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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.

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.

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.

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.

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

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.

The purpose of this paper is to investigate the perceptions of key informants on a national support programme for the development of new care models (NCM) in England (2015/2016–2017/2018). It focuses on the perceived facilitators and barriers affecting the development and implementation of the NCM programme and offers some insight into the role of national level support in enabling local integration initiatives.

A set of 29 interviews were carried out with a variety of respondents at the national level (including current and past programme leads, strategic account managers, advisors to the programme and external regulators) between October 2017 and March 2018, and analysed thematically.

A set of facilitative elements of the programme were identified: the development of relationships and alliances, strong local and national leadership, the availability of expert knowledge and skills, and additional funding. Challenges to success included perceived expectations from the national Vanguard programme, oversight and performance monitoring, engagement with regulators, data availability and quality, as well as timetables and timescales. Crucially, the facilitators and challenges were found to interact in dynamic and complex ways, which resulted in significant tensions and ambiguities within the support programme.

While the sample was drawn from a range of different senior players and the authors ensured a diverse sample associated with the NCM support programme, it inevitably cannot be complete and there may have been valuable perspectives absent.

The paper demonstrates that the analysis of facilitators and challenges with respect to the national support of implementation of integrated care initiatives should move beyond the focus on separate influencing factors and address the tensions that the complex interplay among these factors create.

The purpose of this study is to examine the implementation, care processes and sustainability of an integrated, intermediate Acute Response Team (ART) service. The primary aims of the service are to enhance the level of health and social care integration across a range of organisations, to ensure a timelier and appropriate service for people in the community at risk of admission to hospital.

A qualitative methodology was employed in order to gain a deep understanding of the experiences of staff members within the ART service and external stakeholders. Twenty-one professionals took part in a focus group or one-to-one interviews. Data were analysed thematically.

The key to successful implementation was that the service was co-created from the “ground-up” with support from local provider organisations. The inclusion of general practitioners (GPs) as part of the team was instrumental in setting up and maintaining the service and seems to be unique in intermediate care settings. Referrals into the ART service were dependent on awareness of the service at the interface with mainstream services. Transitions out were sometimes delayed due lack of availability of social care packages. To ensure sustainability of the ART and other integrated intermediate care services, continued resources, especially skilled staff members, are necessary.

This study adds to the intermediate care and acute response service literature by offering insights into “what works” from a professional perspective in terms of service implementation, care processes and sustainability, in an integrated care system.

The purpose of this paper is to identify the range, type and outcomes of technological innovations aimed at supporting older people to maintain their independence within the context of integrated care at home. We also discuss key emergent themes relevant to the use of person-centred technology for older people in integrated care and propose recommendations for policy and practice.

An integrative review methodology was used to identify and describe recent scientific publications in four stages: problem identification, literature search, data evaluation and data analysis.

Twelve studies were included in the review. Three studies described remote consultations, particularly telemedicine; five studies described tools to support self-management; three studies described the use of healthcare management tools, and one study described both remote consultation and self-care management. Emergent themes were: acceptability, accessibility and use of digital technologies; co-ordination and integration of services; the implementation of digital technologies; and safety and governance. Several recommendations are proposed relevant to integrated care teams, technology developers and researchers.

This review uniquely considers the extent to which novel digital technologies used in integrated care for older people are person-centred.

This paper provides a European overview of alternative approaches to integrated care for older people, drawing from a wider European project entitled PROCARE. It discusses the structural complexities that create the challenges in integrated care, compares and contrasts approaches to integrated care through a structure and process framework, and considers the place of person‐centred seamless care in European health and social care models.

I present and evaluate various explanations for why new workers who were sponsored by oldtimers tend to have better job outcomes (better performance, more satisfaction, and less turnover) than do new workers who were not sponsored.

My evaluations involve searching for evidence that fits (or does not fit) each of the explanations.

The two most popular explanations argue that the job benefits of sponsorship arise because (a) sponsored newcomers have more realistic job expectations than do unsponsored newcomers, or (b) the quality of sponsored newcomers is greater than that of unsponsored newcomers. Unfortunately, these explanations have weak empirical support. A third explanation, largely untested as yet, attributes the performance benefits of sponsorship to social pressures that can arise when someone is sponsored for a job. These pressures include efforts by newcomers to repay the people who sponsored them, efforts by sponsors to assist the newcomers they sponsored after those persons have been hired, and stereotypes among coworkers about the kinds of people who get jobs through sponsors. Although limited as yet, the evidence regarding this new explanation seems promising.

More research on this third explanation for sponsorship effects should be done. Suggestions for how to do such research are reviewed and a relevant experiment is presented.

The ideas and evidence presented here could help employers who want to improve the job outcomes of their new workers. Poor outcomes among such persons are a major problem in many settings.

Although some of my ideas have been mentioned by others, they were not been described in much detail, nor were they tested. My hope is that this chapter will promote new theory and research on the performance benefits of sponsorship, a topic that has been largely ignored in recent years.

This paper aims to describe the methodological approach to and outcomes of a European multi‐consortium EU 7th Framework funded project entitled “INTERLINKS”. The project sought to develop a concept and method to describe and analyse long‐term care and its links with the health and social care systems, and formal and informal care.

Through the development of a template, it accumulated and validated practice examples that described good policy and practice, transferable across EU member states.

The outcome was to assemble a range of themes, sub‐themes and 135 key issues into a web‐based framework for LTC that is illustrated by over 100 examples of validated practice in LTC for older people.

Key messages emanating from the project are provided, with an emphasis on the need for greater investment and pluralist evaluation of initiatives that seek to address the interfaces and links between care services.

The project is unique in that it provides a comprehensive and accessible interactive European database of policy and projects that directly address the problems of interfaces between service provision for older people, and contributes towards the evidence base in discrete areas of LTC.

This chapter reviews identity, culture, and Indigeneity, examining indigenous research pathways as a decolonizing research method. In this context, the chapter explores indigenous research challenges. It explores phenomenology of practice, reflexive ethnography, and grounded theory as possible research methods to advance indigenous studies and help decolonize research methods.

Service transformation of health and social care is currently requiring commissioners to assess the suitability of their contracting mechanisms to ensure goodness of fit with the integration agenda. The purpose of this paper is to provide a description and critical account of four models of contracting, namely Accountable Care Organisations, the Alliance Model, the Lead Provider/Prime Contractor Model, and Outcomes-based Commissioning and Contracting.

The approach taken to the literature review was narrative and the results were organised under an analytical framework consisting of six themes: definition and purpose; characteristics; application; benefits/success factors; use of incentives; and critique.

The review highlighted that while the models have relevance, there are a number of uncertainties regarding their direct applicability and utility for the health and social care agenda, and limited evidence of effectiveness.

Due to the relative newness of the models and their emerging application, much of the commentary was limited to a narrow range of contributors and a broader discussion is needed. It is clear that further research is required to determine the most effective approach for integrated care contracting. It is suggested that instead of looking at individual models and assessing their transferable worth, there may be a place for examining principles that underpin the models to reshape current contracting processes.

What appears to be happening in practice is an organic development. With the growing number of examples emerging in health and social care, these may act as “trailblazers” and support further development.

There is emerging debate surrounding the best way to contract for health and social care services, but no literature review to date that takes these current models and examines their value in such critical detail. Given the pursuit for “answers” by commissioners, this review will raise awareness and provide knowledge for decision making.

Researchers have spent considerable time studying how racial-ethnic minorities experience poorer health than whites [Townsend, P., & Davidson, N. (Eds). (1990). Inequalities in health: The black report. England: Penguin Press; Platt, L. (2006). Assessing the impact of illness, caring and ethnicity on social activity. STICERD Research Paper No. CASE108 London England), and how low socioeconomic status (SES) can negatively influence health status (Lynch, J., & Kaplan, G. (2000). Socioeconomic position. In: L. F. Berkman & I. Kawachi (Eds), Social epidemiology (pp. 13–55). New York: Oxford University Press]. This research investigates the relationship between class and race and perceived health status among patients with chronic conditions. More specifically, we apply the concept of social capital to assess whether the quantity of health information seeking behaviors (HISB) via social networks mediates the relationship between race and health status, and between SES and health status. Regression, t-test and ANOVA analyses of 305 surveys completed at a chronic illness management clinic in a Northwest research hospital reveal three important findings: first, that social class affects perceived health status more strongly than race; second, that frequency and amount of HISB do not play a significant role in perceived health status, regardless of race or SES; and third, that an interaction effect between frequency and amount of HISB suggests that the way that patients seek health information, and the quality of that information, may be more useful indicators of the role of social capital in HISB than our study can provide.