Search results

This article describes a process undertaken to develop a set of commissioning principles to support the commissioning of secure learning disability services across England. The principles, shaped around the 11 competencies laid down in the World Class Commissioning competencies framework (Department of Health, 2008a), were produced following a scoping exercise that looked at provision and commissioning of secure learning disability services within each strategic health authority (SHA) area in England. Specific details were collected about types of services provided, including detailed service specification, quality indicators, how these (specialist) services link with local services (secure and non secure) and cost of services. Information collected about commissioning concentrated on strategic vision, practical commissioning arrangements, how the quality of services was monitored, how access to services was controlled and how ‘secure’ service users are reintegrated back into local (non secure) services and communities. This scoping exercise was augmented by qualitative data obtained from interview with a group of former service users. Themes generated through the interviews were integrated within the general guidance. A quality assurance framework based on the World Class Commissioning Competencies is proposed, against which specialist and local commissioners can benchmark their current commissioning arrangements.

Four routes or pathways have now been identified by which individuals may come within the scope of PSA 16 National Indicator 149, which is concerned with monitoring efforts to achieve settled accommodation for individuals with significant mental health problems. This article focuses on their needs and the identification of those with mental health needs as seen through these four principal routes. An understanding of these four possible pathways can help to identify areas for priority action, local delivery chains and partnerships, and also highlight some of the challenges and risks in and for delivery.

To increase the global competitiveness of their service business, servitized manufacturers transition towards global services. Yet, the literature has not addressed this development. This study is one of the first to investigate how servitized manufacturers can manage the globalisation of their service business.

The study explores two cases of servitized manufacturers that transitioned from a local organisation of multi-domestic international services to a global-service organisation. The data were collected via semi-structured interviews, observations, and secondary sources.

The authors identify four elements of global service provision: operating model, global performance management, relationship governance, and staffing and employee development. The authors discuss each element and the connections between them, which the authors summarise in a proposed framework for global service provision.

The contributions of this research relate to the proposed framework of global service provision, which extends current conceptualisation of globalisation of routine services. The authors show the unique elements of global service provision of servitized manufacturers and discuss the theoretical and practical implications of the work.

Despite enormous progress in health globally, primary healthcare services in many developing countries are facing different challenges. Many studies have documented that decentralisation could be useful in supporting and developing health services closer to citizens. The purpose of this paper is to assess the effect of decentralisation on health services, and to draw general lessons which might help to develop appropriate strategies to improve health services in Nepal.

A mixed method was used, consisting of reviews of current literatures relevant to decentralisation and health performance, engaging with health service inputs‐outputs data between 2001 and 2007, and assessing the range of choices (management, finance and governance) available to local authorities using Bossert's “decision‐space approach”.

Decentralisation in many countries, including Nepal, suggests a new form of service delivery.

Review of the selected studies in triangulation with health services data has revealed that decentralisation in many cases has improved access to, utilisation of, and management of health services. The effects on other performance dimensions such as policy, equity, quality and service effectiveness are poorly investigated topics in the literature. The findings suggest that the successful implementation of decentralisation requires a broader context of institutional capacity building and resource management, and underlines the need for their consideration during implementation processes, and further investigation.

Between 2006 and 2016, local communities in semi-arid Bobirwa sub-district in the Limpopo Basin part of Botswana had endured notable fluctuations in the delivery of critical ecosystem services. These changes have been coupled with adverse effects on local people’s livelihood options and well-being. However, a few such studies have focussed on the semi-arid to arid landscapes. This study therefore aims to provide recent knowledge and evidence of consequences of environmental change on semi-arid arid landscapes and communities.

To examine these recent changes in key ecosystem services, the authors conducted six participatory mapping processes, eight key informant interviews and several rapid scoping appraisals in three study villages. The analyses were centred on changes in seasonal quantities, seasonality, condition of ecosystem service sites, distance to ecosystem service sites and total area providing these services. Drivers of change in the delivery of key ecosystem services and the associated adverse impacts on human well-being of these recent changes in bundles of ecosystem services delivered were also analyzed.

Results show that adverse weather conditions, drought frequency, changes in land-use and/or land-cover together with unsustainable harvesting because of human influx on local resources have intensified in the past decade. There was circumstantial evidence that these drivers have resulted in adverse changes in quantities and seasonality of key ecosystem services such as edible Mopane caterpillars, natural pastures, wild fruits and cultivated crops. Similarly, distance to, condition and total area of sites providing some of the key ecosystem services such as firewood and natural pastures changed adversely. These adverse changes in the key ecosystem services were shown to increasingly threaten local livelihoods and human well-being.

This paper discusses the importance of engaging rural communities in semi-arid areas in a participatory manner and how such information can provide baseline information for further research. The paper also shows the utility of such processes and information toward integrating community values and knowledge into decisions regarding the management and utilization of local ecosystem services under a changing climate in data-poor regions such as the Bobirwa sub-district of Botswana. However, the extent to which this is possible depends on the decision makers’ willingness to support local initiatives through existing government structures and programmes.

This study shows the importance of engaging communities in a participatory manner to understand changes in local ecosystem services considering their unique connection with the natural environment. This is a critical step for decision makers toward integrating community values in the management and utilization of ecosystem services under a changing climate as well as informing more sustainable adaptive responses in semi-arid areas. However, the extent to which decision makers can integrate such findings to inform more sustainable responses to declining capacity of local ecosystems in semi-arid areas depends on how they value the bottom-up approach of gaining local knowledge as well as their willingness to support local initiatives through existing government structures and programmes.

The large scale and far reaching functions of local government in the United Kingdom today are eloquent proofs of the universal demand for local services of high quality and wide coverage extending into almost every sector of life from literally the cradle to the grave. In the cities of Britain local government is often found to employ more people than any other single organisation. There are some 25,400 councillors in Britain and around 2,500,000 employees. The total expenditure of local authorities in England and Wales for 1984–85 was estimated at £24,323,000,000.1 The services provided include departments for development and planning, art galleries, libraries, museums, engineers, building surveyors, environmental health, architects, estate surveyors, housing, leisure and recreation, social services, economic development, education, transport, highways, trading standards, fire brigade, and police. In addition each local authority has departments mainly concerned with services to the other departments: the chief executive or secretary, personnel and management, solicitor, treasurer, and central purchasing services. Each of these departments has several important subdivisions, and clearly all require a constant inflow of information, and increasingly it is recognised local authorities generate large quantities of important information which can be used more widely with benefit within the authority, as well as outside.

Social and economic trends toward local governance form the context for health and mental health policy and the reorganization of care systems for cost-containment in the United States. Local management of public–private collaborations is promoted by state agencies as a means of rationalizing mental health care and community support services. This chapter analyses the local process of developing public–private partnerships for mental health care, based on an ethnographic case study of county Mental Health/Mental Retardation and behavioral health committees and coalitions in Texas, from 1995 to 2001. Following this period, local service agencies continued collaboration to increase community awareness and resources for care. Findings were that while the rapid transition to local control under conditions of reduced resources impeded implementation of a public–private mental health care system, commitment to a service safety net for persons with mental disabilities was sustained.

The article considers the challenges involved in measuring the performance of local public service networks through an empirical analysis of Comprehensive Area Assessments (CAAs), a short-lived but pioneering attempt to gauge the effectiveness of local governments, health trusts, police and fire services in England.

Primary data about the implementation and impact of CAAs were gathered using a mixed method approach, including surveys of local public services, inspectorates and residents together with focus groups and semi-structured interviews in 12 case study areas.

CAAs encouraged agencies to strive to achieve better partnership working but did not provide sufficiently robust comparative data to enable managers to benchmark their performance against other areas or identify good practice elsewhere. Policy makers hoped that citizens would use CAAs to hold services to account but the process failed to attract media or public interest.

The logic of a more ‘joined-up’ approach to performance assessment of local partnerships is compelling. But in practice it is difficult to achieve because institutional arrangements at a national level mean that different sectors work within very different budget systems, professional networks and performance frameworks. Assessing the outcomes achieved by local partnerships also presents new challenges for inspection agencies and requires them to use new kinds of evidence.

This is the only attempt to date to evaluate CAAs and adds to an understanding of the challenges of assessing the performance of local public service partnerships. It highlights new questions for researchers and policy makers about the types of evidence needed to measure partnership performance and the extent to which the public may use the results.

The purpose of this paper is to explore how conflict-affected communities in Ukraine (the Lugansk region) can develop sustainable mental health services in decentralised settings. The main interest focuses on community stakeholders’ perception of their problems and solutions that communities can create to achieve better mental health coverage.

A series of roundtables (RTs) (4 RTs, 62 participants overall), accompanied by interactive brainstorming techniques, were conducted with communities’ representatives/stakeholders from the East of Ukraine (Lugansk region, a government-controlled area) during the year 2021. Participants (health, mental health, social care workers and administration representatives) were provided with the opportunity to discuss mental health services’ development challenges and create affordable solutions for their communities. Results of discussions were submitted to qualitative analysis and offered for review by participants.

Decentralisation in Ukraine led to allocating funds alongside responsibilities for developing the services to communities. Most of the communities appear not to be ready to acknowledge the role of mental health services, entirely relying on the existing weak psychiatric hospital-based system. Awareness-raising interactive capacity-building activities for the community leaders and decision-makers effectively promote community-based mental health services development. Five clusters of challenges were identified: leadership, coordination and collaboration problems; infrastructure, physical accessibility and financial problems; mental health and primary health-care workforce shortage and lack of competencies; low awareness of mental health and available services and high stigma; war, crises and pandemic-related problems. Communities stakeholders foresaw seven domains of action: increasing the role of communities and service users in the initiatives of governmental bodies; establishing in the communities local coordination/working groups dedicated to mental health service development; developing the community-based spaces (hubs) for integrated services provision; embedding the mental health services in the existing services (social, administrative and health care); mental health advocacy and lobbying led by local leaders and service users; increasing capacity of communities in financial management, fundraising; developing services by combining efforts and budgets of neighbouring communities.

The study has potential limitations. Participants of the roundtables were mostly appointed by local authorities, so some of them didn`t have a motivation for mental health services development. Service users were involved only from the facilitators` side, not from the side of communities; therefore, it was impossible to include their view of problems and solutions. Obtained data were limited to the opinion of local professionals, administration workers and other local stakeholders. The human rights aspect was not clearly articulated in the tasks of the roundtables.

To the best of the authors’ knowledge, the paper is original in terms of its topic (connecting decentralisation and local stakeholders’ engagement for understanding the challenges of mental health services development) and research strategy (engagement of Ukrainian communities, qualitative analysis of the discussion results and applying the best practices and international recommendations to the local context).