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Article
Publication date: 2 September 2021

Andrew Healey, Alexandra Melaugh, Len Demetriou, Tracey Power, Nick Sevdalis, Megan Pritchard and Lucy Goulding

Many patients referred by their GP for an assessment by secondary mental health services are unlikely to ever meet eligibility thresholds for specialist treatment and…

Abstract

Purpose

Many patients referred by their GP for an assessment by secondary mental health services are unlikely to ever meet eligibility thresholds for specialist treatment and support. A new service was developed to support people in primary care. “the authors evaluate” whether the phased introduction of the Lambeth Living Well Network (LWN) Hub to a population in south London led to: a reduction in the overall volume of patients referred from primary care for a secondary mental health care assessment; and an increase in the proportion of patients referred who met specialist service eligibility criteria, as indicated by the likelihood of being accepted in secondary care.

Design/methodology/approach

The evaluation applied a quasi-experimental interrupted time series design using electronic patient records data for a National Health Service (NHS) provider of secondary mental health services in south London.

Findings

Scale-up of the Hub to the whole of the population of Lambeth led to an average of 98 fewer secondary care assessments per month (95% CI −118 to −78) compared to an average of 203 assessments per month estimated in the absence of the Hub; and an absolute incremental increase in the probability of acceptance for specialist intervention of 0.20 (95% CI; 0.14 to 0.27) above an average probability of acceptance of 0.57 in the absence of the Hub.

Research limitations/implications

Mental health outcomes for people using the service and system wide-service impacts were not evaluated preventing a more holistic evaluation of the effectiveness and cost-effectiveness of the LWN Hub.

Practical implications

Providing general practitioners with access to service infrastructure designed to help people whose needs cannot be managed within specialist mental health services can prevent unnecessary referrals into secondary care assessment teams.

Social implications

Reducing unnecessary referrals through provision of a primary-care linked mental health service will reduce delay in access to professional support that can address specific mental-health related needs that could not be offered within the secondary care services and could prevent the escalation of problems.

Originality/value

The authors use NHS data to facilitate the novel application of a quasi-experimental methodology to deliver new evidence on whether an innovative primary care linked mental health service was effective in delivering on one of its key aims.

Details

Mental Health Review Journal, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1361-9322

Keywords

Content available
Article
Publication date: 24 October 2018

Euan Sadler, Jane Sandall, Nick Sevdalis and Dan Wilson

The purpose of this paper is to discuss three potential contributions from implementation science that can help clinicians and researchers to design and evaluate more…

Abstract

Purpose

The purpose of this paper is to discuss three potential contributions from implementation science that can help clinicians and researchers to design and evaluate more effective integrated care programmes for older people with frailty.

Design/methodology/approach

This viewpoint paper focuses on three contributions: stakeholder engagement, using implementation science frameworks, and assessment of implementation strategies and outcomes.

Findings

Stakeholder engagement enhances the acceptability of interventions to recipients and providers and improves reach and sustainability. Implementation science frameworks assess provider, recipient and wider context factors enabling and hindering implementation, and guide selection and tailoring of appropriate implementation strategies. The assessment of implementation strategies and outcomes enables the evaluation of the effectiveness and implementation of integrated care programmes for this population.

Research limitations/implications

Implementation science provides a systematic way to think about why integrated care programmes for older people with frailty are not implemented successfully. The field has an evidence base, including how to tailor implementation science strategies to the local setting, and assess implementation outcomes to provide clinicians and researchers with an understanding of how their programme is working. The authors draw out implications for policy, practice and future research.

Originality/value

Different models to deliver integrated care to support older people with frailty exist, but it is not known which is most effective, for which individuals and in which clinical or psychosocial circumstances. Implementation science can play a valuable role in designing and evaluating more effective integrated care programmes for this population.

Details

Journal of Integrated Care, vol. 27 no. 3
Type: Research Article
ISSN: 1476-9018

Keywords

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Article
Publication date: 13 June 2008

Nick Sevdalis, Flora Kokkinaki and Nigel Harvey

The purpose of this paper is to present the concept of consumers' erroneous affective self‐forecasts, and discuss the implications of such forecasts for consumer…

Abstract

Purpose

The purpose of this paper is to present the concept of consumers' erroneous affective self‐forecasts, and discuss the implications of such forecasts for consumer purchasing behaviour and marketing planning.

Design/methodology/approach

First, the literature on inaction inertia – the lowering of the likelihood that a bargain will be taken once a better bargain has been missed – is reviewed. Second, the literature on affective self‐forecasting is reviewed. Finally, the implications that the authors synthesis of the behavioural evidence carries for marketing are discussed.

Findings

The inaction inertia literature implicates the regret that consumers associate with purchasing a discounted item once they have missed a much larger discount on it as a major contributing factor to consumers' unwillingness to purchase the item on the second occasion. The literature on affective self‐prediction suggests that regret (and other emotions) is systematically mispredicted.

Research limitations/implications

The likely effect of erroneously anticipated regret in inaction inertia situations is depressed purchasing behaviour. The paper argues that because affective anticipations are typically erroneous, their impact on consumer decision‐making processes cannot be deemed rational. It is proposed that marketing should intervene to either increase the accuracy of such anticipations, or to lead consumers to discount them.

Practical implications

Price promotions can have negative side effects, such as those observed in inaction inertia circumstances. To some extent, these are driven by consumers anticipated regret (and possibly other relevant emotions). Marketing techniques can counteract the disproportionate impact of such emotions.

Originality/value

The paper offers a synthesis of behavioural evidence on inaction inertia and affective self‐forecasting – two quite separate literatures that have yet to be brought together in the present context. In addition, the paper outlines implications for marketing and suggests possible strategies to moderate the discussed effects.

Details

Marketing Intelligence & Planning, vol. 26 no. 4
Type: Research Article
ISSN: 0263-4503

Keywords

Content available
Article
Publication date: 13 June 2008

Ross Brennan

Abstract

Details

Marketing Intelligence & Planning, vol. 26 no. 4
Type: Research Article
ISSN: 0263-4503

Content available
Article
Publication date: 4 May 2021

Christine Jorm, Rick Iedema, Donella Piper, Nicholas Goodwin and Andrew Searles

The purpose of this paper is to argue for an improved conceptualisation of health service research, using Stengers' (2018) metaphor of “slow science” as a critical yardstick.

Abstract

Purpose

The purpose of this paper is to argue for an improved conceptualisation of health service research, using Stengers' (2018) metaphor of “slow science” as a critical yardstick.

Design/methodology/approach

The paper is structured in three parts. It first reviews the field of health services research and the approaches that dominate it. It then considers the healthcare research approaches whose principles and methodologies are more aligned with “slow science” before presenting a description of a “slow science” project in which the authors are currently engaged.

Findings

Current approaches to health service research struggle to offer adequate resources for resolving frontline complexity, principally because they set more store by knowledge generalisation, disciplinary continuity and integrity and the consolidation of expertise, than by engaging with frontline complexity on its terms, negotiating issues with frontline staff and patients on their terms and framing findings and solutions in ways that key in to the in situ dynamics and complexities that define health service delivery.

Originality/value

There is a need to engage in a paradigm shift that engages health services as co-researchers, prioritising practical change and local involvement over knowledge production. Economics is a research field where the products are of natural appeal to powerful health service managers. A “slow science” approach adopted by the embedded Economist Program with its emphasis on pre-implementation, knowledge mobilisation and parallel site capacity development sets out how research can be flexibly produced to improve health services.

Details

Journal of Health Organization and Management, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1477-7266

Keywords

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