-effectiveness of health and social care for people and populations by ensuring that services are well coordinated around their needs -it is by definition both 'patient-centred' and 'population-oriented'. Quality improvement is measured against four types of benefits: patient experience, clinical outcome, patient safety and cost efficiency. The report identifies key barriers to integrated care, including: quality of IT and communication system, operating procedures between health and social care, unclear rules on transfer of funds from one institution to another, risk aversion, varying clinical practice, cultural differences, and lack of clarity about where accountability lies. The report suggests that Monitor’s role in enabling the provision of integrated care cuts across its responsibilities for: pricing, competition, continuity of service, licensing, and its general corporate functions. (Edited publisher abstract)
Developing an integrated assessment tool for the health and social care of older people
- Author:
- TAYLOR Brian J.
- Journal article citation:
- British Journal of Social Work, 42(7), 2012, pp.1293-1314.
- Publisher:
- Oxford University Press
Assessment tools have a key function in relation to co-ordinating care, communication between professionals and gathering data for monitoring and service improvement. There are challenges facing co-ordinated assessment processes in health and social care of older people because of the wide variety of care pathways in primary, acute, ‘intermediate’ and community care settings. This paper outlines the development of the Northern Ireland Single Assessment Tool (NISAT) for the health and social care of older people. The purpose of the tool is to facilitate access to appropriate health and social care interventions ranging from non-complex to complex co-ordinated care and to be suitable for use in primary, acute and community health and social care including intermediate care. The development involved stakeholders from a wide range of professions, older people and carers. The process included a survey of existing care management assessment tools, various working groups and testing reliability using vignettes and trained actors. Older people were engaged in a music, dance and visual arts project on the theme of assessment to inform the tool development. The components of the tool and their development are reviewed, including considering the role of social work in contributing to specialist assessment as distinct from the role of co-ordinating a holistic assessment process.