bluuebunny/crossref_metadata_2025 huggingface dataset:
Modernising Adult Social Care: Researching the Impact of Reform on Service Users
Authors: Newman Janet
Published: August 2011

This article highlights challenges faced by researchers in the Department of Health's programme of research on Modernising Adult Social Care in trying to assess the impact of reform on service users. It explores the changing relationship between service users and service providers, focusing in particular on the author's own research as part of an ESRC/AHRB‐funded project on Creating citizenconsumers: changing relationships and identifications. Rather than a one‐way relationship between policy reform and user impact, the article highlights the importance of bringing users into the research process itself.
Managing Assistive Technology in Hospice Homecare: Implications for Multi‐disciplinary Teams
Authors: Cornes Michelle , Weinstein Pauline
Published: August 2011

Assistive technology can make a significant difference to the lives of service users and carers, especially when dovetailed with health, housing and social care. In support of this aim, the UK Government recently announced £80 million funding for a Preventive Technologies Grant over two years from April 2006, to extend the benefits of new technology ‘community alarms’ with the aim of reducing the number of avoidable admissions to residential care and to hospital. Once the preserve of the allied health professions, multi‐disciplinary teams of professionals are increasingly expected to take on responsibility for assistive technology and the equipment that accompanies it. This article explores the use of assistive technology from the perspective of practitioners working in multi‐disciplinary hospice homecare. It draws on the findings of a small evaluative study of 25 hospice homecare schemes which participated in a project centred on rapid access to community alarm technology. It considers obstacles to implementation and workforce development issues arising out of an increased focus on assistive technology as a means of better managing the support of terminally ill people at home.
Modernising Adult Protection: An Inside or an Outside Job?
Authors: Manthorpe Jill , Penhale Bridget , Perkins Neil , Pinkney Lisa , Kingston Paul
Published: August 2011

This article presents an analysis of modernisation as it affects adult protection in England. One of the key policy goals of modernisation has been to improve protection of service users. The article outlines some areas of good practice that are emerging and draws attention to some of the latent conflicts that are apparent.
Joint Working Between Social and Health Services in the Care of Older People in the Community: A Cost Study
Authors: McCrone Paul , Iliffe Steve , Levin Enid , Kharicha Kalpa , Davey Barbara
Published: August 2011

There have been few economic evaluations of joint working between social and health care. This paper focuses on collaboration between professionals providing care for people aged 75 and over, and examines the economic costs of contacts made by social workers with community nurses, GPs and older people or their carers. Two areas were studied, one where social care and primary care services were co‐located, and the other with social work teams located separately from local health services. The two forms of social care location had an impact on contacts and costs but overall it was fairly small. Contact costs made up only a small amount of the overall costs of care These findings suggest that altering the organisational arrangements for care delivery may improve the process of care delivery, but result in only minor changes to the proportion of overall resources directed to older service users.
The Castlefields Integrated Care Model: The Evidence Summarised
Authors: Lyon David , Miller Julia , Pine Kirsty
Published: August 2011

This article presents and reviews the evidence from a pilot project in the North of England in which a social worker was based in a surgery and worked proactively with a district nurse to introduce an integrated case management approach for patients in the practice. Decision‐making was noticeably simplified and speeded up, with most assessments completed in a single day. The authors recommend that PCTs should consider the benefits of social care input to case management, especially when planning new services and new roles such as that of community matron.
Independent Mental Capacity Advocates
Authors: Dow John
Published: August 2011

The Mental Capacity Act 2005 provides that independent mental capacity advocates (IMCAs) must be consulted before certain decisions are made on behalf of people who lack capacity. This article describes the principles in the Act under which such decisions are made, the role of IMCAs and proposals for the establishment of the IMCA service.
Dreaming for Real: The Development of Partners for Inclusion
Authors: Fitzpatrick Julia
Published: August 2011

Partners for Inclusion aims to deliver person‐centred support services, following its dream of providing individualised supports for people to have real lives as valued citizens in their communities. The article explores core principles and practical applications in getting the right relationships, and considers some challenges in developing organisational culture and structures which support and reinforce this.
An Individual Budget in Practice
Authors: Tomlinson Caroline
Published: August 2011

This is a personal account of how a family moved from being passive recipients of care to being ‘in control’. Anticipating the expansion of such schemes with the forthcoming White Paper, the account explains the mechanics of an individual budget enabling self‐directed care.
Integrated Team Working Part II: Making the Inter‐Agency Connections
Authors: Hudson Bob
Published: August 2011

In the first of these two articles on integrated team working (Hudson, 2006) the focus was on the nature of the front‐line integration ‐ the Sedgefield Integrated Team (SIT). Positive findings were reported on the ways in which professionals from disparate backgrounds under single management were working together for service users. However, it is important to nail the myth that front‐line staff will happily and creatively collaborate if only managers would leave them to it. The reality is that initiatives like SIT have no qualities of spontaneous growth or self‐perpetuation ‐ they need to be planned, created and nurtured by policy‐makers and managers. This article looks at how these activities, known locally as the ACCESS programme (Adult Community Care Enhancement Strategy for Sedgefield), were undertaken in Sedgefield.
Delivering Unique Care: Care Co‐ordination in Practice
Authors: Adam Ruth
Published: August 2011

The National Primary Care Development Team (NPDT) is spreading the Unique Care approach to case management across the country, and this article presents a case study of how Brent is successfully implementing Unique Care through the Care Co‐ordination Service. It aims to outline key steps in the development of the service, moving from the initial vision, to pilot phase and on to mainstreaming of the service. The collaborative methodology was adopted. The evidence suggests impressive reductions in service use, alongside an increase in quality of life and improved perception of health and social care services among older people who have had contact with the team.
Learning from Doing: Implications of the Barking and Dagenham Experience for Integrating Health and Social Care
Authors: Wistow Gerald , Waddington Eileen
Published: August 2011

Local government and the NHS in Barking and Dagenham embarked on a bold initiative in 2001 to integrate health and social care management structures. Although it was not sustained, this local experience is an important source of learning as the search for improved partnership working enters yet another new phase. In particular, it demonstrates that the route to better outcomes depends on managing not only the tension between structure and culture, but also that between national targets and local discretion in services based on fundamentally different principles of governance: central management and local accountability.
Extra Care Housing for People with Dementia
Authors: Dow John
Published: August 2011

This article considers some of the legal complexities involved in developing extra care housing for people with dementia.
From Care Management to Case Management: What can the NHS Learn from the Social Care Experience?
Authors: Jacobs Sally , Hughes Jane , Challis David , Stewart Karen , Weiner Kate
Published: August 2011

Care management has developed in a variety of forms. This diary study explores differences in the approach taken to care management in three distinct social service settings: community‐based older people's teams, hospital social work teams also for older people and community‐based teams for adults with mental health problems. Conclusions are drawn both for social care and for health services developing case management for people with long‐term conditions.
In Control: The Story so Far
Authors: Sanderson Helen , Duffy Simon , Poll Carl , Hatton Chris
Published: August 2011

In Control is a system of self‐directed support. This paper tells the story of its first two years and of the pilot implementation projects run in six local authorities. The key findings from the evaluation are that people are more self‐determined, people have a better sense of direction in their lives, people's support has improved, people's money situation has improved, people are improving their home situation and people's community lives are improving.
Implementing the White Paper: The Leadership and Management Challenge in Remodelling the Workforce
Authors: Hoodless Donald
Published: August 2011

This article highlights important points raised in a keynote speech delivered at the Guardian's Managing New Realities conference on 22nd March 2006. It draws particularly on the New Types of Worker project created by Skills for Care, and emphasises the need for local leadership to overcome the barriers to collaboration that are likely to prevent emergence of a remodelled workforce in practice, which is seen as central to effective implementation of the White Paper.The article underlines the need for:• a national coherent framework setting out the pathway to realising the visions set out by the White Paper• a local framework to deliver primary social care, with the primary care trusts and local government working as one• a common set of cultural values throughout health and social care• clear and agreed funding arrangements, along with a workforce development programme to keep pace with changing service requirements• public support for change, to achieve a seamless service without the gaps that lead to tragedy.It is through addressing these challenges to primary health and social care that the remodelling of the workforce will come about.
New Roles in Mental Health: The Creation of the Approved Mental Health Practitioner
Authors: Rapaport Joan
Published: August 2011

The current role of the approved social worker (ASW) will be changed to that of the approved mental health practitioner, who may be a nurse or other mental health professional, if proposed legislation comes into force in England and Wales. This has implications for service users, carers and the mental health workforce. This article draws on literature and a conference discussing this change attended by practitioners and policy‐makers. It considers the complexity of the ASW role and the implications for the AMHP, and sets the related issues in the context of integrated working.
Connected Care in Hartlepool: From Origins Towards Reality?
Authors: Wistow Gerald , Callaghan Gill
Published: August 2011

Hartlepool's connected care pilot is a partnership between residents, councillors, Turning Point, the NHS and the local council in one of the most deprived wards in England. A local audit was conducted by residents, demonstrating the relevance of information held by the community about its needs, ambitions and interactions with services. A new service model aims to provide integrated responses to complex need, commissioned through a local partnership agreement and delivered through a social enterprise. The implementation will demonstrate how far real power is shifting to local people.
Direct Payments: What Needs to Change?
Authors: Speed Iain
Published: August 2011

The national direct payment scheme has been introduced to give disabled people more personal control over care and support needs. I have cerebral palsy, and have been a user of direct payments for just under ten years. On the whole, the scheme has given me far more independence by allowing me to receive personal care when I choose, but there are demands and areas that I think have a negative impact and that need changing. The importance of this improved independence is more significant as I have a professional career and it, too, makes demands and responsibilities on my time.
Operating a Pooled Budget and Lead Commissioning Using Health Act Flexibilities: The Oxfordshire Experience
Authors: Roberts Diana
Published: August 2011

The article outlines the approach taken in Oxfordshire to pool significant County Council Social & Community Services and Primary Care Trust budgets to purchase primarily bed‐based services to achieve the right outcomes for services users and best value for the organisations. It sets this initiative in the context of relevant Oxfordshire data. It describes the processes involved, the benefits and outcomes to date and the initial lessons learnt.
Partnering Through Networks: Can Scotland Crack it?
Authors: Hudson Bob
Published: August 2011

Unlike the Westminster Parliament, the Scottish Parliament has shown little interest in marketoriented policies like foundation trusts, payment by results and practice‐based commissioning; rather, the emphasis has been on collectivism and partnership working. This article examines the growing interest in Scotland in ‘networks’, especially the idea of ‘managed care networks’ in respect of services for older people. It looks at different interpretations of the concept, the determinants of network effectiveness, and how networks might be operationalised and evaluated.
Are Foundation Trusts a Good Thing? Issues for Community Stakeholders
Authors: Lusk Frank
Published: August 2011

This article reviews the government thrust for foundation trust status for NHS providers, drawing out implications for public engagement, partnerships with wider stakeholders and the relationship with social care services. It explains the potential benefits of the change, in the context of expressed concerns about privatisation, the particular difficulties for community services like mental health, and uncertainties about existing s31 partnership agreements.
Partnership Working and Outcomes — A Case of the Hare and the Tortoise?
Authors: Edwards Amanda
Published: August 2011

‘Slow and steady wins the race’ is the conclusion of Aesop's fable. In ensuring that we do not fall asleep on the way (like the hare), is there a danger that in the race to demonstrate improved outcomes we will miss the opportunity to build knowledge about how partnerships can deliver better results for people who use services? This article argues for an ambitious agenda, accompanied by a more patient, focused approach to evaluation that helps us to learn and develop new questions.
Organisational Issues Facing a Voluntary Sector Mental Health Service for Homeless Young People
Authors: Taylor Helen , Stuttaford Maria , Vostanis Panos
Published: August 2011

The voluntary sector has an important role to play in the provision of services for people with mental health needs of lesser severity, thus complementing statutory services, as suggested by recent national policy. This article describes such a service for young homeless people, and discusses the perceptions of key stakeholders of the benefits and challenges of such a service. The service largely met the mental health needs of young people who would not have easily accessed statutory mental health services, and who fulfilled the criteria (low/moderate need) of the service. Challenges for the future included the different organisational cultures, the professional isolation of the mental health practitioners and the lack of operational and commissioning links with statutory mental health services.
Commissioning Services for Older People with Mental Health Problems: Is There a Shared Vision?
Authors: Tucker Sue , Hughes Jane , Scott Judy , Challis David , Burns Alistair
Published: August 2011

UK policy seeks to shift commissioning of services ‘closer to the people’ with a view to establishing shared visions of local care services grounded in the opinions and priorities of the public. The participation of older people with mental health problems and their carers in the strategic planning process has been patchy, however. This article compares practitioner and public perspectives of the services that should be provided for older people with mental health problems in an area of North West England. Significant differences were found in the services the various stakeholder groups prioritised for development, and in their views on how they should be organised. The implications for commissioning are discussed.
Evaluating Personalised Services
Authors: Smith Andy
Published: August 2011

The article describes the Five Dimensions of Person‐Centredness, an evaluation tool developed specifically to explore supported living and inclusion‐orientated organisations. It explores some of the learning gained from using the evaluation process with four organisations in Scotland, and includes identification of common themes that make the difference when personalising support.
Holistic Thinking and Integrated Care: Working with Black and Minority Ethnic Individuals and Communities in Health and Social Care
Authors: Harrison Philomena
Published: August 2011

The purpose of this paper is to introduce a series of articles which explore the theme of holistic care and integrated practice with BME individuals and communities who access health and social care services.
Changing the Focus of Community Mental Health Teams: A Study in one English Locality
Authors: Hatfield Barbara , Sharma Indhu , Ryan Tony
Published: August 2011

This study of community mental health teams (CMHTs) in Knowsley aimed to provide information about changes to the service user group and the nature of work undertaken in the teams following the implementation of the national service framework for mental health. Clear changes in the balance of work undertaken were identified, reflecting successful implementation of the new policies and appropriate selection of cases. Issues raised by such developments are summarised in view of their relevance to other localities.
NHS Learning Disability Services: Implications of the Cornwall Report
Authors: Dow John
Published: August 2011

‘NHS bodies who run care homes or domiciliary agencies must immediately seek to register their services with CSCI’. This was the first of a number of national recommendations in a report by the Healthcare Commission last year following an investigation into services for people with learning disabilities in Cornwall. This article will consider the implications of this recommendation in the context of the requirements of the Care Standards Act.
Local Area Agreements: Strategic Facilitators for Integrated Care?
Authors: Watson Mark
Published: August 2011

Local area agreements (LAAs) are important vehicles for carrying forward an integrated local agenda, and there is no shortage of documentation explaining to local authorities why this is so, what they need to do, when it needs to happen and who needs to be involved. This article looks at research on the experiences of those delivering LAAs in local authorities which outlined practical steps that need to be taken to support front‐line teams grappling with the challenges that arise in taking forward integrated care delivery.
Building Capacity in Health and Social Care Partnerships: Key Messages from a Multi‐Stakeholder Network
Authors: Cook Ailsa , Petch Alison , Glendinning Caroline , Glasby Jon
Published: August 2011

Successful development of health and social care partnerships is contingent on the contribution of all stakeholder groups to overcome the ‘wicked’ issues that beset the field. This article explores four key issues, identified by a network of diverse stakeholders as vital to the future of health and social care partnerships, and proposes ways in which individuals and organisations from all stakeholder groups can support health and social care organisations to work together to deliver good outcomes to service users and their carers.
Anticipatory Case Management and Practice‐Based Commissioning in Oxfordshire
Authors: Peretz Liz , Bright Sarah
Published: August 2011

This case study describes how two of the Government's key initiatives have been brought together to drive the integration agenda locally. Practice‐based commissioning is being used in one English county to integrate health and social care practice, and so promote independent living in the community. A model of anticipatory case management is being developed at local level, focusing on individuals identified by use of a standard tool (PARR) as at risk of re‐admission to hospital. Historical barriers to this sort of initiative are being overcome.
Commentary
Authors: Harrison Philomena
Published: August 2011

Gilbert's article underlines the need for social and mental health services to recognise spirituality as part of the ‘whole person’. To do this effectively in our multi‐cultural, multi‐faith society will require dismantling of stereotypes and sensitivity to the needs of BME communities.
Working Jointly to Scrutinise Health?
Authors: Coleman Anna
Published: August 2011

What difference is the operation of local authority health scrutiny making to the oversight and democratisation of decision making by health bodies? This article provides an insight into how a group of local authorities in England tackled the operation of a specific joint health scrutiny committee. This example highlights building relations with associated health bodies and other local authorities, choice of health scrutiny agenda, ways of working, capacity of committees, ambiguities within the policy itself, and the difficulties and challenges of adding meaningful democratic oversight to the decision‐making processes of NHS bodies. This review highlights some of the benefits of health scrutiny, but suggests that engaging more fully with patients and the public in such reviews could result in a more influential and inclusive process.
Creating Integrated Care: Evaluation and Management of Local Care in Sweden
Authors: Ahgren Bengt
Published: August 2011

It seems impossible to create a comprehensive evaluation model which fully takes into account the multi‐dimensional context of integrated health and social care. Clinical integration, as a prerequisite for efficient outcomes of integration, must nonetheless get special attention. For more extensive evaluations, a quality chain matrix, including co‐operating acts by different providers, has proven to be useful. Examples of evaluated services in Sweden are given, and the management benefits of the use of evaluation data are highlighted.
The Challenge of Building the Knowledge Base in Changing Contexts of Care
Authors: Blewett James
Published: August 2011

This article examines the role of research dissemination in the development of the knowledge base that underpins the integration of care. It does so from the perspective of the university‐based social care research dissemination network Making Research Count (MRC). The author, who is the Research Director for MRC in London, looks at the experience of this project in the context of the surprisingly limited evidence on the effectiveness of different models of research dissemination.
Black and Minority Ethnic People and Mental Health in Britain: An Holistic Approach
Authors: Marrington‐Mir Parveen , Rimmer Annette
Published: August 2011

This paper challenges the medically dominated mental health orthodoxy in Britain. It advocates an integrated community development approach underpinned by anti‐racist, empowering practice. It offers successful practice examples of a holistic, self‐governed mental health system for Black people in Britain. The paper draws on the philosophy of social action and Ubuntu, the African model of collective support, and arguments for empowerment and participation. Together these influences form the basis of community development work in Britain and globally.
Reducing Unplanned Hospital Admissions and Hospital Bed Days in the Over 65 Age Group: Results from a Pilot Study
Authors: Keating Patrick , Sealy Angela , Dempsey Linda , Slater Beverley
Published: August 2011

Against a background of an ageing population, rising emergency admissions and a policy direction moving towards providing care in the least intensive setting, this paper presents the dramatic results achieved in a 22‐week pilot of undivided health and social care replicating the Castlefields study and using Unique Care principles. In the context of practice‐based commissioning, where GP practices develop and commission services that represent the best model of care and use of resources for their patients, the potential for creating savings from this approach are discussed.
Mental Capacity Act
Authors: Dow John
Published: August 2011

This article will examine the changes in law brought about by the Mental Capacity Act and consider the practical implications for health and social care staff.
Connected Care in Hartlepool Re‐visited: Can a Holistic and Community‐ Centred Approach Survive Implementation?
Authors: Wistow Gerald , Callaghan Gill
Published: August 2011

This article is the second which the Journal of Integrated Care has published about the Hartlepool connected care pilot. It takes up the narrative from the launch of the community audit report in February 2006 to the project's successful bid to become one of the 26 DoH social enterprise pilots some 12 months later. It seeks to understand the barriers encountered as the pilot sought to implement a service model based on an audit of local needs and ambitions. It identifies the need for support outside the local policy systems if holistic, community‐based initiatives are to be initiated and implemented. In addition, it considers some of the implementation dilemmas that the pilot posed for local agencies and that it had itself to face and resolve during this second phase in its development.
Adult Care Joint Ventures: Some Possible Futures
Authors: Freeman Tim , Peck Edward
Published: August 2011

In this second and concluding paper on adult care joint ventures, the authors detail the very different approaches to adult care services taken by four case study sites, exploring the local contours and aspirations underlying their decisions. These are not intended as ‘off the shelf’ solutions for wide dissemination, rather to encourage others to engage with the legacy of previous partnership working and specific local contingencies.
Outcomes for Users and Carers in the Context of Health and Social Care Partnership Working: From Research to Practice
Authors: Miller Emma , Whoriskey Margaret , Cook Ailsa
Published: August 2011

There is currently much policy emphasis on both partnership working between health and social services in the UK and on the outcomes delivered by services. This article provides an account of two consecutive projects centred on these two themes. The first project, at the University of Glasgow, sought to address the lack of evidence about the outcomes delivered to service users by partnerships. Following from this project, the Joint Improvement Team of the Scottish Government commissioned the researchers to develop a toolkit to involve users and unpaid carers in performance management in community care in Scotland. The remit of this second project expanded during 2007 as it became linked with the development of the emerging National Outcomes Framework for community care in Scotland. This article outlines the outcomes‐based piloting work currently under way in Scotland.
Mental Health Act 2007
Authors: Dow John
Published: August 2011

The Mental Health Act 2007 makes significant amendments to the Mental Health Act 2003, and also amends the Mental Capacity Act 2005 with the introduction of ‘deprivation of liberty safeguards’.
Thinking Holistic, Thinking Integrated?
Authors: Harrison Philomena
Published: August 2011

The purpose of this article is to review the series of five articles which have appeared in the Journal since the June 2007 edition. The authors of the articles in the series were tasked with exploring the theme of holistic care and integrated practice with BME individuals and communities who access health and social care services. This article explores how far this issue has been addressed, and offers some ways forward in thinking about integrated care for BME individuals and communities.
Towards World Class Commissioning? New Approaches to Service Delivery for People Facing Social Exclusion
Authors: Kramer Richard
Published: August 2011

Persistent and particular health and social care challenges face socially excluded groups and communities in the more deprived areas of the country. Involvement of communities in design and delivery of services, including those whose voices have traditionally not been heard, will help to shape services to meet better their health and well‐being needs. Effective community‐led commissioning can empower individuals and communities by giving them the chance to voice their needs, while local ownership of the process will increase the relevance of services, and improve their uptake and sustainability. For commissioners, the ‘World Class’ commissioning agenda is about connecting development of services with the real requirements of communities, and increasing engagement and satisfaction with services.
Disability Discrimination Law — ‘From Derision to Acceptance to Respect’
Authors: Dow John
Published: August 2011

A recent High Court case involving restrictions on eligibility criteria has highlighted the importance of public bodies' general equality duty under section 49A of the Disability Discrimination Act 1996.
Community Health (and Care) Partnerships in Scotland
Authors: Freem Isobel , Moore Keith
Published: August 2011

This article attempts to describe the Scottish approach to integrated care, covering historical background, policy context, progress towards implementation and current issues.
Assessing the Impact of Integrated Delivery Systems: Practical Advice from Three Experiments Conducted in Quebec
Authors: Bravo Gina , Raîche Michel , Dubois Marie‐France , Hébert Réjean
Published: August 2011

Interest has grown in integrated care models as means of responding better to the needs of frail older adults. In order to provide appropriate input for health policy reforms, the effects of integrated care must be assessed with sound methodologies. Based on three experiments conducted in the province of Quebec, Canada, this article provides practical advice on key issues involved in evaluating integrated care models.
What does the Human Rights Act add?
Authors: Dow John
Published: August 2011

Private care homes will become directly subject to the Human Rights Act, under new provisions in the Health and Social Care Bill. What difference will this make in practice?
The Effectiveness of Home Care Reablement — Developing the Evidence Base
Authors: Glendinning Caroline , Newbronner Elizabeth
Published: August 2011

Adult social care services are increasingly establishing reablement services as part of their range of home care provision, sometimes alone, sometimes jointly with NHS partners. Typically, home care reablement is a short‐term intervention, often free of charge, that aims to maximise independent living skills. This paper describes two small studies examining the impact of home care reablement on subsequent service use. The evidence so far strongly suggests that a period of home care reablement can reduce the subsequent use of home care services and that, for some people, these benefits may last for a year or more. However, a number of organisational and cultural factors can limit the immediate and longer‐term benefits of home care reablement.
The Mental Health of Older People: Taking a Long View
Authors: Manthorpe Jill , Iliffe Steve
Published: August 2011

This article is the first of a series on older people's mental health services (OPMH Focus 2008‐09). It sets out some of the challenges facing commissioners, and uses recommendations from a recent inquiry to outline possible commissioning objectives.
Health Scrutiny and Practice‐based Commissioning: Contradictory or Complementary?
Authors: Coleman Anna , Harrison Stephen , Checkland Kath
Published: August 2011

The Local Government Act (2000) introduced new Overview and Scrutiny Committees, composed of elected non‐executive councillors, that can respond to proposals from the NHS for changes in services and also set their own agendas for more detailed scrutiny, including of the NHS. Limited capacity has meant that the focus of scrutiny has often been on statutory consultations from the NHS, service provision, NHS organisations and only occasionally on wider issues. However, it is commissioning that is officially seen as the main vehicle for shaping NHS services, so health scrutiny ought logically to address itself more to commissioning than to investigating providers. Practice‐based Commissioning (PBC) was introduced in 2004 with the aim of engaging front‐line clinicians in commissioning health care, though most such commissioning is being undertaken by groups of practices joining together to form consortia, rather than by individual GPs. In principle, this makes it more practicable for health scrutiny to include PBC, but consortia are not statutory bodies and cannot be compelled to participate. We suggest ways in which this omission might be addressed.
Beyond the NSF: Continuing Older People's Involvement and Engagement
Authors: Cornes Michelle , Weinstein Pauline , Leahy Pat , Duncan Mary
Published: August 2011

In this article we report findings from a small scale user‐controlled study which explores involvement and engagement in terms of the legacy of the National Service Framework for Older People (NSFOP) and the new opportunities that are opening up around community well‐being and active citizenship. A key finding of the study is that, when participating in implementation of a major policy initiative, older people's reference groups and forums require good support: practical help with administrative tasks and more professionalised support to help develop members' skills as activists and campaigners. We distill what this means for practice in a commissioning framework which can be used to specify support services that may be provided to older people's groups by external organisations such as the voluntary and community sector. Here, involvement and engagement are understood as a dynamic relationship between three stakeholder groups (older people, the statutory sector, and the voluntary and community sector). We pinpoint likely tensions in these relationships and how they might be addressed.
Independence and Learning Disabilities: Why we Must also Recognise Vulnerability
Authors: Fyson Rachel
Published: August 2011

Services for adults with learning disabilities are currently based on the promotion of four key principles: rights, independence, choice and social inclusion. This paper will argue that, while these principles are welcome, they need to be balanced against a fifth principle ‐ that vulnerable adults must be protected adequately against the risk of abuse. It will draw both on recent high‐profile cases of violence and abuse against people with learning disabilities and on research evidence to explore whether current plans to transform adult social care through the use of self‐directed support and individual budgets offer a safe future.
The Heart of Integration
Authors: Rayner Hugh
Published: August 2011

The Medical Director of an NHS Hospital Trust in the Midlands gives a personal account of his thinking about integrated care and its importance in the immediate future. He underlines that integrated care requires a shift in behaviour, culture and attitudes, and outlines helpful approaches which can stimulate and support this. He illustrates the way change has been approached in local services, with particular emphasis on supporting self‐care and on primary care/secondary care partnership (or vertical integration).
Delayed Hospital Discharge in England and Scotland: A Comparative Study of Policy and Implementation
Authors: Godfrey M , Townsend J
Published: August 2011

Delayed hospital discharge has long been of policy interest in the UK. This paper presents findings from a comparative study of policy and approaches to implementation of reimbursement, in England, and Joint Action Planning, in Scotland, designed to tackle the problem of delayed hospital discharge.
Integrated Complaints Procedures for Health and Social Care
Authors: Dow John
Published: August 2011

The Department of Health plans to reform the NHS and social care complaints arrangements from April 2009. This article looks at the proposals and considers some of the key issues.
A review of Alam and Bagchi's “Supply chain capability as a determinant of FDI”
Authors: Niederman Fred A.
Published: August 2011

Purpose

The purpose of this commentary is to discuss the interpretation of the work by Alam and Bagchi in the larger context of foreign direct investment (FDI) in practice.

Design/methodology/approach

This commentary is an essay.

Findings

While this paper does a creditable job of inferring relationships based on available data, conclusions regarding the dynamics of FDI decision making in practice should be avoided. This is because all of the data used is inferred from observable precursors and effects of FDI, but does not observe actual decision making in practice.

Research limitations/implications

While noting that conclusions based on inference from observable and countable artifacts of FDI should be handled with caution, there are no recommendations in this essay about what alternative methods other researchers could use to obtain this sort of information.

Originality/value

The cautionary message of this commentary is not unique, but should be repeated frequently, as people all have a tendency to project from the data they have to what they would like to know.
The strategic development of subsidiaries in regional trade blocs
Authors: McDonald Frank , Josef Tüselmann Heinz , Voronkova Svitlana , Golesorkhi Sougand
Published: August 2011

Purpose

The purpose of this paper is to explore the relationships between the strategic development of subsidiaries and the likelihood of subsidiaries exporting on an intra‐regional basis to European markets.

Design/methodology/approach

The paper defines the strategic development of subsidiaries as increases in autonomy, embeddedness in host locations and use of networks and host country sourcing. The location of subsidiaries in industrial clusters is also considered. Use is made of multinomial probit analysis of a survey of 391 UK‐based subsidiaries to identify the relationships between the strategic development of subsidiaries and supplying European markets.

Findings

The study finds some evidence that there are links between increasing networks and supplying European markets, but there is no evidence that developing host country sourcing is associated with European supply. Location in an industrial cluster is consistently associated with supplying European markets, and autonomy also appears to be closely associated with supplying European markets.

Research limitations/implications

Extension of the research is required to other regional trade blocs such as Mercosur and North American Free Trade Agreement. The role of networks and the links to location in industrial clusters require further exploration, and future research needs to include the services and knowledge‐intensive sectors.

Originality/value

The paper adds to the understanding of subsidiary development in the context of intra‐regional trading and thereby expands the literature on the regional strategy of multinationals. It highlights the importance of different types of autonomy for encouraging intra‐regional trade by foreign‐owned subsidiaries, and the central role of location in industrial clusters.
The rate of penetration by multinationals into emerging markets: evidence from BRIC
Authors: Johansson Johny K. , Leigh Laurence
Published: August 2011

Purpose

The purpose of this paper is to provide an empirical assessment of the degree to which global firms have penetrated markets in emerging countries in the new millennium. The focus is on the “big four” emerging countries of Brazil, Russia, India, and China (BRIC), and the study examines penetration in three product categories: beer, hair care, and carbonated soft drinks.

Design/methodology/approach

The conceptual development draws on a normative‐descriptive framework, predicting the behavior of multinationals from normative models of their strategic behavior. Predictions are evaluated against market share data for the multi‐domestic product categories.

Findings

Multinationals with strong global brands will introduce their global brands and be successful also in multi‐domestic local markets where preferences differ across countries. However, the key to success is not always their global brands, but could equally likely be an acquired local brand. Some local brands successfully defend their markets, and even venture abroad into neighboring regions.

Research limitations/implications

Globalization does not mean the success of global brands as much as success of global firms. In the end, the penetration of local emerging markets is not necessarily from global brands, but from global companies with acquired local brands.

Originality/value

The paper establishes that any fear of elimination of valued local brands is overblown. It also helps dispel the myth that emerging countries cannot develop strong international brands on their own. But one issue remains: the financial clout of global firms is difficult for emerging firms to counter.
Designing an evaluation framework for community mental health promotion
Authors: Barry Margaret
Published: August 2011

This paper describes the development of an evaluation framework to document the process, impact and outcomes of a community‐based mental health promotion project. This initiative, the Rural Mental Health Project, is concerned with the promotion of positive mental health in rural communities in the Republic and Northern Ireland. As a community‐based initiative, this project involves multi‐component interventions that are implemented with diverse target groups across a range of community settings. Assessing the process of programme implementation is critical in order to capture and document the realities of programme planning and implementation. The evaluation approach adopted in this project is based on a logic model research paradigm (Scheirer et al, 1995). This model gives equal emphasis to process and outcome evaluation and seeks to relate the realities of programme implementation to intended programme outcomes. Project activity is tracked prospectively in order to examine the detail of actual programme delivery and its influence on expected project outcomes. This paper outlines the model as applied in this project and explores the methodological and practical challenges in evaluating complex community interventions.
Promoting mental health through physical activity: examples from practice
Authors: Jones Martin , O'Beney Carol
Published: August 2011

The physical health benefits of exercise are well established but there is also growing research evidence of links between physical activity and mental health benefits, including mood elevation, better cognitive functioning and improved self‐perception, self‐esteem and selfefficacy. Physical activity has also been shown to enhance the effectiveness of psychological therapies and to have a role in improving quality of life and symptom management for people with a wide range of mental health problems. Physical activity has a double benefit, since people with mental health problems are also at increased risk of a range of physical health problems, including cardiovascular disease, endocrine disorders and obesity. However referral to a physical activity specialist is rarely available in psychiatric settings. This paper gives two examples of how provision of physical activity facilities and programmes staffed by qualified specialists can contribute towards improving mental health and quality of life for people with mental health problems.
Mental health impact of neighbourhood renewal programmes
Authors: Krasner Evelyn , Copeland Jill
Published: August 2011

There are strong links between the mental health promotion and neighbourhood renewal agendas. In this paper we describe the process we have undertaken to develop a framework for monitoring and evaluating progress achieved by a neighbourhood renewal programme in East Hull (Preston Road) against a set of indicators of positive community mental health. Through a series of face‐to‐face and paper consultations with representatives of the Preston Road regeneration programme, a range of measures were devised to support the indicators and to identify sources of data that would provide evidence of progress on each measure. The framework that has emerged (and which is still open to development) will enable us to observe trends in the indicators over time. This will inform an evaluation of the impact of the regeneration programme on the community's mental health and provide the basis for the production of a Preston Road ‘mental health status’ report.
The impact on mental well‐being of the urban and physical environment: an assessment of the evidence
Authors: Chu Annette , Thorne Alice , Guite Hilary
Published: August 2011

In 2001 each primary care trust in England was required to undertake a needs assessment in preparation for the development of a mental health promotion strategy. In Greenwich, it was decided to include the physical environment as one of the themes. This paper describes the findings of a literature review undertaken of health, social sciences and architectural research and the preliminary conceptual model subsequently developed to pull together all aspects of the interface between the urban and physical environment and mental well‐being. The literature review identified five key domains that impacted on this relationship: control over the internal housing environment, quality of housing design and maintenance, presence of valued ‘escape facilities’, crime and fear of crime, and social participation. That these domains can be confounded by socio‐economic and demographic factors and also interact with cultural factors and housing type suggests the importance of a public health approach, which focuses on causal systems rather than simply on individual causal factors.