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The purpose of this paper is to provide an update to a review of the joint working literature in the field of health and social care for adults, with particular emphasis given to the experiences of users and carers.

The aims of the literature review remained largely the same as those of the original, they were to identify: models of joint working, evidence of effectiveness and cost-effectiveness and the factors promoting or hindering the models. However, to reflect the growing interest in the experiences of users and carers a fourth aim was added to map these experiences. Given their prominence in terms of policy debates about integration, the review focused on jointly organised services for older people and people with mental health problems in the UK only.

The review demonstrates tentative signs that some initiatives designed to join-up or integrate services can deliver outcomes desired by government. Importantly some studies that report the experiences of users of services and carers suggest that they perceive benefits from efforts to join-up or integrate services. However it is our contention that the evidence is less than compelling and does not justify the faith invested in the strategy by current or previous governments.

The study updates our knowledge of the impact of joint working in the field of health and social care for adults. Importantly the paper highlights what is known about the experiences of users and carers of joint/integrated services.

The purpose of this paper is to outline the development of a training package for service users and carers with an interest in NHS health and social care research. It demonstrates how the developers used their unique experience and expertise as service users and carers to inform their work.

Service users and carers, NHS Research and Development Forum working group members, supported by health professionals, identified a need for research training that was tailored to other service user and carer needs. After reviewing existing provision and drawing on their training and support experience, they developed a training package. Sessions from the training package were piloted, which evaluated positively. In trying to achieve programme accreditation and training roll-out beyond the pilots, the group encountered several challenges.

The training package development group formed good working relationships and a co-production model that proved sustainable. However, challenges were difficult to overcome owing to external factors and financial constraints.

Lessons learnt by the team are useful for other service users and carer groups working with health service professionals. Training for service users and carers should be designed to meet their needs; quality and consistency are also important. The relationships between service user and carer groups, and professionals are important to understanding joint working. Recognising and addressing challenges at the outset can help develop strategies to overcome challenges and ensure project success.

The training package was developed by service users and carers for other service users and carers. Their unique health research experience underpinned the group’s values and training development.

This paper explores how a research‐based understanding of outcomes in social care can be incorporated into practice. Drawing on research by the Social Policy Research Unit and the practical experience of North Lincolnshire Social Services Department, this paper highlights how culture change and the involvement of stakeholders are key to using outcomes ideas as a motivational framework for service improvement.

The purpose of this paper is to explore the role of carers as coordinators of care in their own right. It outlines how statutory and voluntary agencies can work together to support carers in this role, yet also help them work towards personal outcomes to sustain their own quality of life. It also proposes that approaches to working with carers can reveal lessons for integration.

The research analysed data from focus groups and document analysis to examine how carers and professionals experienced two different approaches to engaging with carers: the Midlothian carer ' s assessment and VOCAL ' s outcomes focused approach. From this, several themes emerged which are relevant to the current debate on integration.

Carers were found to be key co-ordinators of care who play a role in the integration of services. Approaches to working with carers can better enable personal outcomes, and integrate carers as equal partners. In addition, improved integration between services can also improve outcomes for carers.

Approaches to working with carers should be carer and outcome focused, and partnership working can mean that carers feel more empowered and included. This helps to achieve personal outcomes, as well as enhance integrated working between other services. However, differentiation between services might, in places, contribute to better outcomes for people.

This paper shifts the focus of integration to look the role of carers as equal partners, and also illustrates how statutory and voluntary services can work better together, while preserving their distinct identities.

I describe the development of a group in North London that aimed to increase the involvement of carers in the development and monitoring of mental health services across the borough. I enabled the carers to evaluate their experiences of the group using a participatory action research model. The evaluation was divided into two phases. Phase 1 focused on how the carers developed effective processes to facilitate the individuals in the group to represent not only their experiences but those of the collective. I describe how a critical incident facilitated this discussion and how the carers used the action research cycle to enable this change. Phase 2 enabled the group to reflect on their experiences of the group's impact upon them. The carers identified the following main themes of their experience of the group: shared experience of mental health stigma; empowerment and increased confidence; increased knowledge to enable them to care for themselves and their loved one more effectively, although this was tinged with a sense of frustration. In this process, I reflect on the vision that I had for Carers Against Stigma (CAS) as a user researcher and practitioner working with carers. I discuss the potential conflict that I faced as a practitioner and researcher initiating a carer‐led group. The theoretical implications of the individual service representative representing the views of the collective are discussed, and their needs for access and support to be involved in research and service evaluation are identified.

The purpose of this paper is to reflect on the development of a recovery-oriented training programme for mental health care-givers. It also considers the effectiveness of using participatory research methods that promote involvement of people with diverse expertise to co-produce this programme. It presents a rationale for developing recovery-oriented training, which employs blended learning, comprising face-to-face and e-learning.

A small advisory group consisting of professionals, experts-by-experience (service users) and -by-caring (care-givers) and an academic developed a blended learning programme about the recovery approach for mental health carer-givers. This paper details the participatory approach supported by an action research cycle that contributed to the design of the programme, and the specific impact of experiential knowledge on its development.

Reflections on the advisory group process are described that led to the co-production of the course. This leads to consideration of the value of using this research approach to develop a carer-focused programme. The content of the recovery-oriented training programme is presented which adopts blended learning. This leads to discussion of potential of this format to improve carers’ access to training.

It is proposed that this recovery-oriented course, building on a previous study, has the potential to positively influence outcomes for the training programme participants (the care-givers) and the person they support. It is suggested that blended learning may in part overcome some of the barriers carers experience to accessing and participating in traditional interventions. Reflections on the process of co-production underline the value of participatory research in designing this recovery-oriented course for carers.

Policy and practice documents are increasingly adopting a focus on outcomes. This article seeks to clarify what is meant by the term ‘outcome’, the outcomes that have been highlighted in key policy documents, and the extent to which they reflect the outcomes prioritised by service users. The discussion will draw on the early stages of a DoH‐funded project exploring the effectiveness of health and social care partnerships from the perspectives of service users.

The purpose of this paper is to examine the effects of an integration programme on service users from users’ own perspective.

Multi-method approach was used. Both quantitative and qualitative data collection and analysis were employed to uncover and examine service users’ views of the impact of the integration programme.

An improvement in the physical functioning of one in three occupational equipment users; a rise in the level of satisfaction of 85 per cent of occupational health and 82 per cent of physiotherapy users; older people with complex problems and high-level needs were able to be helped to live at home; and waiting times for both assessment and for services within two weeks and four weeks were below the national achievement and ministerial targets. The impact of the integration programme on users was complex. Positive outcomes were achieved for some user groups and individuals but not for others. A lack of change outcomes in social care, and service users’ low level of satisfaction with social care services appears to be associated with the impact of agency work and the predominant aim in social work of achieving maintenance and prevention outcomes.

This paper contributes to knowledge on what and how the total integration in Cambridgeshire has benefited users.

The purpose of this paper is to examine the role of service user and carer involvement in NHS research and describe the nature of this involvement in three specialist mental health Trusts. It also aims to discuss the value of service user and carer involvement and present the perspective of the service user and research manager.

The paper reviews patient and public involvement policy and practice in the NHS and NHS research. It examines the effectiveness of involvement activity and utilises a case example to demonstrate the impact of patient/service user involvement on the NHS and the individuals who take part.

The paper concludes that service user involvement is essential if research is to support the development of health services that clearly reflect the needs of the service user and impact positively on service quality.

Service user involvement is an established element of NHS research and development at both national and local level. The Department of Health strategy for research, Best Research for Best Health, reiterates both the importance of research that benefits the patient and the involvement of the service user in the research process. Despite this, the changes in Department of Health support funding for research, introduced by the strategy, may inadvertently lead to some NHS Trusts experiencing difficulty in resourcing this important activity.

The paper illustrates the effectiveness of successful patient and public involvement in research. It also identifies how involvement has developed in a fragmented and uncoordinated way and how it is threatened by a failure to embed it more consistently in research infrastructure.

The purpose of this paper is to discuss learning about service-user and carer involvement from an action research (AR) study into self-directed support implementation in one English mental health trust. The paper promotes appointing and supporting carers and people with experience as co-researchers to obtain authentic local perspectives when undertaking service implementation or redesign.

The researchers used an AR spiral method incorporating carers and people with mental health experience as co-researchers. The co-researchers worked alongside the lead researcher gathering data from focus groups, training sessions and other meetings over four years and attending collaborative steering group meetings alongside professional workers throughout the study.

The authors suggest that participation gave co-researchers a powerful and effective voice in this service redesign. This approach revealed more authentic research data and required professionals to be more accountable for their perceptions and to make explicit their understandings throughout the study, which enabled more effective working. Steering group participation was central to securing this participation.

The paper illustrates how carer and service-user co-researchers can be supported to benefit both mental health organisations undergoing change and to co-researchers themselves. It also identifies AR’s utility in uncovering learning as well as structuring change.