Search results

The purpose of this paper is to describe the development of an eating disorder care pathway for adults with eating disorders, in a northern borough town. It arose out of a need to reduce and address inconsistent access to services and treatment pathways.

The development involved a mapping exercise of current service delivery, a review of the literature on eating disorder care pathways, consultation workshops, the engagement of service users and carers, and the development of draft pathways for patients and carers.

Significant emphasis was on raising awareness, prevention, identification and assessment, treatment and recovery. Two pathways were proposed, one for service users focusing on awareness raising/prevention, identification and assessment, treatment, stabilisation and relapse prevention and one for carers/families focusing on carers being identifiable in their own right to receive support for caring for someone with an eating disorder.

A limitation of the care pathway under development was the difficulty obtaining an accurate figure of the true number of cases of eating disorders in the local area. This, together with the lack of any form of systematic review or meta-analysis of care pathways made identifying the number of people suffering from eating disorders and developing an effective model difficult.

The proposed pathway places significant emphasis on increasing knowledge, incorporating the patient perspective, and enhancing the recognition and understanding of eating disorders in the community. A model was created that could be implemented successfully and identify patients suffering from eating disorders, when the true incidence of eating disorders remains hidden.

This paper aims to describe the experience of a secure learning disability service in participating in the national Shared Pathway pilot project in secure services.

Some background drivers to the project are explored as well as the experience of service users and staff who were involved in the pilot project. Recommendations on service‐wide implementation of the Shared Pathway are made.

The Shared Pathway will lead to considerable changes in practice. This will also have resource implications.

The paper shows that the Shared Pathway may be useful in ensuring evidence based outcomes are routinely used by clinicians in secure services in collaboration with patients. It may also clarify to patients what their role is in engaging in treatment that helps them in moving through secure services.

The purpose of this paper is to explore the views of NHS England (NHSE) and Her Majesty’s Prison and Probation Service (HMPPS) commissioners about the Offender Personality Disorder (OPD) pathway.

A thematic analysis of four semi-structured interviews with NHSE and HMPPS commissioners is conducted.

Commissioners offered a cautious but confident assessment of the potential effectiveness of the OPD pathway, drawing particular attention to its potential to enhance the confidence and competency of staff, offer better value for money and provide enhanced progression routes for offenders with personality disorders. Additionally, commissioners identified a number of potential risks for the pathway including wider system flux, funding availability, multi-agency working, offender engagement and the need to evidence effectiveness.

The analysis is based on a small number of interviews. However, there are only a limited number of commissioners involved with the OPD pathway.

While the stronger focus on progression in the OPD pathway is a welcome departure from a narrow focus on high security Dangerous and Severe Personality Disorder (DSPD) services, the foundations of the OPD pathway ultimately lie with the DSPD programme and similar challenges are likely to follow. The system within which the pathway operates is subject to a great deal of flux and this inevitably poses significant challenges for pathway services, staff and offenders, as well as for those of us charged with its evaluation.

There has been limited empirical work with commissioners in the mental health field. The paper offers a unique insight into the perspectives of those responsible for commissioning the OPD pathway.

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.

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.

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.

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.

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.

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

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

This article describes the development of the Supported to Independent Living project (SIL), which is for the support and care for people with mental health needs in Oxfordshire to live as independently as possible in ordinary housing in the community. The project is a partnership between NHS Oxfordshire (Primary Care Trust), the Oxfordshire Supporting People programme and Oxfordshire County Council Social and Community Services.Although there was a very vigorous development of community living for people with longstanding mental health needs through the provision of group homes, particularly in Oxford City that started in 1963, there has not been an overall strategy for the development of mental health services for the County as a whole. The needs of a diverse, younger, often more mobile and potentially more challenging group of service users for housing with appropriate care and support have not been met.A joint strategy between the County Council and the Primary Care Trust (PCT) to meet these needs has therefore been developed that introduces a pathway of linked accommodation and support arrangements. These range from intensive support through to floating support in the community, and are intended to offer individuals a guided pathway away from specialist services to more mainstream provision. The services are based on the principles of recovery, personalisation and ordinary housing.As well as achieving significantly reconfigured services the strategy has to deliver savings to meet the cuts imposed on the Supporting People programme grant by Central Government.The project has involved the PCT and the County Council in close partnership working, and important and significant involvement of and engagement with service users and carers. A framework agreement has been agreed by all of the organisations involved. It sets out the roles and responsibilities of each and covers local government, the NHS, housing and support.

The purpose of this paper is to focus on the evolving field of hybrid services within the customer service domain. The distinguishing characteristic of hybrid services is its rapid advancements and intersection of technology innovations mixed with customer service approaches.

Extensive research and analysis has identified numerous models to measure service quality and most of these models are derived from the SERVQUAL. Since SERVQUAL is not clearly focused to analyze the customer’s experience, the authors have used mixed methods of data collection. The two sources of data are both primary and secondary data. Primary source of research is semi-structured feedback with key operations manager and front line employees involved in the business process outsourcing industry. Secondary source of data is based on case studies of organizations engaged in information technology and ecommerce.

In this study, the author suggests multivariate hybrid pathways to streamline and deliver exceptional customer experience, which enhances the customer retention and firm’s competitive advantage. This study emphasizes on the imminent growth of hybrid services within the customer service domain. The distinguishing characteristic of hybrid services is its rapid advancements and intersection of technology innovations mixed with customer service approaches. The customers’ interactions with a firm are gaining proportional complexity due to the intercourse of human and technology interactions.

This study integrates the diverging but distinct pathways that influence customer experience. The study is centralized on the theme that there is a progressive dependence of human interactions with technological developments. It highlights the advent of new digital technologies that are the catalyst for personalized customer experiences.

This paper aims to examine the unique Chinese context by analyzing the city labels (e.g. smart city and eco city) used by Chinese local governments at or above the provincial capital level to represent themselves (adopted city labels) and the developmental pathways they actually pursued (adopted developmental pathways).

The authors compared the city brand choices to those anticipated based on their geographic and economic contexts (predicted city labels and developmental pathways) as well as the directives outlined in national planning documents (imposed city labels and developmental pathways). The authors identified ten main categories of city labels used to designate themselves and establish the frequency of their use based on municipal plan documents, economic and geographic data and national plan documents and policy reports, respectively.

The authors discovered that both local economic development and geographic factors, as well as top-down administrative influences, significantly impact city branding strategies in the 38 Chinese cities studied. When these models fall short in predicting adopted city labels and pathways, it is often because cities favor a service-oriented reputation over a manufacturing-focused one, and they prefer diverse, multifaceted industrial images to uniform ones.

The originality and value of this paper lie in its contribution to the academic literature on city branding by developing a predictive model for brand development at the municipal level, with explicit attention to the national-local nexus. The paper’s approach differs from existing research in the first cluster of city branding by not addressing issues of stakeholder involvement or adoption and implementation processes. Additionally, the paper’s focus on the political power dynamics at the national level and urban governance details at the municipal level provides a unique perspective on the topic. Overall, this paper provides a valuable contribution to the field of city branding by expanding the understanding of brand development and its impact on the socioeconomic environment.

Responding to calls for deeper analysis of the conceptual foundations of service infusion in manufacturing, this paper examines the underlying assumptions that: (i) manufacturing firms incorporating services follow a pathway, moving from pure-product to pure-service offerings, and (ii) profits increase linearly with this process. We propose that these assumptions are inconsistent with the premises of behavioural and learning theories.

Machine learning algorithms are applied to test whether a successive process, from a basic to a more advanced offering, creates optimal performance. The data were gathered through two surveys administered to USA manufacturing firms in 2021 and 2023. The first included a training sample comprising 225 firms, whilst the second encompassed a testing sample of 105 firms.

Analysis shows that following the base-intermediate-advanced services pathway is not the best predictor of optimal performance. Developing advanced services and then later adding less complex offerings supports better performance.

Manufacturing firms follow heterogeneous pathways in their service development journey. Non-servitised firms need to carefully consider their contextual conditions when selecting their initial service offering. Starting with a single service offering appears to be a superior strategy over providing multiple services.

The machine learning approach is novel to the field and captures the key conditions for manufacturers to successfully servitise. Insight is derived from the adoption and implementation year datasets for 17 types of services described in previous qualitative studies. The methods proposed can be extended to assess other process-based models in related management fields (e.g., sand cone).

This paper aims to examine effective diagnostic and treatment pathways for attention deficit hyperactivity disorder (ADHD) in prison settings given the high prevalence of ADHD and comorbidities in the prison population.

Two studies were carried out in two separate prisons in London. Firstly, data were collected to understand the prevalence of ADHD and the comorbidities. The second study used quality improvement (QI) methodology to assess the impact of a diagnostic and treatment pathway for prisoners with ADHD.

Of the prisoners, 22.5% met the diagnostic criteria for ADHD. Nearly half of them were screened positive for autistic traits, with a higher prevalence of mental disorders among prisoners with ADHD compared to those without. The QI project led to a significant increase in the number of prisoners identified as requiring ADHD assessment but a modest increase in the number of prisoners diagnosed or treated for ADHD.

Despite various challenges, an ADHD diagnostic and treatment pathway was set up in a prison using adapted QI methodology. Further research is needed to explore the feasibility of routine screening for ADHD in prison and examine at a national level the effectiveness of current ADHD prison pathways.

Lengthy and complex routes to specialist care may negatively affect clinical profiles of trauma survivors accessing mental health services. The purpose of this study was to describe the characteristics and referral pathways of a cohort of clients accepted by a specialist trauma service in England; and investigate the associations between referral pathways and clients’ clinical profiles, namely, pre-treatment levels of post-traumatic stress, depression, anxiety, stress and post-traumatic growth.

Data on 117 consecutive, accepted referrals were extracted from clients’ clinical records. Information on demographics, trauma histories, clinical presentations and referral pathways was synthesised through summary statistics. Correlational analyses were conducted to test associations with pre-treatment scores.

Clients accessing the service were highly complex and mostly experienced prolonged, interpersonal trauma. Pathways to the service varied, but 50% of the sample had at least four “steps” in their referral histories and seven previous clinical contacts. The average time between trauma and specialist referral was 16.34 years. The number of referral steps positively, significatively and moderately correlated with anxiety and stress at pre-treatment.

Limitations include issues around collecting past referral information, the small sample size for clients with available pre-treatment data and the lack of post-treatment scores.

This evaluation provides an informative overview of the characteristics and referral pathways of clients accessing a specialist trauma service. It also offers preliminary insights on the relationship between clients’ routes into the service and their clinical profiles. Practice, commissioning and research implications are discussed.