Search results

Connected Care, Turning Point's model for involving the community in the design and delivery of integrated health and well‐being services, aims to involve the community in the commissioning process in a way which fundamentally shifts the balance of power in favour of local people. The model has been tested in a number of areas across the country, and previous articles in the Journal of Integrated Care have charted the progress of the original pilot in Hartlepool. Cost‐benefits of the approach are now becoming clearer. Implementation of a new community‐led social enterprise in Hartlepool began in 2007, and today its Connected Care service provides community outreach, information, access to a range of health and social care services, advocacy, co‐ordination and low‐level support to the people of Owton. Key lessons, from Hartlepool and elsewhere, have centred on the value of making the case for service redesign from the ‘bottom up’ and building the capacity of the community to play a role in service delivery, while also promoting strong leadership within commissioning organisations to build ‘top‐down’ support for the implementation of outcomes defined through intensive community engagement. The new Government's ‘localism’ agenda creates new opportunities for community‐led integration, and the Connected Care pilots provide a number of learning points about how this agenda might be successfully progressed.

This article is the second which the Journal of Integrated Care has published about the Hartlepool connected care pilot. It takes up the narrative from the launch of the community audit report in February 2006 to the project's successful bid to become one of the 26 DoH social enterprise pilots some 12 months later. It seeks to understand the barriers encountered as the pilot sought to implement a service model based on an audit of local needs and ambitions. It identifies the need for support outside the local policy systems if holistic, community‐based initiatives are to be initiated and implemented. In addition, it considers some of the implementation dilemmas that the pilot posed for local agencies and that it had itself to face and resolve during this second phase in its development.

Hartlepool's connected care pilot is a partnership between residents, councillors, Turning Point, the NHS and the local council in one of the most deprived wards in England. A local audit was conducted by residents, demonstrating the relevance of information held by the community about its needs, ambitions and interactions with services. A new service model aims to provide integrated responses to complex need, commissioned through a local partnership agreement and delivered through a social enterprise. The implementation will demonstrate how far real power is shifting to local people.

Too many health and social care services are failing to meet people's complex needs. In this paper, ‘complex needs’ is presented as a framework to help understand multiple interlocking needs that span health and social issues. The concept encompasses mental health problems, combined with substance misuse and/or disability, including learning disability, as well as social exclusion. The paper outlines a strategy for promoting the well‐being and inclusion of people with complex needs. At the heart of this strategy is a new kind of delivery model: connected care centres, a type of bespoke social care service, a model which has been endorsed by the Social Exclusion Unit (SEU). In addition, the paper describes how new responses from existing services can promote better support for people with complex needs, such as a reformed commissioning process and a new ‘navigational’ role for the social care worker.

Persistent and particular health and social care challenges face socially excluded groups and communities in the more deprived areas of the country. Involvement of communities in design and delivery of services, including those whose voices have traditionally not been heard, will help to shape services to meet better their health and well‐being needs. Effective community‐led commissioning can empower individuals and communities by giving them the chance to voice their needs, while local ownership of the process will increase the relevance of services, and improve their uptake and sustainability. For commissioners, the ‘World Class’ commissioning agenda is about connecting development of services with the real requirements of communities, and increasing engagement and satisfaction with services.

The purpose of this paper is to explore how clinical nurse education and nursing students’ care practices are shaped by different logics of care.

Inspired by Mol’s work on care, the paper explores care practices connected to the clinical education of nurses. The empirical data were generated from longitudinal, multi-sited ethnographic fieldwork among nursing students in clinical practice combined with follow-up interviews with the students and their supervisors.

The paper illustrates how three logics of care shape clinical education: the logic of relational care, the logic of care education and the logic of care production. The paper demonstrates how the logics unfold and entangle in everyday clinical education. On the one hand, care of patients based on the relationship between patient and nurse is highly valued. On the other hand, this logic is not institutionalized in the same way as practices induced by the logic of care production and the logic of care education.

The paper may be of value to scholars and practitioners in clinical education, as well as to health educational policy makers. The findings focus on paradoxes produced by conflicting logics in practice, thus offering new reflections and alternative sensemaking of well-known problems connected to clinical education.

Imagine a world where mental health is everybody's business and mental health problems no longer a source of social stigma. Jennifer Rankin believes this isn't an impossible dream and sets out here the government policies and practical steps currently being taken to achieve it.

Care farming is an underexplored example of agricultural diversification. In their process of diversification, care farmers are newcomers to the healthcare sector, facing high entry barriers and lacking the skills required to build a solid and legitimate presence in this new domain. Changes in the care regime have provided opportunities for new players, like regional organizations of care farmers, to gain access to care budgets. The purpose of this paper is to describe and analyze how strategies designed to establish regional organizations of care farms with similar access to institutional resources unfold and are translated into entrepreneurial behavior, organizational identity and legitimacy, and help provide access to care budgets.

Using entrepreneurship, identity formation and legitimacy building as guiding concepts, the authors interviewed stakeholders and analyzed activities and documents to gain a broad perspective with regard to the organizations, skills and activities.

The authors identified two types of regional care farm organizations: a cooperative and a corporate type. While the corporate type clearly exhibited entrepreneurial behavior, leading to a trustful and appealing organizational identity, substantial fund-raising and an early manifestation of institutional and innovative legitimacy in the care sector, the cooperative type initially lacked entrepreneurial agency, which in turn led to a lack of legitimacy and a slow development toward a more professional market-oriented organization. Manifesting entrepreneurial behavior and strategically aligning the healthcare and agricultural sectors, and building up both institutional and innovative legitimacy in the care sector proved to be crucial to the successful development of regional organizations of care farms. This study contributes to existing literature by exploring relationships between entrepreneurial and institutional strategies, legitimacy, organizational identity and logics.

This study contributes to the literature by exploring how in times with changes in institutional logics, strategies to establish new organizations unfold. The authors have shown how differences in strategy to establish new organizations with similar access to institutional resources unfold and are translated into diverging organizational identities and degrees of legitimacy. Entrepreneurial behavior is the key to create a trustful and appealing identity and innovative and institutional legitimacy which is important for providing access to an institutionalized sector.

How will the relationship between patients, the service level and the geographic conditions in healthcare develop in the future? The task will be of great impact for location of new properties and the use of existing healthcare buildings. In order to improve healthcare space requirements, it is important to understand the expression “horizontal integrated care”. Defining terms will enhance the communication between providers, companies and individuals. The research also looks into the phenomenon of “local hospital”. The first step is to analyse these terms and describe the definitions from collected material obtained by a questionnaire, interviews and searches on the Web. The main issue is to give the conception a broad validity. This study gives a definition that can be shared by most parties in healthcare today and will enhance the communication in healthcare issues.

The following paper is a “Q & A interview” conducted by Joanne Pransky of Industrial Robot Journal as a method to impart the combined technological, business and personal experience of a prominent, robotic industry engineer-turned entrepreneur regarding the evolution, commercialization and challenges of bringing a technological invention to market.

The interviewee is Dr Yulun Wang, an inventor, self-taught entrepreneur, business leader and world-renowned authority on robotics and health care. Dr Wang shares his successful three-decade journey that began with researching the market needs and aligning himself with medical experts, followed by pioneering robotic solutions specifically for the health care industry. In the process, Dr Wang founded and spearheaded both a public and private robotics company.

Dr Yulun Wang received a BSc and an MSc in Computer Science, and a PhD in Electrical Engineering, from the University of California, Santa Barbara (UCSB). After teaching at UCSB for a few years, with a grant he won from NASA, Dr Wang founded Computer Motion, Inc. in 1989 and conducted research on endoscopic robots. Computer Motion went public in 1997 and later merged with its competitor, Intuitive Surgical (NASDAQ:IRSG) in 2003 to forge the multi-billion dollar surgical robotics industry. Dr Wang founded InTouch Technologies (d.b.a. InTouch Health), in 2002, named one of the fastest-growing biomedical companies in the USA by INC Magazine.

Dr Wang launched his career at the intersection of health care and technology with his invention of the voice-controlled robotic arm AESOP, the first US Food and Drug Administration (FDA)-cleared surgical robot. His next generation ZEUS robotic surgical system (ZRSS), was cleared by the FDA in 2001. Also in 2001, ZRSS was used in the world’s first telesurgery, as surgeons in New York controlled the arms of the Zeus to perform a cholecystectomy on a patient in Strasbourg, France, via a high-speed fiber optic supplied by France Telecom. This led Dr Wang to found InTouch Health, a company that pioneers remote presence robot systems that enable health care professionals to provide more effective and efficient health care. Dr Wang has received multiple other entrepreneurship and leadership awards, including being elected to the prestigious ranks of the National Academy of Engineering in 2011. He is the author of over 50 scientific publications, and holds over 100 patents registered in his name. Dr Wang serves on several boards, including the American Telemedicine Association (ATA) Board of Directors, where he also serves as an officer.