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Explores the implications for continuity of care of the wide range of policy initiatives currently affecting the management and use of human resources in the UK National Health Service. Draws on the findings of a short study undertaken in 2001 comprising a policy document analysis and a series of expert seminars discussing the impact of the policies in practice. A variety of potential long‐term gains for continuity of care were identifiable in the current raft of policy initiatives and seminar participants agreed that, when these policies are fully implemented, continuity of care should be enhanced in several ways. However, the impact to date has been rather more equivocal because of the damaging effects of the process of policy implementation on continuity within the system and on staff attitudes and values. If continuity of care is accepted as an important element of quality in health care, more attention must be given to developing strategies which support system continuity.

Continuity of forensic mental health care is important in building protective structures around a patient and has been shown to decrease risks of relapse. Realising continuity can be complicated due to restrictions from finances or legislation and difficulties in collaboration between settings. In the Netherlands, several programs have been developed to improve continuity of forensic care. It is unknown whether professionals and clients are sufficiently aware of these programs. The paper aims to discuss this issue.

The experienced difficulties and needs of professionals and patients regarding continuity of forensic care were explored by means of an online survey and focus groups. The survey was completed by 318 professionals. Two focus groups with professionals (15 participants), one focus group and one interview with patients (six participants) were conducted.

The overall majority (85.6 percent) reported to experience problems in continuity on a frequent basis. The three main problems are: first, limited capacity for discharge from inpatient to outpatient or sheltered living; second, collaboration between forensic and regular mental health care; and, third, limited capacity for long-term inpatient care. Only a quarter of the participants knew the existing programs. Actual implementation of these programs was even lower (3.9 percent). The top three of professionals’ needs are: better collaboration; higher capacity; more knowledge about rules and regulation. Participants of the focus groups emphasized the importance of transparent communication, timely discharge planning and education.

Gathering best practices about regional collaboration networks and developing a blueprint based on the best practices could be helpful in improving collaboration between setting in the forensic field. In addition, more use of systematic discharge planning is needed to improve continuity in forensic mental health care. It is important to communicate in an honest, transparent way to clients about their forensic mental health trajectories, even if there are setbacks or delays. More emphasis needs to be placed on communicating and implementing policy programs in daily practice and more education about legislation is needed Structured evaluations of programs aiming to improve continuity of forensic mental health care are highly needed.

Policy programs hardly reach professionals. Professionals see improvements in collaboration as top priority. Patients emphasize the human approach and transparent communication.

The purpose of this paper is to explore the views of people with learning disabilities on issues associated with continuity of care in the transition from full-time education to adult care and support.

Data collection was undertaken with people with learning disabilities and staff in two advocacy organisations in one area of England in 2012. In total, 19 participants attended three focus groups. Analysis focussed on continuity of care and was guided by the framework approach to qualitative analysis.

Teachers, social workers in children’s services and youth workers were identified as making important contributions to the transition process. Information relating to learning and social development was identified as most important to inform transition planning with less priority accorded to health, communication, and self-care and independence. Participants appeared to value principles which underpin continuity of care.

This study provides insights into attributes of continuity of care valued by people with a learning disability. Possibilities of translating these attributes into practice within localities are explored. Findings could be used to inform strategic planning locally to promote service integration thereby contributing to continuity of care within transition planning.

Continuity of care in the transition planning process is highlighted in policy guidance with recognition that both practice and procedures require improvement. This research explores areas for development from the perspective of people with learning disabilities.

The purpose of this paper is to consider some notions that are currently in use in integrated care, with the aim of exploring whether these notions improve the quality and integration of care.

Notions like “continuity of care”, “coordination of care”, “team‐working” and “partnerships” are some of the wide variety of terms increasingly employed within the range of initiatives and efforts that aim to enhance the quality of health and social care environments for patients and users. While each of these notions seems to represent a worthy cause in the quest for better care, and is accompanied by varying extents of evidence of its effectiveness, conceptual clarity of each notion remains a challenge. This paper undertook a detailed examination of what each of these notions comprises, how it is measured objectively and subjectively, whilst highlighting any apparent overlap between the notions.

From the analysis of the four notions, two main patterns of dysfunctional features emerged: the first pattern involved issues of multiple, imprecise and constricted definitions; the second pattern had to do with imprecise or conflicting assessments of how the different notions or dimensions thereof are related to one another.

A review of the literature suggests that the meanings, and consequently the measurement, of these notions could benefit from less ambiguity in order to prevent confusion about what precisely is being implemented and measured.

In order that calls for quality improvement do not become slogan statements, there is an urgent need for integrated framework(s) that add clarity to an already compound web of notions. This could contribute to improving the quality of research and evidence base of this complex field.

The purpose of this paper is to provide a commentary on “Learning disability services: user views on transition planning”.

The commentary provides a discussion of the concept of continuity of care (Forbes et al., 2001; Freeman et al., 2000) in relation to transition from children’s to adults’ services for young people with intellectual/developmental disabilities.

Continuity of care is an important consideration for this population and is emphasised in recent policy initiatives in England, as well as being highlighted by young people and their families as a significant aspect of their transition experience. Despite this, evidence suggests it is not currently achieved for many young people and their families, and a number of challenges that may contribute to this are highlighted.

The commentary emphasises that continuity of care should be a key consideration for services supporting young people and their families at transition.

Patients with chronic obstructive pulmonary disease (COPD) suffer many physical disabilities which cause many problems in their life. These patients really need to have continuity of care based on cooperation between patient, the family and their care givers in order to achieve an integration of care. The purpose of this paper is to assess the impact of continuous care on quality of life of patients with COPD.

A before–after quasi-experimental study was carried out with 72 patients with COPD at Beheshti educational hospital of Hamadan University of Medical Sciences. The patients who met inclusion criteria were randomly allocated into an intervention group (n=36) and a control group (n=36). The patients completed the St George’s Respiratory Questionnaire before and after their care. The intervention comprised continuous care with orientation and sensitization sessions (2 weeks), control and evaluation sessions (45 days) for intervention group and with routine care in the control group. Data were analyzed with SPSS, descriptive and inferential statistics were conducted to measure differences between intervention and control group.

Continuity of care improved significantly the quality of life of COPD patients in general, and in the symptoms, activity and impact domains (P=0.001). In contrast, routine care did not improve quality of life for patients in general, and in the symptoms, activity and impact domains (P=0.05).

Continuity of care has a positive impact on quality of life for COPD patients. Health care system should utilize continuity of care models as an overall plan for patients with COPD. Moreover, managers of health care system could reduce burden of chronic diseases by employing continuity of care models in planning patient care.

Examines issues raised by Changing Childbirth. Summarizes an IMS/RCM report and is based on research in maternity units at different stages in the adoption of various approaches to developing continuity of care. It is concerned with the effect on midwives′ working lives and explores issues of grading, responsibility, working hours, career progression and job satisfaction.

The purpose of this study is to understand health care providers' experiences with delivering a novel Integrated Care (IC) Program that co-ordinates hospital-based clinical services and home care for thoracic surgery patients, including perceptions on the provision of person-centred care and quality of work life.

The authors conducted a process evaluation using qualitative methods to understand provider experiences in the Integrated Care (IC) Program and to identify areas for programme improvement. Study data were collected using a focus group with thoracic surgeons, open-ended survey with home care providers, and semi-structured interviews with lead thoracic surgeons and IC leads, who are nurses serving as the primary point of contact for one consistent care team. Data were analysed using thematic analysis.

The IC Program was successful in supporting a partnership between health care providers and patients and caregivers to deliver a comprehensive and person-centred care experience. Informational continuity between providers was facilitated by IC leads and improved over time with greater professional integration and adaptation to the new care delivery processes. Differential impacts were found on quality of work life for providers in the IC Program.

This study describes provider experiences with delivering integrated and person-centred care across the hospital to home continuum, which can inform future integrated care initiatives.

Women with little-to-no English continue to have poor birth outcomes and low service user satisfaction. When language support services are used it enhances the relationship between the midwife and the woman, improves outcomes and ensures safer practice. However, this study has shown a reluctance to use professional interpreter services by midwives. This study aims to understand the experiences of midwives using language support services.

A maximum variation purposive sampling strategy was used to recruit midwives (N = 12) to a qualitative, semi-structured interview study. Data were analysed using thematic analysis.

Four themes were generated from the data analysis with a central organising concept of “Navigating Care Without Language”. These themes were: “Continuity as Key”, “Facilitating Tools”, “Networks of Support” and “Innovative Planning”. Each of these themes had between three and four sub-themes. It was found midwives are keen to support women with language barriers. However, support can be difficult due to the unavailability of equipment and resources; lack of continuity (of interpreter and midwife); inability to plan for the acute care of women who require interpreter services; and the system not being accessible enough to women who require language support services, thus causing them to fall through the net.

Continuity of carer appears to be a protective factor due to the flexibility, relationship and continuum of support. This study will aid the development of education for undergraduate, post-graduate and practising midwives. It will also inform policymakers working to improve the service offered to women who speak little-to-no English.

Hospital managers are constantly confronted with capacity and continuity problems that tempt them to investigate the possibility of further job differentiation. In The Netherlands, the hospital physician represents a new breed of physicians who are not oriented towards a medical specialism but towards a patient domain. The hospital physician represents a controversial kind of job differentiation that is expected to stimulate more continuity. This case study shows how medical specialists themselves are starting to address the fragmentation caused by specialization. According to the professionals involved, the hospital physician constitutes a solution that does not threaten their professional values. They report a number of ways in which this job type can contribute to solving the problems reported. However, concerns have been raised about the risks of developing these new jobs without changing the existing professional and work structures.