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The purpose of this paper is to report on the findings of the first stage of a project seeking to evaluate and overcome inter-professional barriers between health and social care staff within a single, co-located, integrated community team. The project seeks to answer the following questions: first, Do inter-professional barriers to integrated working exist between health and social care staff at the interface of care delivery? Second, If inter-professional barriers exist, can joint health and social care assessments help to overcome them? The paper develops the current evidence base through findings from a staff questionnaire and the initial findings of a pilot study of joint health and social care assessments aimed at overcoming inter-professional barriers to integration.

The first stage of the project involved running an anonymous, online questionnaire with health and social care staff within a single, co-located community adult health and social care team. The questionnaire aimed to explore staffs’ perceptions of inter-professional collaboration when assessing the health and care needs of service users with a high degree of complexity of need. The second element of the study presents the initial findings of a small pilot of joint health and social care assessments. A second staff survey was used in order to provide a “before and after” comparative analysis and to demonstrate the effect of joint assessments on staffs’ perceptions of inter-professional collaboration at the interface of care delivery.

Health and social care staff value joint working as a means of improving quality of care. However, they also felt that inter-professional collaboration did not occur routinely due to organisational limitations. Staff members who participated in the pilot of joint assessments believed that this collaborative approach improved their understanding of other professional roles, was an effective means of enabling others to understand their own roles and helped to better identify the health and care needs of the most complex service users on their caseloads. Initial findings suggest that joint assessments may be a practical means of overcoming inter-professional barriers related to a lack of communication and lack of understanding of job roles.

The questionnaires highlighted the need for integration strategies that are aimed at facilitating collaborative working between staff of different professions, in order to achieve the aims of integration, such as a reduction in duplication of work and hand-offs between services.

To date, few studies have explored either staff perceptions of collaborative working or the effectiveness of joint assessments as a means of overcoming inter-professional barriers. This paper adds new data to an important area of integration that legislators and researchers increasingly agree requires more focus. Although the findings are limited due to the small scale of the initial pilot, they provide interesting and original data that will provide insight into future workforce integration strategies.

Recent scholarship reveals the imagery of the professional as the “ideal citizen”. The linkage between professionalism and citizenship is here approached from the perspective of democratic social justice in order to examine the persistence of gendered inequalities in the health care system. The paper aims to examine the ideas framing professionalism, both in sociological theory and historically, asking what gendered hierarchies mean in modern health care systems, and why and how they persist in the conditions of liberal democracy.

The question is approached through both sociological literature and an analysis of historical framings of professionalism; the Finnish health care system is employed as a case. The reason for keeping the discussion close to a specific case is that different professional fields, countries and historic contexts differ from each other in democratically relevant respects.

Traditional sociological theory assumed that professional privilege was based on essentially neutral expertise that benefits democracy only if protected from bureaucracy and politics. The recent theoretical turn reframes professional knowledge as socially defined, but the destabilisation of professional knowledge claims is not without problems. The paper refers to the persisting tensions between changing governance and gendered hierarchies in health care and argues for new approaches that suggest ways through which professional expertise can be democratically represented in politics.

The interdisciplinary framework uses political theory on social justice to examine how health care politics frame professionalism.

The purpose of this paper is to investigate how managers in social and health care evaluate the knowledge sources affecting their decision‐making, and how the evaluations were associated with the managers' professional background, activity sector, gender, age and management experience.

The study data are gathered from a questionnaire survey to the middle‐line doctor, nurse and social managers (n=404) within the responsibility area of a Finnish university hospital. Assessed the proportions of individual knowledge sources in the complete data set and their associations with the subjects' background data. In addition, grouping of individual knowledge sources variables are made using factor analysis.

The findings indicate that social and health care managers attempt to utilize diverse knowledge sources. Overall, professional experience and education, organization budget, and action plans of one's own unit are estimated as knowledge sources with the greatest impact. Manager's professional background and activity sector are associated with the kind of knowledge affecting their decision‐making. Some differences are noted between genders, but differences with respect to age or management experience are non‐significant.

Social and health care organizations represent expert organizations where decision‐making is steered by professions and management tasks.

This paper suggests that the future decision‐makers will be required to identify versatile knowledge areas across cultural barriers, and to be capable of making comprehensive decisions affecting the entire organization.

The purpose of this paper is to understand the perspectives of frontline health and social care professionals in relation to delays in discharge from community hospitals.

A qualitative approach was taken, using semi-structured interviews and non-participant observation, within three community hospitals in NHS Scotland. In total, 12 frontline health and social care professionals were interviewed and observation of the multi-disciplinary team meeting was completed. Thematic content analysis was used to analyse the data produced.

The key findings were delayed discharge as an issue, lack of resources and capacity, difficulties in the relationship between acute and community health staff, silo working between health and social care, conflicting pressures on staff, and influence over services and external factors. There were perceived different ways of working within acute health, community health and social work, which were suggested to reduce efficiency, cause tension and ultimately result in delays. All professionals perceived an inability to influence any of the factors causing delays in discharge.

The internal issues regarding inter-professional working could potentially damage integration, indicating a need to teach collaborative team skills as well as quality improvement training to support staff to challenge and change current ways of working.

The paper contributes to the evidence base of community hospitals. There are implications for both health and social care policy.

This article aims to look first at how entrepreneurial identity fits into the picture we currently have of social and health care professionals who most often work in paid employment in the public sector, and second, how entrepreneurial identity is constructed. We discuss whether professional identity and entrepreneurial identity can be separated, and how meaningful that question is. Is the role of entrepreneurship limited in the context of health and social care professional services, or can we see the emergence of a new kind of entrepreneurial identity with special features related to the complexity within the provision of services in social and health care?

The materials from two previous studies by the authors are used in the article as empirical data to investigate the questions of identity and professionalism. The methodology is based on re‐reading and re‐interpretation of both empirical studies and theoretical literature.

There are differences and different logics of work‐related identity building among the entrepreneurial groups and among professional groups. Despite this and even if part of the research tradition emphasizes this difference and the separateness of these identities, we argue that identities are fluid, changing, layered and overlapping. As identities cannot be predetermined or classified according to economic earnings logic only, but that they are malleable, evolving, interconnected, and intertwined. In addition, the paper raises the contradiction of stereotypically “masculine” entrepreneurial goals and the stereotypically “female” ideology of care existing as tension within entrepreneurship in social and health care.

The research limitations relate to the research design of not using ethnographical data.

The article has no direct practical implications. The results might have relevance to education.

The article has social implications in the ways the identities are discussed through various discourses in the societies.

The article has both originality in the settings and value in bringing different discussions together, as well as in its ability to widen the theoretical discussions and empirical studies on identities, paid employment and entrepreneurship.

That social franchising programs induce favorable outcomes is readily taken for granted, albeit lacking robust empirical support. Addressing this situation, this paper takes a closer look at a fractional social franchising program in the public health-care sector in Vietnam to better understand how such programs work. This paper aims to expand the nascent body of empirical research that has examined the inner workings of social franchising programs from the perspective of clients by focusing on the health professionals who work there.

Using an exploratory qualitative research design, the authors conducted 25 semistructured interviews with health professionals of a fractional franchising program called Sisterhood, which introduced reproductive health and family planning services into existing health facilities in Vietnam. Interviews were triangulated with Sisterhood’s internal documents as well as with publicly available reports.

The analysis highlights two pathways through which the social franchising program brought about positive change. On the one hand, the analysis suggests that many of the positive outcomes reported by public health professionals were consistent with the stated goals and measures used by the Sisterhood program, providing evidence that improving the quality of health care for disadvantaged communities can be achieved through careful design and execution. On the other hand, the analysis revealed beneficial outcomes that were outside the scope of the Sisterhood program and, in this sense, “unexpected.” Specifically, the paper sheds light on unintended knowledge spillover effects in which nonfranchised health professionals began to adopt new practices and principles introduced by the social franchising program.

The paper taps into a largely under-researched phenomenon – fractional social franchising – from the perspective of health professionals. Unpacking how the social franchising program created favorable outcomes, some by design and others by accident, the paper opens new empirical and policy insights into how social franchising can improve public health in hard-to-reach communities in the global South. Based on the findings, the authors argue for the intentional promotion and institutionalization of knowledge transfers from franchised to nonfranchised health facilities to reinforce and scale up the positive impact of social franchising. The authors conclude by emphasizing the need for future research to adopt a complexity-sensitive approach that accounts for the dynamic, nonlinear adoption pathways social franchising can take. Such an approach is essential to uncover the beneficial outcomes that can result from social franchising programs but cannot be readily predicted by program design.

Integrated care policies have been at the heart of recent health reforms in many European countries. The purpose of this paper is to study the integration from the perspective of health care personnel working in primary health care clinics.

The study employs data from interviews collected in a research project examining patient choice and integrated care in primary health care clinics in Finland. The interviews were conducted in five cities in Southern Finland in 17 primary health care clinics in Autumn 2014. Among the interviewees there were both doctors (n=32) and nurses (n=31).

The typical problems hindering integration were, according to the workers, poor communication and insufficient information exchange between professionals, unclear definition of responsibilities between professionals, and lacking contacts and information exchange between health and social care professionals. To secure availability and continuity of care, doctors and nurses did extra work and exceeded their duties or invented ad hoc solutions to solve the problem at hand. According to professionals, patients were forced to take an active role as coordinator of their own care when responsibilities were not clearly defined between professionals.

This paper highlights that successful integration requires taking into account the requirements of the day-to-day work of health care clinics, and clarifying what facilitates and what hinders practical collaboration between different actors in health care and between health care and other service providers.

The purpose of this paper is to outline a work‐based, professional education series of workshops, focusing on issues of sex and sexuality training for health and social care professionals who work with adults with a moderate to severe acquired brain injury. The series of workshops were conducted by a trained psychosexual therapist and couples counsellor from Headway Brain Injury Association, and held at the Royal Hospital for Neuro‐disability in 2009 to raise health and social care professionals' awareness about sexuality issues for this patient population. A case study of the series is presented, which we hope will add to the discourse about the sexual needs of people with a moderate to severe acquired brain injury. Overall, participants were positive about the education and learning achieved within the workshop series.

The emphasis on outcomes rather than process is an area that is receiving significant attention across the delivery of public sector services, and the question ‘so what?’ is increasingly being asked of service providers. With service user self‐direction being the focus of both provision and commissioning over the coming years, there will be an increasing need to justify the delivery and development of social care in terms of the end result. Strong leadership and vision is required across the public sector if this change, in both organisational culture and service user expectation, is to be achieved.Leadership as both a competency and an organisational function has been well researched within health and social care. The literature largely points towards the need for clarity and strength within the strategic vision, especially when considering the management of change and multifaceted partnerships, both of which are crucial to the delivery of social care outcomes. The actual detail of the outcome framework, and the means by which it can be measured and quantified, is still an area of debate, and as such the aim here is to highlight some of the benefits and barriers that may be faced as the reform of the social care system evolves, with a specific focus on the impact that leadership can have on the delivery of an outcome‐focused mental health social care serviceThe analysis of outcome‐focused organisations is a relatively new concept in health and social care, and as such this paper seeks to debate the evidence in terms of whether leadership contributes to better service user outcomes in mental health social care. Dynamics within organisations, professions and with service users are all key considerations in the achievement of positive outcomes, and the role of the leader is to empower the staff group to power share and move towards co‐production in order to embed choice, control and service user contribution in the overall philosophy and culture of mental health service provision and developments.The overall conclusions of this paper are that leadership is important in terms of shaping services, ensuring governance and promoting innovation, and as a result it is possible to suggest that leadership and positive outcomes do have a direct correlation.

The purpose of this paper is twofold. First, to examine the impact on mental health social work of integrated care; and second, to explore the effectiveness of the use of deliberative research, a methodology which is new to mental health social work research.

Developed to enable examination of policy, deliberative research is underpinned by a desire to permit choice and change brought about through an iterative dialogue. This communication is based on informed and respectful equality between policy makers or implementers and those subject to that implementation. In order to achieve this equality, participation in debate by participants is viewed as essential, including as part of the process, participants becoming better informed about the phenomenon in question.

The findings show that effective mental health social work underpins successful integrated care which, in turn, is viewed as relevant. In addition, people who access services identified that mental health social workers are well positioned as facilitators and explainers in integrated care. The issue to be further explored by research, therefore, is not whether services should be delivered separately or in an integrated way, but how to keep improving and developing integrated care and especially the impact of ongoing power differentials.

The use of deliberative research worked reasonably well as an underpinning methodology for this study in that it sought to achieve the opinions of the public, in this instance consumers who provided or accessed mental health social work. The ethical need to ensure no harm came to this particular group meant that their opinions were not debated with the whole. This limitation to iterative dialogue is undoubtedly a consideration when undertaking deliberative research on such populations. This study offered just this, a one-off event, as in reality the commitment from participants to attend more than this one session would have been prohibitive.

The test, practically, comes with the events for data collection. This is not just the debate as to whether these, as one-off events, bring about agreement and not deliberation, but also whether researchers can, with a group that has particular needs, effectively integrate them into the deliberation. Given that it is an ethical priority to ensure that the participants are not harmed, this is not always going to be possible where the “public” includes those who may be vulnerable.

Deliberative research methodology is a new approach in mental health social work research. The influential finding is activism: people who access services recognise and suggest a challenge to the normative power differential in integrated care, as embodied in mental health social workers, and it is this aspect that warrants further investigation.