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The purpose of this paper is to consider what implications the government's policy of personalisation has for social care workers in terms of the skills that they need to achieve more personalised support for people using services and family carers.

A total of 86 semi-structured interviews were undertaken with a purposeful sample of social care commissioners, family carers, representatives of voluntary organisations and carers’ workers based in four contrasting localities in England.

Participants highlighted the need for social care workers to have more specialist knowledge both about different complex health conditions and about services in their locality. The need to offer tailored support to carers that took account of the time they had been caring and the particular issues that they faced in terms of the health problems that the person for whom they cared was emphasised. The relational aspects of care are important.

This was an exploratory study and may need to be replicated before generalisations could be made.

Existing published research on personalisation rarely discusses its implications for the social care workforce in terms of their skills. There is also still only a limited literature looking at personalisation from the perspective of family carers and those working with family carers.

The purpose of this paper is to present findings from face-to-face interviews with three former care staff who were proven to have abused some of the older people living in the care and nursing homes in which they had once worked. The research sought to explore the intra-personal dynamics, personal characteristics and work experiences that led these staff to perpetrate abuse.

Semi-structured interviews were undertaken with three former care and nursing home staff who had committed abusive acts and the data secured subjected to thematic narrative analysis.

None of the three people interviewed had intended to become care staff and reported that the interview and induction processes they experienced did little to establish their suitability for the work they would be undertaking or to prepare them for its demands. Participants expressed their generally negative perceptions of older people, particularly those living with dementia, and told of how they also felt that they were under pressure to conform with the often abusive care home regimes that they had entered. They also recounted some specific abusive practices developed to allow them to manage the constant tension between the time available to complete all of the tasks required when “caring” for older people, and revealed their perceptions of external scrutiny of care home conduct and the behaviours developed to deflect the effectiveness of this oversight. Two interview participants also revealed their unfavourable attitudes to some of the people they were employed to care for that were based upon perceptions of ethnic differences, and of how this had contributed to the abuse they perpetrated.

Though the research draws upon the experiences of only three former care staff, the data reveal some of the intra-personal dimensions of individual staff who have engaged in abusive acts, and illuminates how the care home environment with which they interact can engender conditions under which abuse is more likely to occur.

Unusually, the paper explores the characteristics, perceptions and experiences of care staff who have actually committed abusive acts against those entrusted to their care.

The purpose of this paper is to argue for the institutionalisation of emergent forms of organisation in health and social care and offer a conceptual framework for this purpose.

Drawing on ethnographic research on the organising work of nurses and Translational Mobilisation Theory, this paper extends two classic Straussian sociological concepts – illness trajectory and articulation work – to conceptualise emergent organisation as Care Trajectory Management.

Failures of coordination are well-recognised threats to quality and safety and recent decades have witnessed an explosion of neoliberal technologies and governance arrangements designed to “measure and manage” these risks. Yet in a significant and growing proportion of health and social care provision successful service integration depends not on rational planning, but iterative negotiations and adjustments in response to contingencies. While ubiquitous in health and social care systems, these emergent forms of organisation lack legitimacy, the work involved is relatively invisible and practice is poorly served by prevailing management discourses.

The Care Trajectory Management Framework provides an alternative discourse and logic on which to develop strategies and technologies to support emergent organisational processes in acute and community care contexts.

The purpose of this paper is to underline the importance of taking work practices into account for quality improvement (QI) purposes, highlight some of the challenges of doing so, and suggest strategies for future research and practice. Patient status at a glance, a Lean-inspired QI intervention designed to alleviate nurses of their knowledge mobilisation function, is deployed as an illustrative case.

Ethnographic data and practice-based theories are utilised to describe nurses’ knowledge mobilisation work. The assumptions about knowledge sharing embedded in patient status at a glance white boards (PSAGWBs) are analysed drawing on actor network theory.

There is a disparity between nurses’ knowledge mobilisation practices and the scripts that inform the design of PSAGWBs. PSAGWBs are designed to be intermediaries and to transport meaning without transformation. When nurses circulate knowledge for patient management purposes, they operate as mediators, translating diverse information sources and modifying meaning for different audiences. PSAGWBs are unlikely to relieve nurses of their knowledge mobilisation function and may actually add to the burdens of this work. Despite this nurses have readily embraced this QI intervention.

The study is limited by its focus on a single case and by the inferential (rather than the empirical) nature of its conclusions.

This paper illustrates the importance of taking practice into account in healthcare QI, points to some of the challenges of doing so and highlights the potential of practice-based approaches in supporting progress in this field.

Social networks have been a central focus of sociological research on inequalities but less has focused specifically on chronic illness and disability despite a policy emphasis on resources necessary to support self-management. In this chapter, we seek to unpack overlaps and distinctions between social network approaches and research on the experience and management of chronic illness. We outline four main areas viewed as central in articulating the potential for future work consistent with a critical realist perspective: (1) body–society connections and realist/relativist tensions; (2) the controversy of ‘variables’ and accounting for social and cultural context in studying networks for chronic illness support; (3) conceptualising social support, network ties and the significance of organizations and technology; and (4) translating theory into method.

Videoconferencing between general practitioners and hospitals has been developed to provide higher quality health care services in Norway by promoting interaction between levels of care. This article aims to explore the use of videoconferencing for information exchange and consultation throughout the patient trajectory and to investigate how collaboration affects learning and the patient's treatment.

The approach was interaction analysis supplemented by interviews. Medical discussions concerning the patient were observed for 15 days, creating a trajectory of seven videoconferences. Interviews were conducted to examine the collaboration.

General practitioners and specialists use a different repertoire of knowledge and experiences to report and consult throughout the course of treatment. Over time, new medical problems arose, and the treatment had to be adjusted. The activity remained continuous and contributed to an integrated knowledge and information exchange. Collaboration using videoconferencing across levels of care created opportunities for workplace learning in health services and can lead to continuity, improved coordination, and a higher quality of care.

In contrast to other studies, which state effects, the need for continuity and cooperation in health care, and the ways in which individual differences make it difficult to achieve seamless health care services, this study offers insight into how continuity and cooperation can be achieved. It includes both observations of interactions and interviews of the participants, providing analysis of collaborative work in situ. This provides insight into the content of the interaction over time as a resource for understanding the outcome of the use of technology and improving health care.

This paper aims to present evidence for regarding reflexive practice as the crux of patient safety in tertiary hospitals. Reflexive practice buttresses safety because it is the precondition for flexible systematization – that is, the process that involves frontline clinicians in designing, redesigning and flexibly enacting care processes.

The paper presents an account of a collaborative video‐ethnographic project with a multi‐disciplinary team in an acute spinal unit. Video‐ethnography was combined with video‐reflexivity to provide practitioners with the opportunity to become involved in data interpretation and solution generation.

The study reveals that an outsider analysts/catalyst (or clinalyst) is critical to engaging frontline practitioners in reflexivity. The clinalyst is able to elicit insights and perspectives that assist practitioners in revisiting and revising their processes and practices, principally because video‐based reflexivity connects “what we do” directly to “who we are”.

Because complexity will be an indelible part of health care work, health care organizations should invest in developing “reflexive space” where learning about complexity becomes possible. Instead of continuing to invest in research efforts seeking to derive and test staff compliance with guidelines and protocols, and training centred on simulation, these organization must begin to engage with the lived complexity of clinical work in order to skill up incoming clinicians.

Enhancing clinical practitioners' capability to confront complexity in their practices is currently not a standard component of clinical training or work‐based learning. Video‐reflexive ethnography in tertiary health care is unique in involving clinicians in “making sense” of and deriving solutions from lived complexity.

Worldwide, healthcare systems struggle to sustain the delivery of services at a time of increasing demand, limited resources and growing expectations from users, coupled with dealing with the aftermath of the Covid-19 pandemic and the threat of other outbreaks. There has never been a more important time to sustain innovation and improvements. Using an illustrative case, the authors assess the application of two existing frameworks to identify the key propositions and dimensions required to deliver sustainable services.

This illustrative case study focuses on a service provided by a chronic disease, multidisciplinary community healthcare team in the UK. Experienced-based interviews were conducted with health professionals, patients and relatives to provide a rich account of a care pathway design. A high-level process map is used to visualise the key touch points.

The authors identify all seven propositions of the SERVICE framework being present along with additional dimensions relating to sustaining innovation and improvement.

This research is limited to a chronic disease care pathway. However, the authors believe the results could be applicable to other medical conditions, which are supported by a similar multi-disciplinary service delivery model.

The authors provide a sustainable public service operations SERVICES framework for health professionals and managers to consider when (re)designing care pathways.

This research contributes to the emerging discipline of public service operations research by empirically testing for the first time the SERVICE framework within healthcare. The authors have included additional factors associated with innovation and improvement and recommended further development of the framework to include factors, such as economic sustainability, highly relevant to the context of universal healthcare systems.