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1 – 10 of over 88000As promised in the previous article (Continuing Health Care ‐ the story so far…) this article considers some specific issues in relation to people being cared for at home and in…
Abstract
As promised in the previous article (Continuing Health Care ‐ the story so far…) this article considers some specific issues in relation to people being cared for at home and in relation to children.
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This special issue emphasises how the ‘whole system’ of care is becoming even more complex. With the pending implementation of the Community Care (Delayed Discharges etc) Act…
Abstract
This special issue emphasises how the ‘whole system’ of care is becoming even more complex. With the pending implementation of the Community Care (Delayed Discharges etc) Act 2003, there are pressures on strategic health authorities and local councils to reach agreement on eligibility criteria for continuing health care. But in the wake of a special report from the Health Service Ombudsman, there is still plenty of room for debate about the lawfulness of the criteria.
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Michael Aherne and José L. Pereira
The purpose of this paper is to use a descriptive case study to establish how collaboration, innovation and knowledge‐management strategies have scaled‐up learning and development…
Abstract
Purpose
The purpose of this paper is to use a descriptive case study to establish how collaboration, innovation and knowledge‐management strategies have scaled‐up learning and development in rural, remote and other resource‐constrained Canadian delivery settings.
Design/methodology/approach
Intervention design was realized through a one‐time, collaborative, national capacity‐building project. A project portfolio of 72 sub‐projects, initiatives and strategic activities was used to improve access, enhance quality and create capacity for palliative and end‐of‐life care services. Evaluation was multifaceted, including participatory action research, variance analysis and impact analysis. This has been supplemented by post‐intervention critical reflection and integration of relevant literature.
Findings
The purposeful use of collaboration, innovation and knowledge‐management strategies have been successfully used to support a rapid scaling‐up of learning and development interventions. This has enabled enhanced and new pan‐Canadian health delivery capacity implemented at the local service delivery catchment‐level.
Research limitations/implications
The intervention is bounded by a Canada‐specific socio‐cultural/political context. Design variables and antecedent conditions may not be present and/or readily replicated in other nation‐state contexts. The findings suggest opportunities for future integrative and applied health services and policy research, including collaborative inquiry that weaves together concepts from adult learning, social science and industrial engineering.
Practical implications
Scaling‐up for new capacity is ideally approached as a holistic, multi‐faceted process which considers the total assets within delivery systems, service catchments and communities as potentially being engaged and deployed.
Originality/value
The Pallium Integrated Capacity‐building Initiative offers model elements useful to others seeking theory‐informed practices to rapidly and effectively scale‐up learning and development efforts.
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Julienne Meyer, Hazel Heath, Cheryl Holman and Tom Owen
This paper highlights the need for researchers to work across disciplinary boundaries in order to capture the complexity that care practitioners have to engage with everyday in…
Abstract
This paper highlights the need for researchers to work across disciplinary boundaries in order to capture the complexity that care practitioners have to engage with everyday in care home settings. Drawing on findings from a literature review on the complexity of loss in continuing care institutions for older people, the case is made for less victim blaming and more appreciative approaches to research. The way this thinking informed the development of a further literature review on quality of life in care homes (My Home Life) is discussed. Findings from this second study are shared by illustrating key messages with quotes from older residents, relatives and staff living, visiting and working in care homes. These best practice messages focus on: transition into a care home; working to help residents maintain their identity; creating community within care homes; shared decision‐making; health and health services; end‐of‐life care; keeping the workforce fit for purpose, and promoting positive culture. The importance of collaborative working in both research and practice is discussed. The paper is likely to be of interest to all those concerned with improving and developing evidence‐based practice in the care home sector, including users and service providers, managers, commissioners and inspectors, policy‐makers, researchers and teachers.
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The purpose of this paper is to assess the practical implications for integrated care of the UK public sector Ombudsmen's maladministration findings over recent years.
Abstract
Purpose
The purpose of this paper is to assess the practical implications for integrated care of the UK public sector Ombudsmen's maladministration findings over recent years.
Design/methodology/approach
This is a review of reported UK public sector Ombudsmen decisions.
Findings
Through their published findings of maladministration, the UK public sector Ombudsmen have made an important contribution to the promotion of good practice in integrated care.
Originality/value
This paper identifies themes relevant to integrated care within Ombudsmen decisions in recent years.
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Diane Seddon, Kate Jones and Mari Boyle
This article presents the key findings from a collaborative study about the experiences and support needs of carers whose relatives are admitted into a nursing or residential care…
Abstract
This article presents the key findings from a collaborative study about the experiences and support needs of carers whose relatives are admitted into a nursing or residential care home. Drawing upon data from carers' qualitative accounts, it considers carers' post‐admission roles, responsibilities and profiles, and the contribution carers make to the continued care of their relative. Carers' post‐admission caring experiences are described in detail and differences between spouse carers and carers involved in looking after a parent are identified. A temporal model depicting the complex and dynamic nature of carers' postadmission experiences is presented. The implications for policy and practice are discussed.
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Elizabeth Welch, Karen Jones, Diane Fox and James Caiels
Integrated care continues to be a central aim within health and social care policy in England. Personal budgets and personal health budgets aim to place service users at the…
Abstract
Purpose
Integrated care continues to be a central aim within health and social care policy in England. Personal budgets and personal health budgets aim to place service users at the centre of decision-making and are part of a wider long-term initiative working towards personalised and integrated care. Personal budgets began in social care with the national pilot programme of individual budgets, which aimed to incorporate several funding streams into one budget, but in practice local authorities limited these to social care expenditure. Personal budgets then moved into the health care sector with the introduction of a three-year personal health budgets pilot programme that started in 2009. The purpose of the paper is to explore the post-pilot implementation of personal health budgets and explore their role in facilitating service integration. We examine this through the RE-AIM framework.
Design/methodology/approach
During 2015 and 2016, eight organisational representatives, 23 personal health budget holders and three service providers were interviewed, 42 personal health budget support plans were collected and 14 service providers completed an online survey.
Findings
Overall, personal health budgets continued to be viewed positively but progress in implementation was slower than expected. Effective leadership, clear communication and longer-term implementation were seen as vital ingredients in ensuring personal health budgets are fully embedded and contribute to wider service integration.
Originality/value
The paper highlights the importance of policy implementation over the longer-term, while illustrating how the venture of personal health budgets in England could be a mechanism for implementing service integration. The findings can serve to guide future policy initiatives on person-centred care and service integration.
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