Search results

1 – 10 of over 33000
To view the access options for this content please click here
Article
Publication date: 1 October 2005

Penny Banks

The Government's vision for social care highlights choice and control by individuals. This paper draws on findings from a King's Fund study and considers how far…

Abstract

The Government's vision for social care highlights choice and control by individuals. This paper draws on findings from a King's Fund study and considers how far collaborative commissioning is ready to meet the challenges of ensuring a diverse menu of flexible, integrated services for people using either direct payments or individual budgets. It concludes that more needs to be done to build commissioning skills, and other investment in developing the care market will be needed to deliver the Green Paper's aspirations.

Details

Journal of Integrated Care, vol. 13 no. 5
Type: Research Article
ISSN: 1476-9018

Keywords

To view the access options for this content please click here
Article
Publication date: 2 August 2013

Helen Dickinson and Jon Glasby

This paper reports research undertaken into the practices, processes and outcomes of joint commissioning at five English localities. This paper reflects on the…

Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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.

Research limitations/implications

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.

Practical implications

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.

Originality/value

This is one of the first large‐scale studies of joint commissioning conducted in England.

To view the access options for this content please click here
Article
Publication date: 4 May 2009

Deborah Klée

Telford and Wrekin Council and PCT have developed a Health and Well‐being Strategy that includes all health and council services that contribute to this area, including…

Abstract

Telford and Wrekin Council and PCT have developed a Health and Well‐being Strategy that includes all health and council services that contribute to this area, including secondary health care. This article describes the challenges that they faced in understanding and agreeing shared priorities and how they used this whole‐systems framework to keep a clear focus on what local people want and need, bringing together and making sense of national policy such as World Class Commissioning and Putting People First.

Details

Journal of Integrated Care, vol. 17 no. 2
Type: Research Article
ISSN: 1476-9018

Keywords

To view the access options for this content please click here
Article
Publication date: 26 June 2018

Kayleigh M. Nelson, Aimee I. McKinnon, Angela Farr, Jaynie Y. Rance and Ceri J. Phillips

The purpose of this paper is to present an evaluation of a collaborative commissioning approach to improve quality and experience and reduce cost within integrated health…

Abstract

Purpose

The purpose of this paper is to present an evaluation of a collaborative commissioning approach to improve quality and experience and reduce cost within integrated health and social care.

Design/methodology/approach

A multi-method approach is used involving qualitative interviews, documentary analysis and non-participant observation.

Findings

The findings suggest that the approach provides a suitable framework for the collaborative commissioning of integrated health and social care services.

Research limitations/implications

Further research is now needed to provide a definitive evaluation of its value outside of Wales.

Practical implications

With the significant scrutiny on health systems, the approach demonstrates effectiveness in securing quality improvements, achievement of recognised care standards and patient outcomes, while providing scope for financial gains and a goal for stakeholders to engage in effective communication.

Originality/value

This research presents an innovative method for collaborative commissioning and reveals activities that appear to contribute to more effective commissioning processes.

Details

Journal of Integrated Care, vol. 26 no. 4
Type: Research Article
ISSN: 1476-9018

Keywords

To view the access options for this content please click here
Article
Publication date: 6 October 2010

Richard Gleave, Ivy Wong, Jeremy Porteus and Edward Harding

A survey of integrated working between primary care trusts (PCTs) and adult social services across England was undertaken in December 2009 and January 2010. The survey…

Abstract

A survey of integrated working between primary care trusts (PCTs) and adult social services across England was undertaken in December 2009 and January 2010. The survey results are presented in the context of the history of integrated working between health and social care, and the recent policy announcements of the Conservative‐Liberal Democrat Coalition Government.

Details

Journal of Integrated Care, vol. 18 no. 5
Type: Research Article
ISSN: 1476-9018

Keywords

To view the access options for this content please click here
Article
Publication date: 30 September 2013

Carol Ward, Dianne Whitfield and Samantha A. Piggott

The purpose of this paper is to share the challenges of, and learning gained by a voluntary sector organisation, Coventry Rape and Sexual Abuse Centre (CRASAC) in…

Abstract

Purpose

The purpose of this paper is to share the challenges of, and learning gained by a voluntary sector organisation, Coventry Rape and Sexual Abuse Centre (CRASAC) in providing integrated care to victims of sexual violence.

Design/methodology/approach

The paper first considers the big picture, focusing on the current UK public sector commissioning environment, the policy commitment to integrated care, and challenges a current focus on definitions of integration that do not consider wider determinants of health and well-being. As an example of client groups who may not meet narrow criteria, but require person centred coordinated care, the needs of victims of sexual violence are explored, illustrated by a case study within CRASAC.

Findings

Challenges faced by CRASAC include identifying responsibility for specialist commissioning, maintaining strategic partnerships and a lack of cross-sector understanding of the needs of victims of sexual violence. Key learning points are the need to form strategic alliances and partnerships, to lobby and influence decision makers, to develop monitoring tools that demonstrate impact on long-term client outcomes and to constantly raise awareness of the needs of victims of sexual violence. Final reflections focus on the questions these issues raise for the future of specialised integrated care in the voluntary sector.

Originality/value

The paper is of value to commissioners in health, social care and the criminal justice system, in addition to providers of services that are in contact with victims of sexual abuse. These include health, criminal justice, education, police and social care, alongside other voluntary and community sector organisations.

To view the access options for this content please click here
Article
Publication date: 14 March 2016

Eleanor MacKillop

The purpose of this paper is to explore power-resistance plays, or organisational change (OC) politics, from a discourse theory perspective to deepen our understanding of…

Abstract

Purpose

The purpose of this paper is to explore power-resistance plays, or organisational change (OC) politics, from a discourse theory perspective to deepen our understanding of the political and emotional dimensions of these phenomena.

Design/methodology/approach

The paper deploys Laclauian concepts of hegemony, fantasmatic narrative and empty signifiers alongside a recently-developed logics of critical explanation approach in the case study of an English local authority formulating a project of integrated commissioning in response to austerity.

Findings

The paper demonstrates how OC politics are played out in multiple ways, from social and political negotiations over the meaning of commissioning to the refuelling of the authority’s fantasmatic narrative.

Originality/value

The paper’s key value is to illustrate how and why discourse theory can contribute, alongside other discursive frameworks, to the in-depth qualitative and political study of organisational issues such as change.

Details

Qualitative Research in Organizations and Management: An International Journal, vol. 11 no. 1
Type: Research Article
ISSN: 1746-5648

Keywords

To view the access options for this content please click here
Article
Publication date: 15 June 2012

Sylvia Bernard, Fiona Aspinal, Kate Gridley and Gillian Parker

This paper aims to report results from a national survey of primary care trusts (PCTs) that explored the strategic, organisational and practice context of services for…

Abstract

Purpose

This paper aims to report results from a national survey of primary care trusts (PCTs) that explored the strategic, organisational and practice context of services for people with long‐term neurological conditions (LTNCs). It seeks to provide benchmarks for integrated service provision and to discuss possible reasons for the variability in progress.

Design/methodology/approach

Earlier phases of the research identified three models of care that promoted continuity of care for people with LTNCs: community interdisciplinary neurological rehabilitation teams, nurse specialists and pro‐active day opportunities. Based on this evidence, a benchmarking questionnaire was developed and a telephone survey of PCTs in England undertaken in 2009.

Findings

The survey found that the prevalence of models of good practice varied widely across and within PCT areas. Strategic support and commissioning arrangements were also variable. A little over half of responding PCTs had completed a joint strategic needs assessment (JSNA) that included a reference to LTNCs and a quarter of PCTs had no joint commissioning arrangements in place for LTNCs. The complex interplay between strategy, organisational structures and models of delivery, in a context of competing priorities, may account for this variation and patchy progress.

Originality/value

Service provision for people with LTNCs is an under‐researched area, despite having major implications for long‐term care and support. The paper will be valuable to policy makers and commissioners in benchmarking organisational activity and models of good practice for integrated services.

Details

Journal of Integrated Care, vol. 20 no. 3
Type: Research Article
ISSN: 1476-9018

Keywords

To view the access options for this content please click here
Article
Publication date: 5 June 2017

Randall Smith, Robin Darton, Ailsa Cameron, Eleanor K. Johnson, Liz Lloyd, Simon Evans, Teresa June Atkinson and Jeremy Porteus

The purpose of this paper is to provide an overview of the process of commissioning adult social care services in England. It reflects the literature on commissioning at…

Abstract

Purpose

The purpose of this paper is to provide an overview of the process of commissioning adult social care services in England. It reflects the literature on commissioning at the strategic level followed by a section on operational or micro-commissioning. The rest of the paper focusses on the emergence of ideas about outcomes-based commissioning (OBC) in the field of adult social care and ends with critical consideration of the effectiveness of OBC in adult social care as applied to support and care provided in extra care housing.

Design/methodology/approach

The review of strategic and operational commissioning in adult social care in England (and Scotland in brief) is based on both policy documents and a review of the literature, as are the sources addressing OBC in adult social care particularly in extra care housing settings.

Findings

The core of this paper focusses on the challenges to the implementation of OBC in adult social care in the context of provision for residents in extra care housing. Of central importance are the impact of the squeeze on funding, increasing costs as a result of demographic change and the introduction of a national living wage plus the focus on the needs of service users through the idea of person-centred care and resistance to change on the part of adult social care staff and workers in other relevant settings.

Originality/value

Addressing the implementation of OBC in adult social care in England in the context of extra care housing.

Details

Housing, Care and Support, vol. 20 no. 2
Type: Research Article
ISSN: 1460-8790

Keywords

To view the access options for this content please click here
Article
Publication date: 17 October 2016

Jenny Billings and Alison Davis

Current debates surrounding the NHS contract in England are suggesting that it is in need of change to support an integrated health and social care transformation agenda…

Abstract

Purpose

Current debates surrounding the NHS contract in England are suggesting that it is in need of change to support an integrated health and social care transformation agenda that meets the needs of an ageing chronically ill population. The purpose of this paper is to describe a three-phase project in England that sought to develop and validate a whole systems contracting model for integrated health and social care focusing on older people with long-term conditions, and based on joint outcomes.

Design/methodology/approach

A participative mixed-method approach for the development of the contracting model was used; this consisted of a literature review, a design phase drawing on consensus method through stakeholder discussions and an international validation phase.

Findings

The final contracting model consists of four overarching and interrelated core elements: outcomes; partnership, collaboration and leadership; financial: incentives and risk; and legal criteria. Each core element has a series of more detailed contracting criteria, followed by further specifications attached to each criteria.

Research limitations/implications

While the policy environment appears to be conducive to change and encourages the adoption of new ways of thinking, there are difficulties with the implementation of new innovative models that challenge the status quo, and this is discussed.

Practical implications

The paper concludes with reflections on the way forward for local development and implementation.

Originality/value

There is currently much discussion for the need to realign contracting for integrated care that has a better fit for the transformation agenda, but until now, there have been no attempts to develop a whole systems approach that focusses on joint outcomes. This research bridges the gap but recognizes the challenges to implementation.

Details

Journal of Integrated Care, vol. 24 no. 5/6
Type: Research Article
ISSN: 1476-9018

Keywords

1 – 10 of over 33000