Search results for ‘Subject term:"integrated services"’ Sort:
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Changing the care landscape
- Author:
- JONES Simon
- Journal article citation:
- Health Service Journal, 123(6355), 14 June 2013, pp.26-27..
- Publisher:
- Emap Healthcare
The quality of care given to people who are dying is one measure of how much a country values its population. The author looks at the principles and processes of Wales' latest plans to improve end of life care, which are outlined in 'Together for Health - Delivering End of Life Care'. The plan outlines the three main principles of delivery, sets key indicators to measure success, and stresses the importance of integration between the different parts of the NHS, with local government services, and third sector organisations if high quality services are to be delivered. (Original abstract)
Competition and integration in health care reform
- Author:
- HAM Chris
- Journal article citation:
- International Journal of Integrated Care, 12(2), 2012, Online only
- Publisher:
- International Foundation for Integrated Care
There is a growing but still fragile understanding that competition and integration are not necessarily in conflict and can be used together. In one version, this might mean using competition to drive improvements in performance in planned care, and promoting integration to do so in relation to unplanned care and care for people with complex needs. In another, it entails arguing that competition between integrated systems might offer the best of all worlds, if policies can be designed to support evolution in that direction. This paper suggests that a bundle of policy interventions is needed to support the evolution of integrated systems of care. It examines how policies might be crafted to make this happen; How to avoid the wrong kind of integration to develop; and, how can policy makers enable competition between integrated systems. (Publisher abstract)
The development of whole-system integrated care in England
- Authors:
- KENNEDY Claire, MORIOKA Simon
- Journal article citation:
- Journal of Integrated Care, 22(4), 2014, pp.142-153.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to detail the research and findings from a piece of work commissioned by the Local Government Association in England, in May 2013 into the current implementation of integrated care. Design/methodology/approach: The field research was carried out by Integrating Care, a collaborative drawn from leading academics, health and social care executives, analysts and clinicians working in the field of integrated care; along with consultancy support from public sector consultancies PPL and GE Healthcare Finnamore. It comprised a series of local interviews, workshops, modelling and analysis and ongoing engagement. Findings: The paper describes the outputs that were delivered to support the development of “whole-system” integrated health and social care drawing on national and international best-practice, and knowledge gained from experiences of implementation. Social implications: The paper concludes by drawing together the key lessons from the overarching analysis of whole-system integration. This includes the opportunities and the complexities of redesigning and re-implementing better co-ordinated health and social care provision at scale, as experienced in England currently. Originality/value: The paper describes the specific challenges posed through the fieldwork and ongoing development process of integration in England, and the paper reflects upon some of the deeper questions that this has led to. The paper then draws together the research and analysis with emerging, strategic questions around the concept of value in health provision; and begins to question whether this has yet been demonstrated; and, if not, what a demonstration and evidencing of “value” in this context might look like. (Publisher abstract)
Integration and coordination in healthcare: an operations management view
- Author:
- LILLRANK Paul
- Journal article citation:
- Journal of Integrated Care, 20(1), 2012, pp.6-12.
- Publisher:
- Emerald
Policy makers and practitioners have proposed a number of ways and means to promote integrated care. There is, however, little evidence of measurable success. A reason for this is that there is no unanimous definition of integration. This paper is to presents a definition of integration and coordination in health service production, and derives basic design rules. It is based on an operations management perspective and applies a design science methodology to identify purposes, contexts, and design rules. The authors suggests that integration and coordination need to be conceptually separated, as the former means the merger of various service contributions into a common understanding, while the latter means the arrangement of service elements into processes. Basic design rules for bottom-up care integration are presented.
Combating health care fragmentation through integrated health service delivery networks in the Americas: lessons learned
- Authors:
- MONTENEGRO Hernán, et al
- Journal article citation:
- Journal of Integrated Care, 19(5), 2011, pp.5-16.
- Publisher:
- Emerald
High levels of fragmentation characterise health systems in the Americas. In fragmented services users can experience lack of access to services, lack of continuity of care, and the failure of health services to meet their needs. In an effort the tackle the problem of fragmentation, the Pan American Health Organisation (PAHO) has been doing preparatory work for the integrated health service delivery networks (IHSDNs) initiative. IHSDNs are network of organisations that provides, or makes arrangements to provide, equitable, comprehensive, integrated, and continuous health services to a defined population. A literature review, expert meetings, and country consultations in the Americas were used to develop a set of consensus-based essential attributes for implementing IHSDNs. In addition, analysis of 11 country case studies on integration identified good practices and experiences in the integration of health service delivery networks into the health system. The studies suggest that IHSDNs could improve health systems performance. Principal findings include: integration processes are difficult, complex, and long term; integration requires extensive systemic changes and a commitment by health workers, health service managers and policymakers; and, multiple modalities and degrees of integration can coexist within a system. The public policy objective is to propose a design that meets each system's specific organisational needs.
Long-term care in the United States: policy themes and promising practices
- Authors:
- LEHNING Amanda J., AUSTIN Michael J.
- Journal article citation:
- Journal of Gerontological Social Work, 53(1), January 2010, pp.43-63.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This overview of the federal, state and local level policies and practices for long term care of older people in the United States emerging in recent years details the themes that have dominated this field. These include, recruiting and retaining a qualified long term care workforce, devising financing mechanisms for those requiring long term care and evolving away from an institutional-based long term care system to more home and community based social care provision. The authors highlight in particular three promising practices which have evolved in the past few decades. Firstly, the culture change movement, which began in nursing homes, which is now influencing community based long term care. Secondly, service integration involving medical and social care which has improved service delivery overall. Thirdly, the various forms of community residential care which have brought together services and housing in a more home-like environment and improved user outcomes. The authors conclude by detailing recommendations for their twin goal future for long term care, how to improve the health and well-being of individuals of all ages to reduce the need for long term care of older people, along with providing accessible and appropriate long term care to those who do require assistance due to physical, psychological and cognitive impairment.
Integrated social services in Europe
- Author:
- MUNDAY Brian
- Publisher:
- Council of Europe
- Publication year:
- 2007
- Pagination:
- 93p., bibliog.
- Place of publication:
- Strasbourg
Report of a project aiming to review existing work on social services integration across Europe, concentrating on its benefits for the most vulnerable groups and the strengthening of social cohesion, and to develop policy guidelines. In the report, social services refers to personal social services provided for individuals related to their specific needs and circumstances, and the term integration applies to a range of approaches or methods for achieving greater coordination and effectiveness between services to achieve improved outcomes of the service users. It discusses benefits of integrating social services with services such as health and of disintegration of social services, looks at research on theoretical and evidence-based approaches to integration of social services, and reviews models for integrating social and health services, identifying the main barriers to integration. It sets out approaches to integration of social services across selected European countries, and includes policy guidelines for the design and implementation of integrated models of social services.
Reforming the children and young people's workforce: a higher education response
- Author:
- OLIVER Billie
- Journal article citation:
- Learning in Health and Social Care, 7(4), December 2008, pp.209-218.
- Publisher:
- Blackwell
The Every Child Matters change agenda is leading to the creation of new services and new working practices across the children and young people's sectors. These new configurations are leading to the development of new roles that do not necessarily fit with existing, traditional professional qualifications. This paper outlines the response of one university to this policy agenda. The experience of interdisciplinary collaboration and interprofessional curriculum development has mirrored many of the challenges facing colleagues in practice settings. In reflecting on these challenges, this study highlights some of the key issues facing higher education providers in developing an appropriate educational response. The study identifies the need for collaborative and strategic partnership between higher education and practice colleagues in order to prepare a future workforce. It further identifies the desirability of a champion with the capacity and determination to keep the agenda from getting lost within all the other uni-disciplinary agendas that operate within universities.
Building capacity for the children's workforce: findings from the knowledge review of the higher education response
- Authors:
- TAYLOR Imogen, SHARLAND Elaine, WHITING Russell
- Journal article citation:
- Learning in Health and Social Care, 7(4), December 2008, pp.184-197.
- Publisher:
- Blackwell
In the UK, there is rapid and far-reaching policy change designed to provide integrated services to children, young people and their families, linking education, social care, health, youth and community, criminal justice and other professions. Higher education institutions must play a significant role in this process given the large proportion of its graduates who will join the Children's Workforce. In 2007, a University of Sussex team was commissioned by the Higher Education Academy Subject Centres for Social Policy and Social Work; Education; Health Sciences and Practice; Medicine, Dentistry and Veterinary Science; and Psychology, in collaboration with the Children's Workforce Development Council and the Children's Workforce Network to undertake a Knowledge Review of integrated children's services in higher education. In this paper, the authors explore the policy context for integrated children's services and its interaction with the educational and workforce agenda. They set out the process of the Knowledge Review and examine its findings thematically, drawing on activity theory. They suggest that to advance the integrated children's services agenda in higher education, four crucial issues need to be addressed: stakeholders need to provide a clear-cut business case for investment; universities and regulators must address disciplinary and associated cultural barriers to change at all levels; funders must invest in supporting pilot initiatives and their evaluation; and finally, academics need to find ways to engage and sustain children, young people and their families in the development process.
The impacts of GP federations in England on practices and on health and social care interfaces: four case studies
- Authors:
- McDONALD R., et al
- Journal article citation:
- Health and Social Care Delivery Research, 8(11), 2020, Online only
- Publisher:
- National Institute for Health Research
- Place of publication:
- London
General practices have begun working collaboratively in general practitioner federations, which vary in scope, geographical reach and organisational form. Objectives: The aim was to assess how federating affects practice processes, workforce, innovations in practices and the interface with health and social care stakeholders. Design: This was a structured cross-sectional comparison of four case studies, using observation of meetings, interviews and analysis of documents. We combined inductive analysis with literature on ‘meta-organisations’ and networks to provide a theoretically informed analysis. Results: All federations were ‘bottom-up’ voluntary membership organisations but with formal central authority structures. Practice processes were affected substantially in only one site. In this site, practices accepted the rules imposed by federation arrangements in a context of voluntary participation. Federating helped ease workforce pressures in two sites. Progress regarding innovations in practice and working with health and social care stakeholders was slower than federations anticipated. The approach of each federation central authority in terms of the extent to which it (1) sought to exercise control over member practices and (2) was engaged in ‘system proactivity’ (i.e. the degree of proactivity in working across a broader spatial and temporal context) was important in explaining variations in progress towards stated aims. We developed a typology to reflect the different approaches and found that an approach consisting of high levels of both top-down control and system proactivity was effective. One site adopted this ‘authoritative’ approach. In another site, rather than creating expectations of practices, the focus was on supporting them by attempting to solve the immediate problems they faced. This ‘indulgent’ approach was more effective than the approach used in the other two sites. These had a more distant ‘neglectful’ relationship with practices, characterised by low levels of both control over members and system proactivity. Other key factors explaining progress (or lack thereof) were competition between federations (if any), relationship with the Clinical Commissioning Group, money, history, leadership and management issues, size and geography; these interacted in a dynamic way. In the context of a tight deadline and fixed targets, federations were able to respond to the requirements to provide additional services as part of NHS Improving Access to General Practice policy in a way that would not have been possible in the absence of federations. However, this added to pressures faced by busy clinicians and managers. Limitations: The focus was on only four sites; therefore, any federations that were more active than those federations in these four sites will have been excluded. In addition, although patients were interviewed, because most were unaware of federations, they generally had little to say on the subject. Conclusions: General practices working collaboratively can produce benefits, but this takes time and effort. The approach of the federation central authority (authoritative, indulgent or neglectful) was hugely influential in affecting processes and outcomes. However, progress was generally slower than anticipated, and negligible in one case. (Publisher abstract)