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Article
Publication date: 31 December 2018

Samantha Dorney-Smith, Emma Thomson, Nigel Hewett, Stan Burridge and Zana Khan

The purpose of this paper is to review the history and current state of provision of homeless medical respite services in the UK, drawing first on the international context. The…

Abstract

Purpose

The purpose of this paper is to review the history and current state of provision of homeless medical respite services in the UK, drawing first on the international context. The paper then articulates the need for medical respite services in the UK, and profiles some success stories. The paper then outlines the considerable challenges that currently exist in the UK, considers why some other services have failed and proffers some solutions.

Design/methodology/approach

The paper is primarily a literature review, but also offers original analysis of data and interviews, and presents new ideas from the authors. All authors have considerable experience of assessing the need for and delivering homeless medical respite services.

Findings

The paper builds on previous published information regarding need, and articulates the human rights argument for commissioning care. The paper also discusses the current complex commissioning arena, and suggests solutions.

Research limitations/implications

The literature review was not a systematic review, but was conducted by authors with considerable experience in the field. Patient data quoted are on two limited cohorts of patients, but broadly relevant. Interviews with stakeholders regarding medical respite challenges have been fairly extensive, but may not be comprehensive.

Practical implications

This paper will support those who are thinking of undertaking a needs assessment for medical respite, or commissioning a new medical respite service, to understand the key issues involved.

Social implications

This paper challenges the existing status quo regarding the need for a “cost-saving” rationale to set up these services.

Originality/value

This paper aims to be the definitive paper for anyone wishing to get an overview of this topic.

Details

Housing, Care and Support, vol. 22 no. 1
Type: Research Article
ISSN: 1460-8790

Keywords

Article
Publication date: 28 June 2021

Michael Clark, Michelle Cornes, Martin Whiteford, Robert Aldridge, Elizabeth Biswell, Richard Byng, Graham Foster, James Sebastian Fuller, Andrew Hayward, Nigel Hewett, Alan Kilminster, Jill Manthorpe, Joanne Neale and Michela Tinelli

People experiencing homelessness often have complex needs requiring a range of support. These may include health problems (physical illness, mental health and/or substance misuse…

Abstract

Purpose

People experiencing homelessness often have complex needs requiring a range of support. These may include health problems (physical illness, mental health and/or substance misuse) as well as social, financial and housing needs. Addressing these issues requires a high degree of coordination amongst services. It is, thus, an example of a wicked policy issue. The purpose of this paper is to examine the challenge of integrating care in this context using evidence from an evaluation of English hospital discharge services for people experiencing homelessness.

Design/methodology/approach

The paper undertakes secondary analysis of qualitative data from a mixed methods evaluation of hospital discharge schemes and uses an established framework for understanding integrated care, the Rainbow Model of Integrated Care (RMIC), to help examine the complexities of integration in this area.

Findings

Supporting people experiencing homelessness to have a good discharge from hospital was confirmed as a wicked policy issue. The RMIC provided a strong framework for exploring the concept of integration, demonstrating how intertwined the elements of the framework are and, hence, that solutions need to be holistically organised across the RMIC. Limitations to integration were also highlighted, such as shortages of suitable accommodation and the impacts of policies in aligned areas of the welfare state.

Research limitations/implications

The data for this secondary analysis were not specifically focussed on integration which meant the themes in the RMIC could not be explored directly nor in as much depth. However, important issues raised in the data directly related to integration of support, and the RMIC emerged as a helpful organising framework for understanding integration in this wicked policy context.

Practical implications

Integration is happening in services directly concerned with the discharge from hospital of people experiencing homelessness. Key challenges to this integration are reported in terms of the RMIC, which would be a helpful framework for planning better integrated care for this area of practice.

Social implications

Addressing homelessness not only requires careful planning of integration of services at specific pathway points, such as hospital discharge, but also integration across wider systems. A complex set of challenges are discussed to help with planning the better integration desired, and the RMIC was seen as a helpful framework for thinking about key issues and their interactions.

Originality/value

This paper examines an application of integrated care knowledge to a key complex, or wicked policy issue.

Details

Journal of Integrated Care, vol. 30 no. 1
Type: Research Article
ISSN: 1476-9018

Keywords

Open Access
Article
Publication date: 25 September 2020

Raphael Rogans-Watson, Caroline Shulman, Dan Lewer, Megan Armstrong and Briony Hudson

The purpose of this paper is to assess frailty, geriatric conditions and multimorbidity in people experiencing homelessness (PEH) using holistic evaluations based on comprehensive…

4627

Abstract

Purpose

The purpose of this paper is to assess frailty, geriatric conditions and multimorbidity in people experiencing homelessness (PEH) using holistic evaluations based on comprehensive geriatric assessment (CGA) and draw comparisons with general population survey data.

Design/methodology/approach

Cross-sectional observational study conducted in a London-based hostel for single PEH over 30 years old in March–April 2019. The participants and key workers completed health-related questionnaires, and geriatric conditions were identified using standardised assessments. Frailty was defined according to five criteria in Fried’s phenotype model and multimorbidity as the presence of two or more long-term conditions (LTCs). Comparisons with the general population were made using data from the English Longitudinal Study of Ageing and the Health Survey for England.

Findings

A total of 33 people participated with a mean age of 55.7 years (range 38–74). Frailty was identified in 55% and pre-frailty in 39%. Participants met an average of 2.6/5 frailty criteria, comparable to 89-year-olds in the general population. The most common geriatric conditions were: falls (in 61%), visual impairment (61%), low grip strength (61%), mobility impairment (52%) and cognitive impairment (45%). All participants had multimorbidity. The average of 7.2 LTCs (range 2–14) per study participant far exceeds the average for even the oldest people in the general population.

Originality/value

To the best of authors’ knowledge, this is the first UK-based study measuring frailty and geriatric conditions in PEH and the first anywhere to do so within a CGA-type evaluation. It also demonstrates the feasibility of conducting holistic evaluations in this setting, which may be used clinically to improve the health outcomes for PEH.

Details

Housing, Care and Support, vol. 23 no. 3/4
Type: Research Article
ISSN: 1460-8790

Keywords

Article
Publication date: 10 June 2019

Kelly Hewett and Laura L. Lemon

This paper aims to explore the internal processes that can enable firms to identify and effectively respond to brand crises, with various groups coordinating and cooperating with…

3287

Abstract

Purpose

This paper aims to explore the internal processes that can enable firms to identify and effectively respond to brand crises, with various groups coordinating and cooperating with each other, and also propose a guiding framework relevant for both managers and researchers.

Design/methodology/approach

A grounded theory methodology was adopted. Data collection included open-ended interviews with 13 executives representing the integrated marketing communications (IMC) function, the integrated corporate communications function and external agencies supporting firms while navigating crises.

Findings

Results revealed a three-stage process of internal coordination efforts during crises: sensing or scanning the environment and gathering insights regarding crises, informing or disseminating these insights throughout the organization to create transparency and responding or reacting to the event via a coordinated effort.

Research limitations/implications

The framework does not directly incorporate input from consumers or customer contact employees, both of which may be relevant.

Practical implications

Findings offer direction for managers to establish processes that prepare for and potentially reduce crises’ negative consequences. In addition, this study reveals the importance of decision-makers being vigilant regarding social media’s influence on such a process.

Originality/value

The conceptual framework moves beyond previous brand crisis research, provides insight into the processes firms use to successfully manage crises and reveals the relevant factors related to internal coordination.

Details

Qualitative Market Research: An International Journal, vol. 22 no. 3
Type: Research Article
ISSN: 1352-2752

Keywords

Article
Publication date: 1 August 2004

George Balabanis, Marios Theodosiou and Evangelia S. Katsikea

Export marketing research over the last four decades has covered a number of theoretical and practical issues such as standardisation and customisation, export development…

4019

Abstract

Export marketing research over the last four decades has covered a number of theoretical and practical issues such as standardisation and customisation, export development processes, barriers to exporting, export performance, etc. Rapid technological, institutional, legislative, economic and attitudinal changes across the globe pose challenges for the future development of export marketing research. The emergence of turbulent and hypercompetitive business environments calls for exporters to reconsider the bases and sustainability of their competitive advantage to overseas markets. In particular, future research should focus on the identification of the right export marketing capabilities that firms should develop or acquire, the ability to leverage or transfer them across markets, and the ability to constantly upgrade them using proper organisational learning routines. Of critical importance are the processes used to develop capability‐based strategies and to manage relationships with international customers. This double issue comprises ten articles that deal with some of the main challenges posed to export marketing.

Details

International Marketing Review, vol. 21 no. 4/5
Type: Research Article
ISSN: 0265-1335

Keywords

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