The personalisation agenda currently appears as a key strand of the Government's approach to health and social care services. On the face of it this offers an exciting new…
The personalisation agenda currently appears as a key strand of the Government's approach to health and social care services. On the face of it this offers an exciting new future where service users drive the way services are joined up, which for some may be welcome given the paucity of evidence to show that the organisationally‐driven partnership working of the past decade has delivered real and tangible outcomes for service users. There is some suggestion that in the future any talk about partnerships will be about this citizen‐state interaction, rather than one between health and social care agencies. This paper argues that there is a real danger in suggesting that personalisation negates the need for health and social care agencies to work together in partnership; instead this interface is more imperative than ever. In this paper we provide an overview of the debates around personalisation and partnership and set out the case why partnership should not be forgotten, and indeed will be key, in the success of the personalisation agenda.
Health and social care partnership working is often predicated on the notion that it improves outcomes for service users. Yet there is a lack of evidence linking…
Health and social care partnership working is often predicated on the notion that it improves outcomes for service users. Yet there is a lack of evidence linking partnerships to changes in outcomes. Against this background, the Health Services Management Centre at the University of Birmingham designed the Partnership Outcomes Evaluation Toolkit (POET) specifically to evaluate health and social care partnerships in terms of service user outcomes. This paper reports on the field testing of POET with Sandwell Integrated Support Service. This research provided a number of interesting insights into this service, and indicated some dissonance between staff and service user and carer expectations.
This paper reports research undertaken into the practices, processes and outcomes of joint commissioning at five English localities. This paper reflects on the…
This paper reports research undertaken into the practices, processes and outcomes of joint commissioning at five English localities. This paper reflects on the implications of this study for the practice of joint commissioning.
A case study approach to the research was adopted where the assumptions about what joint commissioning should deliver in five “best practice” sites. These hypothesised relationships about organisational processes, services and outcomes were then tested through the collection of primary and secondary data. Methods of data collection included an online tool based on Q methodology, documentary analysis, interviews and focus groups.
Very little of what we found seemed to relate directly to issues of joint commissioning. Respondents often spoke of joint commissioning conflating it with issues of commissioning or joint working more generally. We found a variety of different definitions and meanings of joint commissioning in practice suggesting that this is not a coherent model but varies across localities. Little evidence of improved outcomes was found, due to practical and technical difficulties.
Joint commissioning is not a coherent model and is applied in different ways across different contexts. As such we may need to ask very different questions of joint commissioning to those typically asked.
It is important that local sites are clear about what they are trying to deliver through joint commissioning or else risk that it becomes an end in itself. Some of the current reforms taking place in health and social care risk pulling apart existing relationships that have taken significant time and resource to develop.
This is one of the first large‐scale studies of joint commissioning conducted in England.
This paper seeks to reflect on English care trusts as an example of a structural approach to integration.
All current care trusts' chief executives were invited to participate in a semi‐structured interview exploring their experiences. Themes from the interviews were combined with findings from literature and policy review.
The current care trusts can identify a number of advantages from combining health and social care into a single organisation. Equally, they also experienced many of the anticipated difficulties, and in hindsight half of those interviewed would recommend other options to achieving better integrated working. Whilst the “commissioning” function of care trusts will not survive beyond March 2013, “provider” care trusts look set to continue and indeed expand their service delivery. They will be joined both by new integrated social enterprises delivering health and social care.
The experiences of care trusts show the limitations of a single organisational structure as a means to achieve better integration and the impact of a changing national policy landscape on local initiatives. The findings suggest that the current legal flexibilities for integrated working should remain to enable local areas to decide how best to achieve their priorities and to realise the importance of addressing local cultural, practical and leadership issues along with structural barriers.
This paper provides a reflection on the ten years since the option of care trusts were available in England and adds to the current literature which focuses on individual care trusts' development and impact.