bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of the Implementation of the Mental Health Review in Somerset: Methodology
Authors: Gulliver Pauline , Peck Edward , Towell David
Published: August 2011

This paper is the first of two discussing the evaluation of the implementation of joint commissioning and integrated provision of mental health services in Somerset. The paper presents the methods of evaluation, and explores the potential limitations and environmental factors impacting on the effectiveness of data‐collection methods.
Making Sense of the Evidence
Authors: Spittlehouse Claire , Acton Mary , Enock Katie
Published: August 2011

Using evidence in social services decision‐making is becoming increasingly important. Through the Centre for Evidence‐Based Social Services, the Critical Appraisal Skills Programme has developed training for social services practitioners to enable them to develop skills in making sense of research papers, in order to use this evidence appropriately.
Charging for Home Care Services
Authors: Tree Duncan
Published: August 2011

The Department of Health's reaction to the Audit Commission's report on charging for home‐care services is considered in the light of its longstanding failure to help local authorities in a clear and unequivocal way to deal with one of the most difficult policy issues in community care.
(2) User Participation Now: Evidence‐Based Practice in Best Value
Authors: Buchanan Ian
Published: August 2011

The user voice has been diminished by New Labour's increased reliance on regulation and inspection, notably in Best Value. Reflecting on community care implementation, the paper contends that within Best Value users may maximise their influence in an evidence‐based practice frame.
Over the Hills and Far Away: Providing Accessible Day Care Services for Older People in Rural Areas
Authors: Le Mesurier Nick , Duncan Gem
Published: August 2011

This paper describes a dispersed service operated by Age Concern Leominster in North Herefordshire. The service uses local facilities to offer day‐care services to older people living in isolated rural communities. Discussion focuses on the challenges facing a service provider in developing and maintaining a localised service across a diverse range of communities, and presents a series of essential strategies for success.
The ‘Joined up’ Management of Adult Health and Social Care Services in Northern Ireland: Lessons for the Rest of the UK?
Authors: Campbell Jim , McLaughlin John
Published: August 2011

This article describes and critically analyses the development of the ‘integrated service’ in Northern Ireland, with particular reference to community care for adults. Evidence from a number of studies is used to identify the strengths and weaknesses of this service.
Managers and Professionals: Another Perspective on Partnership
Authors: Dustin Donna
Published: August 2011

This article summarises the preliminary findings of a qualitative exploratory study conducted through a series of eight group interviews with statutory sector social work care managers (SW/CMs). While managers may have moved on to the implementation of partnership, SW/CMs are still struggling with the implications of the purchaser/provider split. The article highlights issues that are problematic for SW/CMs and makes tentative suggestions to their line managers.
Local Authorities and Violence to Social Work Staff: Towards a Common Framework
Authors: Kedward Carol
Published: August 2011

The National Task Force on Violence to Social Care Staff is expected to establish clear policy and practice standards for the management of violence to staff. The paper profiles present practice, based on the responses of 30 local authorities to a questionnaire, identifies key issues and suggests a framework for good practice.
(2) The NHS Plan: Maintaining the Human Touch
Authors: Glasby Jon
Published: August 2011

Although the NHS Plan stopped short of forced mergers of local authority social services departments with NHS bodies, it may nevertheless lead to a form of amalgamation by stealth. Irrespective of the organisational dilemmas this raises, this paper emphasises the need to retain a central focus on the experience of users.
(3) The NHS Plan: Long‐term Care: Continuing Challenges at the Health/Social Care Boundary
Authors: Vellenoweth Chris
Published: August 2011

The NHS Plan incorporates the long‐awaited response of the Government to the report of the Royal Commission on the Costs of Long‐Term Care. This article argues that the risk of cost shunt between funding agencies is perpetuated, and that new forms of care will need to be included within the standards assurance of the newly established National Care Standards Commission.
Service Users and Community Care: New Roles, New Knowledges, New Forms of Involvement?
Authors: Beresford Peter
Published: August 2011

This article considers the key role that service users' perspectives and knowledges now play in the development of community care. It explores their differences from the political and professional discourses which they challenge, and argues that their equal treatment is overdue.
Multidisciplinary Working and the New NHS: More Messages from Northern Ireland
Authors: Withington Suzanne , Giller Henri
Published: August 2011

The authors suggest that their recently developed curriculum guidance on multidisciplinary working for DipSW students in Northern Ireland raises some key issues of relevance to health and social care professionals coming to grips with the integrated‐working imperative of the new NHS Plan.
Making Connections: Learning Disability Services and Primary Care Groups/Trusts
Authors: Giraud‐Saunders Alison
Published: August 2011

This paper affirms the importance of making connections between learning disability services and primary care groups/trusts, while acknowledging the challenges. Ideas for local action indicate the need for clarity about the roles of learning disability specialists and for determination to continue moving forward during organisational change.
What is Intermediate Care? Looking at Needs
Authors: Enderby Pam , Stevenson Jan
Published: August 2011

Managing operational change using a whole‐systems approach will be the key to re‐engineering services, including intermediate care and rehabilitation for older people. This article outlines an approach used in Sheffield which is based on eight categories of need.
The Rough Road and the Smooth Road: Comparing Access to Social Care for Older People via Area Teams and GP Surgeries
Authors: Le Mesurier Nick , Cumella Stuart
Published: August 2011

This article discusses the results of a comparative evaluation of a social worker in primary care with her equivalents in an area team. Direct referral is found to be more efficient than referral to the area team, enabling the attached social worker to manage a higher workload and improved levels of contact with service users and the primary care team. The options available for service users are thus enhanced, with consequent cost advantages for the social services department.
Evaluation of the Implementation of the Mental Health Review in Somerset: Results after Fifteen Months of Data Collection
Authors: Gulliver Pauline , Peck Edward , Towell David
Published: August 2011

This paper presents the second set of results from the evaluation of the implementation of joint commissioning and combined provision of mental health services in Somerset. Comparisons with baseline data are made and key emerging questions are identified.
Occupational Therapy as a Seamless Pathway in North East Glasgow
Authors: Cointet Sonia , Alexander Jean , Campbell Margaret , Hunter Lorna
Published: August 2011

This is a locality case study which starts with a detailed overview of an inter‐agency process to study the feasibility of integrating occupational therapy services, and concludes with a brief description of the model proposed.
Coughlan and After
Authors: Dow John
Published: August 2011

Eighteen months after the Coughlan judgement, health and local authorities are still awaiting revised guidance on eligibility criteria for free nursing care under the NHS. This article looks at the legal implications.
Nice Process — But Did Joint Commissioning Change Anyone's Life?
Authors: Greig Rob , Poxton Richard
Published: August 2011

This article is based on a review of reported studies of joint commissioning in practice, which are surprisingly few in number. It concludes that there is little solid evidence that the process leads to benefits for service users, but there is evidence of its resulting in improved inter‐agency working. A second article in a subsequent issue of this journal will go on to consider whether the new partnership flexibilities offer the potential to learn from this evidence.
Coming to Terms with Primary Care Trusts: The Views of PCG Board Members
Authors: Starkey Fenella , Taylor Pat , Means Robin
Published: August 2011

This article presents the views of board members from two primary care groups in South West England on benefits and concerns relating to the imminent development of primary care trusts, and perceived implications for service delivery and management arrangements.
Developing an Assertive Outreach Service: From Evidence to Practice
Authors: Cunningham Gail , McCollam Allyson
Published: August 2011

Meeting the complex needs of people with severe and enduring mental health problems who are difficult to engage poses a formidable challenge for service providers. An evaluation of a small interagency multi‐disciplinary team in Aberdeen providing assertive outreach for this group identified the key features which helped to sustain clients' lives in the community.
To Charge or not to Charge?
Authors: Dow John
Published: August 2011

Charging for non‐residential care services has always been an emotive political issue. Recent government draft guidance is unlikely to take the heat out of the issue, as it still leaves local politicians with flexibility to determine their own charging policies.
Designing and Implementing Performance Management of Social Care Block Contracts in Fareham/Gosport Social Services Locality
Authors: Ramsay Paul
Published: August 2011

The article provides an account of an approach to managing contract performance in respect of block‐purchased social care services. The approach has confirmed quality threshold assumptions, and confirmed that the toolkit is effective at differentiating performance levels, informing improvement notices and measuring progress towards desired performance thresholds.
Creating a Comprehensive System of Community Services for People with Dementia
Authors: Mitchell John
Published: August 2011

Through a literature review, this article aims to identify the needs of those people with dementia who wish to remain at home, and those of their carers. It goes on to model a range of services that can be linked together to meet these needs comprehensively.
Keep Well at Home — the Over‐75s ‘At Risk’ Project Pilot
Authors: Jones Val , Mulholland Brenda , Shepperd Sasha
Published: August 2011

The Keep Well at Home method we have piloted is simple ‐ initial screen, comprehensive assessment, onward referral and regular telephone monitoring for those aged 75+ at risk of functional decline. Using validated tools, this preventative approach links health and social care and is proving feasible in practice.
Enabling Communication and Enhancing Services for People with Motor Neurone Disease
Authors: Billinghurst Brenda
Published: August 2011

Ignorance about the impact of motor neurone disease (MND) may be undermining services for people with the condition. Challenges around communication in the research setting suggest ways of addressing some potential barriers to quality in the community.
No Secrets: No Excuse
Authors: Manthorpe Jill
Published: August 2011

The Department of Health's guidance on adult protection requires a response from local agencies. The Chair of a local multi‐agency group on adult protection discusses the communication systems and resources required.
Recording and Evaluating Occupational Therapy Outcomes in a Social Services Setting
Authors: Armstrong Sue
Published: August 2011

This article describes how a social services occupational therapy team developed a method of documenting outcomes and evaluating results for equipment and adaptation services. The aims were to capture the qualitative nature of the work and to begin to create evidence on the practice of occupational therapy in social services.
The Politician's Challenge in Health and Social Care
Authors: Brodie Judith
Published: August 2011

The role of the councillor in health and social care is developing as part of the modernisation agenda and consequent legislative changes. This article explores some of the challenges facing local politicians in this transforming environment, providing examples of progress in one local authority.
Can Managers Research their own Services? An Experiment in Consulting Frail, Older Community Care Clients
Authors: Patmore Charles
Published: August 2011

This article describes the test of a method for consulting frail older people about the quality of social services and their unmet needs. The method, home interviews by senior social services managers, was prompted by advice from older social services clients about how best to obtain their views. Results of the interview programme are presented, together with benefits arising specifically from using managers as interviewers and discussion of future application of this approach.
Real Life Research: The Ups and Downs of an Intermediate Care Study
Authors: Trappes‐Lomax Tessa , Ellis Annie , Fox Mary
Published: August 2011

This is the second article about our comparative study of joint health and social care rehabilitation for older people. We discuss what has worked well so far, and how we have tackled the various obstacles to doing systematic research across two complex organisations. We describe our sample group and report on data collection so far.
Care Management in Primary Health Care Teams: The Basingstoke ‘Links Scheme’
Authors: Lindsay Clive
Published: August 2011

A social services team manager traces the development of efforts to build better links with primary health care services, and reports on the benefits which have been observed in evaluations.
Employees with Long‐term Limiting Illnesses or Disabilities
Authors: McLean John
Published: August 2011

This research summary reports on the prevalence, nature and diversity of social services employees with a serious illness or disability, and considers how employers can address their needs.
(2) Care Standards Act (Part 3)
Authors: Dow John
Published: August 2011

This is the third in a series of articles looking at the provisions of the Care Standards Act. This article will look at the establishment of the General Social Care Council and the Protection of Vulnerable Adults (POVA) list.
Care Home Environments, Rehabilitation and Older Persons: A Survey of Current Service Provision in England
Authors: Ward Derek , Severs Martin , Dean Taraneh
Published: August 2011

The emergence of the intermediate care agenda has added momentum to the debate on the use of alternative care settings for the delivery of rehabilitative interventions for older persons. This paper reports on the findings of the first stage of a research programme to investigate the extent of the use of care home environments for the rehabilitation of older people in England. Stage two of the project will explore in more depth the characteristics of the rehabilitation provision identified in stage one.
Social Exclusion and Education
Authors: Mittler Peter , Jackson Sonia , Sebba Judy
Published: August 2011

This overview of policy and policy implementation is based on three individual papers presented in November 2001, and on their discussion by Fellows of the Centre for Social Policy at Dartington. It critically examines the challenge of ‘joined‐up’ working, and calls for better engagement of parents and children in action to promote social inclusion and improve opportunity. After a detailed general review by Peter Mittler, who led the seminar, specific consideration to the education of children in care is given by Sonia Jackson, and to the prospects for evidence‐based inter‐agency developments by Judy Sebba, who was a guest contributor.
How to Develop Needs‐Led, Evidence‐Based Services
Authors: Little Michael , Bullock Roger , Madge Jill , Arruabarrena Ignacia
Published: August 2011

A method of fashioning needs‐led and evidence‐based services on a multi‐agency basis is described. The approach is based on research but is designed for application by professionals and users in agency settings. Its strengths and weaknesses and application on an international scale are discussed, using examples from provision for vulnerable children and families.
Evaluation of the Integration of Health and Social Services in Somerset: Part 2 ‐ Lessons for Other Localities
Authors: Gulliver Pauline , Peck Edward , Towell David
Published: August 2011

In April 1999, Somerset Health Authority and Somerset County Council launched the first fully integrated adult mental health service in England, made up of a joint commissioning board and an integrated services provider. Between January 1999 and June 2001, the authors evaluated the implementation of the integration by investigating the impact of this initiative on service users, their carers, staff members at the new trust, and senior managers and members from health and social services. In this, the second part of the presentation of the results from the evaluation, the main themes relevant to the pursuance of integration in other localities will be drawn out and discussed in light of the literature currently available.
Promoting Patient and Public Involvement in Primary Health Care: Part 1 ‐ Literature Review
Authors: Tee Stephen
Published: August 2011

Primary care groups are required to demonstrate that patients and the public are involved in the planning, delivery and evaluation of the services they provide. However, a review of the literature suggests that managers' ability will be greatly tested if they are to achieve meaningful progress in this area. Some suggestions are made to assist managers in this important role. In the next issue of MCC, Part 2 reports findings from a locality case study.
Making Connexions
Authors: Dow John
Published: August 2011

A legal eye is cast over the new Connexions services, describing their constitutions and responsibilities. Specific reference is made to the needs of young people with disabilities.
Building a Better Health and Social Care Workforce: Challenges in Policy and Practice
Authors: Robinson Janice
Published: August 2011

Shortcomings in the health and social care workforce threaten the achievement of the NHS Plan. Government's recognition of the need to build workforce capacity has led to new strategies for recruiting and retaining staff and for providing the education and training required by both professional and non‐professional staff groups. The new focus on workforce issues has also opened up new opportunities to tackle inequalities regarding race, disability, gender and age. But employers face great challenges, requiring new ways of thinking and working in order to achieve change in the short and longer term.
Modernising the Workforce: Getting the Best from Service Users
Authors: Snow Rose
Published: August 2011

Discriminatory attitudes to (ex) service users may threaten modernisation as they limit and shrink the workforce and prevent committed workers from succeeding. The report of the 1st National Conference of Survivor Workers gives senior managers the knowledge needed to increase the size and capability of the workforce.
Managers' and Practitioners' Experiences of Depression: A Unifying Phenomenon?
Authors: Manthorpe Jill , Stanley Nicky , Caan Woody
Published: August 2011

This article reports the findings of a survey of social work professionals, both managers and practitioners, who reported their experiences of depression and the workplace response. The study identified a high degree of commonality in the accounts of practitioners and managers and some indication that managers have particular difficulties in eliciting a flexible response from their employers. A performance‐orientated culture places particular demands on managers to reduce ‘poor performance’. Managers need to be aware of how depression can affect performance and the crucial role of the workplace in responding to this phenomenon.
The Case for Interprofessional Learning in Health and Social Care
Authors: Billingsley Rhiannon , Lang Linda
Published: August 2011

The agenda for change in health and social care calls for an integrated approach with interprofessional working around care pathways. At the same time there is a shift towards a more user‐centred service. Where does this leave the professions and what is the role of higher education? Interprofessional learning (IPL) is sometimes seen as a threat to professional integrity and identity. However, it may be the key to not only enhancing the patients'/clients' experience of care, but also enriching professional fulfilment. What are the arguments around IPL and what might be the benefits?
Commitment and Work: Social Services Employees
Authors: McLean John
Published: August 2011

Commitment is likely to influence job performance and service quality. This report summarises the findings of a study of social services employees and identifies factors which should be taken into account by employers who wish to address employee commitment.
Should Wrongs Always be Remedied? Liability of Public Authorities in Child Abuse Cases
Authors: Dow John
Published: August 2011

This article considers whether public authorities can still be immune from liability in negligence in relation to their duty of care towards children at risk of abuse. It considers the case law since the decision of the House of Lords in X v Bedfordshire in 1995 up to the decision of the European Court of Human Rights in Z v UK in 2001 and the implications of the Human Rights Act 1998.
Adaptations: Key Evidence for Managers
Authors: Heywood Frances
Published: August 2011

Research into the effectiveness of housing adaptations (Heywood, 2001) showed how housing adaptations contribute powerfully to key national policy objectives in health and social care, but also found some tragic examples of waste. The article considers how good outcomes could be increased, by examining the management policies and practices that systemically caused some expensive adaptations to fail.
Real Life Research: Building an Evidence Base for Intermediate Care
Authors: Trappes‐Lomax Tessa , Ellis Annie , Fox Mary
Published: August 2011

This is the third in a series of articles about trying to develop better evidence for a service on the health/social care interface. All are based on our experiences of carrying out a comparative study of residential rehabilitation for older people. The first two dealt with methodology and implementation. Now we reflect on the completion of the project and the first stages of dissemination.
Setting Standards and Enhancing Choices
Authors: Jones Pam , Manthorpe Jill
Published: August 2011

This article reports on the process of involving older people in one local authority in the construction of standards for residential care. It draws on data from questionnaires, focus groups and interviews. The findings suggest that involving a wide range of individuals in setting and reviewing local care standards is a necessity. A rationale for the exercise of individual choice emerged from the study, confirming that it is an important feature of acceptable residential care.
Involving Older People in the Implementation of the National Service Framework: Making Progress in the North West
Authors: McNally David , Cornes Michelle , Leahy Pat
Published: August 2011

The National Service Framework for Older People (DoH, 2001) is a ten‐year plan which aims radically to improve health services for older people. Central to the plan is the belief that older people should be involved as ‘genuine partners’ in the implementation process. In this article we describe how regional and local implementation teams in the North West of England are working in partnership to develop a coherent and sustainable strategy for engaging with older people.
Disabled Children's Perspectives
Authors: Dow John
Published: August 2011

This article describes the duties of statutory agencies to ascertain the views of disabled children and to involve them in decisions that affect them. Related to this duty is the responsibility to provide speech and language therapy. The role of advocates in supporting disabled children is considered.
Ensuring Access to Short Breaks by Black Disabled Children and their Families
Authors: Flynn Ronny , Patel Pratima
Published: August 2011

There are still barriers preventing Black disabled children and their families from accessing short break services. The paper highlights results of two studies highlighting some of these barriers, together with messages for front‐line staff and managers of children's services.
Why Living in a Deprived Area is a (Hidden) Disability Issue: Some Housing Policy and Practice Implications
Authors: Allen Chris
Published: August 2011

Housing policy debates currently focus on the need to remove physical barriers that exclude disabled people from undertaking normal, everyday activities in the home and neighbourhood environment. They have not yet considered the impact that living in poverty has on the social exclusion of disabled people. This article outlines some key findings from a recent study which found that the everyday experience of living in a deprived area, rather than physical barriers, was a key cause of social exclusion among visual impaired children. However, most housing providers were wedded to the narrow ‘physical barriers’ view of the causes of disability, and were therefore unresponsive to parents' requests for a transfer to a better area for their children.
Money Matters: An Evaluation of the Direct Payment Pilot Project for Parents of Disabled Children in Staffordshire
Authors: Leece Janet , Babb Caroline , Leece David
Published: August 2011

This paper presents the findings from an evaluation of a direct payment pilot project for parents of disabled children in Staffordshire. The study found that, for a variety of reasons, parents accessing direct payments did not report any greater benefits than those using traditional services.
Valuing Assessments and Reports? The Impact of Valuing People on People with a Learning Disability
Authors: Cumella Stuart
Published: August 2011

Valuing People has been widely welcomed by learning disability services. But it promises a major expansion of unenforceable assessments which will divert practitioners from responding to the needs of their clients into the production of reports.
Factors Promoting and Obstacles Hindering Joint Working: A Systematic Review of the Research Evidence
Authors: Cameron Ailsa , Lart Rachel
Published: August 2011

This article reports the findings of a systematic review of the factors promoting and obstacles hindering joint working at the NHS/social services interface. The review provides robust, research‐based evidence about different models of joint working across the interface at the strategic, commissioning and operational levels and describes the factors known to have an impact on the success of joint working.
Wiltshire's Pathways: Engaging Stakeholders in Planning Joined‐up Children's Services
Authors: Fanshawe Peter
Published: August 2011

This is a case study of an innovative process for integrating the commissioning of services for children and families based on identified needs.
Disability, Participation and Welfare to Work in Staffordshire
Authors: Wood Michael
Published: August 2011

Staffordshire's Welfare to Work Joint Investment Plan is an inter‐agency approach to improving job opportunities for disabled people and carers, emphasising the need for their participation in this process. A partnership with Staffordshire University has enabled disabled people to acquire research skills and survey the views of other disabled people on barriers to employment and strategies to overcome them. The article shares this innovative approach to participation and welfare to work.
Partnership Boards ‐ Making Them Work
Authors: Scott Joan
Published: August 2011

Written from the user perspective, this article outlines good practice in the establishment and running of partnership boards in learning disability services. It is based on the experience of People First in Norfolk. The article is presented in a way that highlights the author's recommendations about effective communication.
Implementing Person‐Centred Planning by Developing Person‐Centred Teams
Authors: Sanderson Helen
Published: August 2011

Person‐centred planning is central to Valuing People. This has resulted in lots of planning activity, but implementing plans in services is deeply challenging. Developing person‐centred teams is a key to implementing plans. This article presents a model for developing person‐centred teams based on research. Examples of how teams worked to implement plans are shown to illustrate this process and clarify why it requires a change in thinking as well as a change in practice.
Ordinary Residence
Authors: Dow Jon
Published: August 2011

Supporting People has raised new issues relating to ‘ordinary residence’, as people with learning difficulties move from care homes to supported living schemes. This article examines the legal background and the factors which can determine where a person is ‘ordinarily resident’ and, consequently, which local authority is responsible for providing community care services.
Real‐Life Research: Bridging the Gap between Research and Practice
Authors: Trappes‐Lomax Tessa , Ellis Annie
Published: August 2011

Research partnerships between ‘thinkers’ and ‘doers’ are now thought likely to deliver more useful and useable knowledge for health and social care. So far there is little guidance about making these academic/operational links work on the ground. We have used our own experiences of this approach, together with evidence from existing literature, to explore such partnerships. We conclude that, while they are fine in principle, it is difficult in practice to balance the twin demands of operational relevance and academic rigour. Such links may need rather different and better resourcing if they are to work properly.
Meeting the Social and Emotional Needs of Young Black Disabled People: Messages from Research
Authors: Bignall Tracey
Published: August 2011

This article is based on two research studies exploring the everyday life experiences of young Asian, Caribbean and African disabled people. It suggests ways in which local agencies might help young people meet their social and emotional needs, particularly through the development of peer support groups.
Child Protection Post‐Laming: The Wider Agenda
Authors: Bullock Roger
Published: August 2011

The Laming Inquiry into the death of Victoria Climbié recommends national and local changes to the child protection process. While the benefits of national reforms are uncertain, changes in local practice are clearly necessary. Greater consensus about the information necessary to inform decisions and its interpretation is likely to improve matters. But, it is argued, practice development has to be informed by research into the epidemiology of child abuse and the effects of decisions on children's welfare. A common language to identify and analyse children's needs and relate them to services, manifest in validated practice tools for use by managers and practitioners, is suggested as a way forward.
Duties to Care Leavers
Authors: Dow Jon
Published: August 2011

This article takes a fresh look at the duties to care leavers, focusing on the overlap with adult services in relation to young care leavers over the age of 18.
Can Complexity Theory Provide Better Understanding of Integrated Care?
Authors: Kernick David
Published: August 2011

The patterns of health and social care provision in the community have always been complex. The Government's current call to integrate systems of care can be seen as a search for greater simplicity and predictability, but people in these systems know that any new networks will be equally complex. This article argues that our organisations and systems should no longer be viewed and managed as ‘machines’ with inherent rationality, and suggests that the new intellectual discipline of complexity theory offers a more relevant model with which to view the real world where we operate under the constraints of limited time, knowledge and processing power. The author is a general practitioner with an interest in applying complexity insights to health care organisation.
Making Sense of Organisational Change in Primary Care Trusts
Authors: Waddington Paul
Published: August 2011

This article starts with a case study of organisational development consultancy with a primary care trust (PCT) in the Midlands which has used the generation of metaphorical organisational images as a key working method. It aims to draw out lessons for other localities and organisations facing the challenge of integrating a range of different interests into a coherent and effective whole. It suggests that the lack of ‘organisational literacy’ is a major barrier to progress in health and social care agencies which has to be confronted openly.
Developing Integrated Support for Deafblind People: Social Services Going it Alone?
Authors: Wood Michael , Leece Janet
Published: August 2011

This paper considers recent guidance on social care for deafblind adults and children issued to local authorities in March 2001 by the Department of Health under Section 7 of the Local Authority Social Services Act 1970. It uses Staffordshire Social Services Department's response to the guidance as a case study to identify areas of good practice and make practical suggestions for implementation. The guidance places the responsibility for improving provision to deafblind people squarely on social services, rather than including other agencies such as health and education. The paper argues that this may be hindering the development of integrated services.
Integrated Working: A National Initiative to Bridge the Gap between Research and Practice
Authors: Crawford Alix
Published: August 2011

This article describes a government‐sponsored initiative to promote integrated working in health and local authority services for adults and children. It outlines the policy context for the initiative, its background, what it does and how local organisations can get involved. It particularly emphasises the need to bridge the gap between research and practice.
Home and Away: Home from Hospital, Progress and Prospects
Authors: Waddington Eileen , Henwood Melanie
Published: August 2011

Home from Hospital schemes run in the UK by the British Red Cross meet and match intermediate care policy's objectives. A review of 17 schemes undertaken in 1996 is compared with a review of 55 schemes operating in 2003. It suggests that such schemes are addressing needs and have the potential to develop work in prevention of hospital admission and to improve health generally.
Leading the Drive for Evidence‐Informed Practice
Authors: Hodson Rhiannon , Cooke Elizabeth
Published: August 2011

This article examines the challenges facing agencies working across social care, health, education and voluntary sector boundaries in leading a drive for evidence‐informed practice (EIP). A study conducted by Research in Practice has identified the competencies and functions that managers deem most important to lead an EIP initiative successfully. Views about agencies' current capabilities and confidence to do so vary. Leadership development opportunities are generally perceived as poor. Plans are outlined for an action learning project within the Research in Practice network to support managers to lead EIP effectively.
Improving Intermediate Care: Giving Practitioners a Voice
Authors: Nancarrow Susan
Published: August 2011

This paper presents the experiences and perspectives of practitioners involved in the delivery of intermediate care. The findings emerged from three workshops involving therapists, nurses, social workers and managers from across South Yorkshire which were designed to explore service development issues and practitioner roles in intermediate care delivery. It explores the practitioners' interpretations of intermediate care and their vision for the future of the service, and discusses the implications for services, employers and policy makers.
Organising Social Care Knowledge: In Search of a ‘Fit for Purpose’ Classification
Authors: Grayson Lesley , Boaz Annette , Long Andrew
Published: August 2011

Classification is a useful tool for understanding, organising and accessing knowledge. It can form a valuable part of the infrastructure of evidence based policy and practice by clarifying the full range of knowledge that might be relevant to a practitioner or policy maker's information need. This paper explores two possible classifications for social care, one based on the purposes of knowledge, and the other on the institutional sources of knowledge. Following application to a sample of social care documents, the sources‐based approach is identified as the most ‘fit for purpose’ for the social care community.
Working Partnerships? A Critique of the Process of Multi‐Agency Working in Services to Disabled Children with Complex Health Care Needs
Authors: Townsley Ruth , Watson Debby , Abbott David
Published: August 2011

Recent government policies in relation to children stress the importance of service integration and partnership working, with particular emphasis on combating social exclusion. With reference to findings from a three‐year empirical study, this article examines some key elements of the process of multi‐agency working in services for disabled children with complex health care needs. It highlights some of the barriers to effective partnerships and lists some pointers for policy and practice.
Hidden Shame ‐ A Review of the Needs of Asian Elders with Dementia and their Carers in a Kent Community
Authors: St. John Tara
Published: August 2011

This article outlines the findings and general implications of Mental Health Foundation research into the needs of older Asians with dementia and their carers. The project was carried out in an area with an Asian majority population in North West Kent. The focus is on the identification of need and on factors which block access to care and support. There are recommendations for practitioners and commissioners about raising awareness, service development and training.
Multi‐Agency Public Protection Arrangements
Authors: Dow John
Published: August 2011

Multi‐agency public protection arrangements (MAPPA) involve joint working between agencies involved with certain offenders on their release from prison. This article looks at the statutory background and changes which are taking place from April 2004, as well as problems which can arise with regard to the sharing of information and identifying suitable housing.
What Users Have to Say about their own Organisations: A Local User‐Controlled Study
Authors: Evans Clare , Evans Ruth
Published: August 2011

Based on the experience of Wiltshire and Swindon Users' Network, this article presents findings from a small user‐controlled study of members' perceptions of their own organisation. Peer support, information provision and speaking with a ‘collective voice’ emerged as key aspects of their involvement which members valued. Although WSUN provided a range of opportunities for involvement in social care and health services, members identified training and recruitment of professionals and presentations as areas for greater involvement. The study calls for greater recognition of the important role that usercontrolled organisations can play in empowering users on a personal level, as well as bringing about change in social care and health services through effective user involvement.
Delayed Discharge: Preparing for Reimbursement
Authors: Lymbery Mark , Millward Andy
Published: August 2011

This paper considers the development of policies to implement the Community Care (Delayed Discharges etc) Act 2003 in one locality. It argues that the legislation has stimulated new thinking about the management of the problem of delayed discharge, although many issues remain to be resolved in its implementation.
Information for Older People: The Contribution of Local Authority Websites
Authors: Raynes Norma , Pagidas Dimitri , Margiotta Pat , Lawson John
Published: August 2011

Older people currently do not view websites as a preferred source of information. This may not be a view held in the future. An exploration of local authority websites suggests room for improvement and collaboration with others to shape a future in which websites are joined up and informative for older people.
The New Multi‐Agency Working: Collaborating to Prevent the Social Exclusion of Children and Families
Authors: Edwards Anne
Published: August 2011

The paper focuses on preventative services for children, young people and families. It argues that client‐led service provision calls for flexibility from service providers, using the distributed expertise to be found across the professions involved and a high degree of interprofessional trust. All this, in turn, requires a systemic response from the major agencies if they are to support this new professionalism.
Make Outcomes your Big Idea: Using Outcomes to Refocus Social Care Practice and Information
Authors: Ball Stephen , Mudd Judith , Oxley Marie , Pinnock Mike , Qureshi Hazel , Nicholas Elinor
Published: August 2011

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.
Reimbursement — A Look Back and a Look Forward
Authors: Paley Christine
Published: August 2011

This paper considers the impact of reimbursement on delayed transfers and whole‐systems planning. The paper argues that making hospital discharge work with the focus only on the interface between health and social care will have limited and short‐term results. More radical cultural change is needed to tackle the problems of an ageing society. The paper draws on recent thinking which challenges the way in which services are currently provided to older people, and calls for new ways for services to be commissioned and provided. The paper advocates changes towards community‐based processes and pathways, across a wide range of services and within a much broader whole‐systems framework, to support independence.
The ICON Model ‐ A Case Study for Developing Integrated Care in Ireland
Authors: Tucker Helen , Larkin Veronica , Martin Martina
Published: August 2011

The Midland Health Board in Ireland has invested significantly in promoting integrated care in order to improve the quality and efficiency of its services. Stakeholders in all agencies have shared in the creation of the ICON model that provides a structured approach to integration. The diagrammatic model has enabled shared understanding of providing, managing and receiving integrated health and care services. A resource pack and measurement tool have been developed to continue to support the increasing number of implementation sites for integration across all client groups. The transferability of the project is being tested in another Board in Ireland, and lessons will be shared as the projects progress.
Introducing the International Journal of Integrated Care
Authors: Schrijvers Guus , Manten Erika
Published: August 2011

This article introduces the on‐line International Journal of Integrated Care to British subscribers to the Journal of Integrated Care. It is hoped that a working partnership can be established between the two publications.
‘The Squeaky Wheel gets the Grease’: A Case Study of Service User Engagement in Service Development
Authors: Nancarrow Susan , Johns Anna , Vernon Wesley
Published: August 2011

This paper discusses the practicalities and limitations of establishing a service user consultation group to guide service developments, based on the evaluation of a podiatry patient panel in South Yorkshire. It describes the specific difficulties in recruiting a representative panel of service users, and the gradual acculturation of the panel from a group of challenging activists to unpaid members of the podiatry department.
Involving Patients and Service Users in Student Learning: Developing Practice and Principles
Authors: Gordon Frances , Wilson Fiona , Hunt Tim , Marshall Michelle , Walsh Claire
Published: August 2011

This paper describes work with patients/service users, students and educators, resulting in the identification of key issues to be addressed when planning patient/service user participation in interprofessional student learning. Preparation, communication, support and debriefing for both students and lay participants were revealed as essential for successful patient/service user involvement in education.
Joined‐up Law?
Authors: Dow John
Published: August 2011

The article reflects on the law and current policy and practice and their implications for joint working. Decisions are still determined by separate legislation and guidance, even where joint working is the necessary and approved approach. A universal approach to assessment is advocated.
Older People with Learning Disabilities: Workforce Issues
Authors: Hussein Shereen , Manthorpe Jill
Published: August 2011

The life expectancy of people with learning disabilities has increased substantially. Services for older people with learning disabilities are provided by various sectors and practitioners (generic health and social care, or specialist learning disability or old age). The literature suggests that practitioners do not feel well‐equipped to support people with learning disabilities as they grow older, and older people's services do not always have the opportunity to share experiences and skills. This paper highlights areas such as dementia support, where the intersection between services is not clear, and explores what might help practitioners to meet the needs of people with learning disabilities as they grow older.
Redefining the Role of Support Workers in Intermediate Care: Key Findings from a National Project
Authors: Ottley Erika , Tongue Alison , McGill Marian
Published: August 2011

The Accelerated Development Programme (ADP) is a tried and tested ‘spread’ methodology. It is widely used by the Changing Workforce Programme (CWP) to help health and social care communities to develop, test and implement new and amended roles. Drawing on the evidence for a generic health and social care support worker role and on good practice examples, an ADP was agreed, with the aim of developing 300 support staff working in intermediate care services in England.Teams started to participate in the ADP in September 2003 and the programme ran for 12 months. Towards the end, teams were asked to complete a questionnaire. This paper is based on the picture emerging from analysis of their responses, with key implications drawn out to assist local planning.
Delayed Transfers of Care — An Early Review of Progress
Authors: Behan David
Published: August 2011

Using the findings from a CSCI study undertaken in the first months after the implementation of the Community Care (Delayed Discharges) Act 2003, this article outlines key issues for the immediate future. It is the third in a sequence of articles in the Journal of Integrated Care on this priority policy issue, and the first to report on implementation.
Will Care at Home Replace Care Homes?
Authors: Rice Tony
Published: August 2011

Nursing and residential care homes provide familiar and safe environments where any risks to individuals are minimised. But equally important is maintaining a sense of independence ‐ a balance that's difficult to strike in a supervised home. So could the latest generation of assistive technology provide safety and reassurance for people in their own homes? This article looks at the issues.