bluuebunny/crossref_metadata_2025 huggingface dataset:
Single Assessment Process in Hertfordshire: Investing in Change Management
Authors: Casson Stephen , Skidmore Dorothy
Published: August 2011

This paper describes how Hertfordshire met the challenge of providing a training programme to improve services for older people, with the introduction of single assessment, in the complex setting of a shire county with a number of PCTs, acute trusts, a county partnership trust and a county council social care service.Having set the context for single assessment, it describes the Hertfordshire approach. It focuses on some of the key drivers for successful implementation of such a radical programme of change: the siting of sessions by geographical location, the crucial role of managers and team leaders, setting the context of the sessions in the reality of staff experience, the importance of a shared language, common paperwork and clear protocols, and the role of the local implementation teams in supporting the process both through its implementation phase and into the future.Finally, it recognises that this training programme was only one aspect of equipping staff to be confident and competent in their assessments of older people, and that service improvements will be achieved gradually, requiring commitment from managers and support from the local implementation teams.
Interprofessional Mentorship: Taking on the Challenge
Authors: Marshall Michelle , Gordon Frances
Published: August 2011

The current emphasis on the development of an interprofessional workforce in health and social care puts interprofessional learning at the heart of undergraduate curricula. This paper explores the concept of interprofessional mentorship and considers how this role might be developed in order to facilitate interprofessional learning in the practice placement.
Policy and Legal Influences on Inter‐Organisational Information Sharing in Health and Social Care Services
Authors: Richardson Susan , Asthana Sheena
Published: August 2011

Given pressures both to share and to protect personal information in inter‐agency service provision, this article reviews the ways in which policy and legal influences shape interorganisational information exchange and highlights key developments in government guidance that are designed to promote better information sharing.
The ICON Model — Progress on a Case Study for Developing Integrated Care in Ireland
Authors: Tucker Helen , Larkin Veronica , Martin Martina
Published: August 2011

This article updates an article in Issue 12 (5) of the Journal of Integrated Care, which explained the first two phases of the ICON project in the Midland Area of Ireland. It describes the systems and processes put in place to support improving practice, focusing on process, culture and context, and illustrates the impact so far on individual clients and families, and how this information is being shared.
New Labour and the Public Sector: A Tale of Two Green Papers
Authors: Hudson Bob
Published: August 2011

Public sector reform will be at the heart of Labour's third term of office. The changes under way or planned in children's services and adult social care services in England are prototypes of the pursuit of services that are person‐centred, seamless and proactive, with a focus on positive outcomes and well‐being. This article examines the similarities in approach between the two sets of changes, and warns that implementation will be a difficult task.
Workplace Health Promotion in Domiciliary Care — an Austrian Project
Authors: Hickel Susanne , Palkovich Tamara
Published: August 2011

This article reports practical experiences with workforce health promotion in domiciliary care arising from an ongoing EU‐funded Austrian project. We review research‐based findings on working conditions and indicate starting points for health‐promoting measures. We describe the approach, and give an insight into challenges and obstacles to workplace health promotion in this field of work. The issues have strong relevance for the UK.
Profiling Intermediate Care Patients using the Single Assessment Process: A Road to Better Service Provision?
Authors: Mackenzie Mathew , Carpenter Iain , Kotiadis Kathy
Published: August 2011

This paper demonstrates that three intermediate care services in Shepway, East Kent each cater for distinct patient groups, and that data from a single assessment process (SAP) tool can be used to differentiate between them. By applying statistical techniques, inferences can be made about the likelihood of admission to a particular service, given specific health characteristics. In conclusion, we highlight the utility of standardised assessment as a means of providing data for audit and planning, and stress the importance of the SAP as a means of developing care services.
What do we Mean by Integrated Care? A European Interpretation
Authors: Billings J
Published: August 2011

It is suggested that a common understanding of integrated care between multi‐professional staff is vital to prevent barriers to unification and quality of care. This paper examines qualitative data from PROCARE, a recently completed European project on integrated care for older people, to put forward an interpretation of what integrated care means to staff. Through thematic analysis, four main clusters were identified. The paper suggests that, while the analysis revealed a common and inter‐related European interpretation that was somewhat idealised and moralistic, this was countered by challenges to its implementation that were inseparable from the rhetoric. The paper suggests that a collective, morally strong understanding is unable to prevent barriers to integrated care, and that tensions between services remain a prominent impediment.
New Hurdles for Integrated Commissioning?
Authors: Banks Penny
Published: August 2011

The Government's vision for social care highlights choice and control by individuals. This paper draws on findings from a King's Fund study and considers how far collaborative commissioning is ready to meet the challenges of ensuring a diverse menu of flexible, integrated services for people using either direct payments or individual budgets. It concludes that more needs to be done to build commissioning skills, and other investment in developing the care market will be needed to deliver the Green Paper's aspirations.
Information‐Sharing Databases under the Children Act 2004
Authors: Dow John
Published: August 2011

The Children Act 2004 provides for the establishment of information‐sharing databases. This has provoked some controversy, particularly the inclusion of ‘flags of concern’. This article argues that the Government needs to tread carefully to achieve the right balance between confidentiality and information‐sharing.
Making it Real: Interprofessional Teaching Strategies in Practice
Authors: Gordon Frances , Ward Katie
Published: August 2011

This article discusses the practice‐based teaching strategies required to assist students to develop interprofessional working capability. A role‐play session is presented as an exemplar, but the teaching strategies described can be equally employed in facilitating reflections on practice in real‐life multiprofessional teams.
Meals for Schools — What Next? Multiple Cause and Multiple Response
Authors: Maman Yair
Published: August 2011

Like the Pied Piper, Jamie Oliver ‐ followed by a growing throng of parents and teachers ‐ has forced government action and purse‐strings to raise the financing and therefore the quality of school meals in England. With £280m of new money, it looks as though at last, and at least, children will take in some nutritious food in the course of their young lives. But the reasons for and challenges presented by childhood obesity are multi‐factorial and demand a multi‐disciplinary response. This article considers the various causes of the rise in childhood obesity, and looks at past and planned initiatives aimed at tackling it. It also looks ahead to the potential for future developments that might take the baton carved by Jamie Oliver and pass it on through a range of services.
Focusing on Outcomes: Their Role in Partnership Policy and Practice
Authors: Petch Alison , Cook Ailsa , Miller Emma
Published: August 2011

Policy and practice documents are increasingly adopting a focus on outcomes. This article seeks to clarify what is meant by the term ‘outcome’, the outcomes that have been highlighted in key policy documents, and the extent to which they reflect the outcomes prioritised by service users. The discussion will draw on the early stages of a DoH‐funded project exploring the effectiveness of health and social care partnerships from the perspectives of service users.
The Emergence of Person‐Centred Planning as Evidence‐Based Practice
Authors: Sanderson Helen , Thompson Jeanette , Kilbane Jackie
Published: August 2011

Recent research (Robertson et al, 2005) has demonstrated that person‐centred planning (PCP) leads to positive changes for people. This research shows how PCP is associated with benefits in the areas of community involvement, contact with friends, contact with family and choice. This paper briefly describes this research and its recommendations. In addition it explores the implications for managers and professionals supporting people with learning disabilities.
Evidence‐Informed Practice and Integrated Care: The Launch of research in practice for adults
Authors: Petch Alison
Published: August 2011

The implications of the debates about evidence and knowledge transfer are explored in the context of integrated working and in the wake of a new research utilisation agency for adult social care.
Integrated Team Working: You Can Get it if you Really Want it: Part I
Authors: Hudson Bob
Published: August 2011

The literature on inter‐professional working has not generally yielded evidence of great success, and this has led some to lose patience with the interprofessional enterprise. This article reports the findings of an evaluation of an ambitious programme to integrate social workers, district nurses and housing officers on a locality basis in Sedgefield, County Durham. It articulates an ‘optimistic model’ of inter‐professional collaboration and suggests that the findings of the Sedgefield evaluation offer some support for the validity of the model.
Continuity and Connectivity: Who will Stabilise the Systems that Support Health Care Outside Hospital?
Authors: Sang Bob
Published: August 2011

The success of the forthcoming policy promoting health care outside hospitals will depend on achievement of fully integrated services, especially for individuals at risk of hospitalisation. Using as a case study the evaluation of a community response team, this paper argues that past attempts to achieve such service integration with frail elderly people have been short‐lived because of the impact of restructuring of the major commissioning organisations. While the effectiveness of integrated service developments can be demonstrated, the positive benefits have not been sustained, and valuable learning has been lost. By identifying key aspects of organisational memory, the paper proposes a more relationship‐focused approach to reform in which multi‐agency teams are given the time to establish personal services for vulnerable people.
Practice‐Based Commissioning and the Future of Partnership‐Based Integrated Care
Authors: Lorimer Robin
Published: August 2011

With practice‐based commissioning becoming a requirement in the NHS, this article reviews its potential impact on the established practical arrangements for health and social care partnerships. It raises a number of serious questions about the future and, with the management of longterm conditions in mind, sets out challenges that lie ahead.
The Implications of Individual Budgets
Authors: Duffy Simon
Published: August 2011

This article outlines the idea of an individual budget, which is now being promoted and tested by central government. It defines the idea, and describes the practical and policy consequences that may flow from its implementation. It also sets out some of the policy choices that will necessarily emerge from these developments. This article follows on from the earlier article in JIC (February 2005), which was the first article ever published on the subject.
Implementing Multi‐Disciplinary Teamwork in the New Child Welfare Policy Environment
Authors: Frost Nick , Lloyd Andy
Published: August 2011

This paper draws on a review of research by one of the authors (Frost, 2005) and an ERSC‐funded research project (Frost et al, 2005). The findings from this work are applied to the issues arising from the implementation of Every Child Matters (2003) and the Children Act, 2004. It is argued that implementing the Children Act in order to enable integrated working is a complex process demanding effective leadership and management. A variety of practical ideas to help with implementation are given.
The White Paper and Prospects for Social Care: A Personal View
Authors: Beresford Peter
Published: August 2011

This article offers a personal view of the White Paper, Our Health, Our Care, Our Say, from a service user perspective. The Minister for Care Services, Liam Byrne, has stressed that the philosophy of the White Paper is based on strengthening personal control over support, prevention and the integration of health, social care and other services. This discussion examines the emphasis on health over social care in the presentation of the White Paper. It puts the document in the broader context of social care policy development over the last 20 years, and relates it to the views of service users expressed in consultations leading up to its publication. It considers the White Paper's potential ambiguity, its relation with resource issues and what next steps may be needed to take forward its positive principles.
Making the Link: Ageing and Sight Loss
Authors: Smith Carol
Published: August 2011

This article reports on a national project being developed by the Royal National Institute of the Blind. It is aimed at improving health and social care for older people with sight problems, by focusing on some of the standards of the National Service Framework for older people and applying them to older people with sight problems. The project will identify, develop and disseminate good practice by establishing two pilot sites and conducting desk research.
An Evaluation of Integrated Team Management
Authors: Scragg Terry
Published: August 2011

This article reports the findings of an initial evaluation of integrated team management in a health and social care trust. It describes the main findings and discusses the impact of the new structure from the perspectives of team managers, professionals and service user representatives in the first 12 months of operation.
Chronic Disease Self‐Management by People from Lower Socio‐Economic Backgrounds: Action Planning and Impact
Authors: Boldy Duncan , Silfo Erika
Published: August 2011

Engaging people from lower socio‐economic backgrounds in self‐management of their chronic disease(s) presents particular challenges (Walker & Peterson, 2003). A demonstration project (HealthPartners) targeting such clients with diabetes and/or cardiovascular disease, plus one or more co‐existing conditions and aged 50 years or older, has recently been co‐ordinated by the Canning Division of General Practice in Western Australia. Six new interventions for clients were developed, including one‐to‐one facilitation. Where the latter occurred, a key aspect of client management and commitment adopted by HealthPartners was joint preparation of action plans by client and facilitator. Such action plans covered issues identified, stage of change, goals, actions and progress (the extent to which actions specified in a previous plan had been carried out by the time the plan was revisited). The paper provides an overview of the action‐planning process and its outcomes, and the results of an impact assessment of the programme as a whole. To be effective in changing behaviour, it appears important for many clients to participate in a group with peers in a relevant activity.
Commissioning Community Well‐Being: Focus on Older People and Transport
Authors: Manthorpe Jill , Cornes Michelle , Rapaport Joan , Moriarty Jo , Bright Les , Clough Roger , Iliffe Steve
Published: August 2011

In this article we consider community well‐being and new approaches to reinvigorating partnership working for older people's services. In particular, we focus on improving transport for older people. We draw on findings from a series of public consultations, group discussions and interviews with older people in 10 purposively selected localities in England. Although there was great diversity in the issues raised by older people on the subject of transport, both across and between the sites, we point to a number of core analytical themes which could assist commissioners in developing a citizens' framework designed to address this traditionally ‘wicked’ issue.
The Implementation of Single Shared Assessment in Meadowbank, Falkirk: A Joint Future
Authors: MacNamara Gail
Published: August 2011

This paper briefly describes a small research study, and presents its findings on the factors that have had an impact on the implementation of single shared assessment (SSA) in co‐located primary care and social work teams. Findings highlight continuing difficulties of policy implementation and the need for ongoing support, guidance and training.
Using Project Evaluation to Build Capacity for Integrated Health Care at Local Levels
Authors: Elmer Shandell , Kilpatrick Sue
Published: August 2011

Capacity‐building evaluation featuring multidisciplinary cross‐agency workshops fostered continuous quality improvement, while focusing on skills required and systemic barriers to health care integration between GPs and a regional hospital.
Creation of a Care Trust: Managing the Project
Authors: Lavender Andrew
Published: August 2011

This paper summarises the key factors identified within the project to create a care trust in Torbay. It should benefit other organisations considering integrating health and social care services, particularly in light of the direction indicated by the recent White Paper. This document identifies some of the core components and issues that need to be addressed.
Integrating Care in Community Hospitals
Authors: Tucker Helen
Published: August 2011

There is a strong tradition of integration in rural community hospitals which has been largely unrecognised in the past. The national strategy for health in England now gives community hospitals a central role in providing integrated health and social care, in a policy referred to as ‘care closer to home’. The evidence emerging from international and national studies is demonstrating the benefit of the community hospital model of care. Public support for community hospitals over their 100‐year history has been strong, with value being placed on accessibility, quality and continuity. There is, however, a tension between the national policy and the current financial pressures to close or reduce services in one in three community hospitals in England. Innovative ways of owning and managing these services are being put forward by communities who are actively seeking to maintain and develop their local hospitals. The challenge is to demonstrate that community hospital services are valued models of person‐centred integrated care, and to demonstrate their contribution to the health and well‐being of their communities.
Individual Budgets: On the Launch Pad
Authors: Stevens Martin
Published: August 2011

This article presents plans to evaluate the individual budget pilots in England. The setting up of the 13 pilot projects is described, and the evaluation's questions and approaches are outlined. The article outlines some of the central challenges being encountered as the pilots get under way.
Extending Direct Payments to Those who Lack Capacity
Authors: Dow John
Published: August 2011

The White Paper (DoH, 2006) stated that the Government wanted more people to enjoy the benefits of direct payments. This article looks at the Government's proposals for extending direct payments to those who lack capacity.
Partnership in Inspection: Lessons from the Review of the NSF for Older People
Authors: Klee Deborah , Manthorpe Jill
Published: August 2011

Joint reviews are an approach to partnership working between those involved in inspection and regulation. They provide great opportunities and some challenges. This article describes a case study of the review of the National Service Framework for Older People. It discusses culture and commitment, organisational imperatives and governance.
Integrated Care — Foundation Trust or Social Enterprise?
Authors: Hill Rachel
Published: August 2011

The journey to find the right vehicle for delivering learning disability services is set in the context of foundation trust and social enterprise options being introduced into the wider NHS. The Ridgeway Partnership shares the challenges it is facing as an integrated service that is caught in the middle of these options.
The Bournewood Provisions
Authors: Dow John
Published: August 2011

Local authorities and PCTs will have new responsibilities under amendments to the Mental Capacity Act, proposed in the Mental Health Bill introduced in November 2006. Under the proposals, care homes and hospitals will need to obtain authorisation from the local authority or PCT if it is considered necessary to deprive a person lacking capacity of their liberty in order to provide care or treatment.
Practice‐Based Commissioning: Learning from a Development Programme
Authors: Slater Beverley , White Jacquie
Published: August 2011

This paper describes the first year of a national programme supporting implementation of one of the key policy initiatives forming part of the programme of health reform in England, practice‐based commissioning (PBC). The paper presents an audit of service redesign initiatives based on the first six months' work of 27 sites in the first wave of the programme, and discusses the early practical learning about the implementation of PBC by both participants and stakeholders. The role of the programme in facilitating two‐way links between policy development and practical implementation is highlighted, and the development of the programme, and other parallel learning routes, to meet the emerging needs of particular groups in relation to practice‐based commissioning is described.
Building Bridges in Liverpool: Delivering CAMHS to Black and Minority Ethnic Children and their Families
Authors: Fatimilehin Iyabo
Published: August 2011

The Building Bridges service was implemented as the result of an assessment of the psychological and mental health needs of black and minority ethnic children and families in Liverpool. This article describes the development of the service, and draws links between the existing literature, government legislation and implications for CAMHS.
What Lies Ahead for Partnership Working? Collaborative Contexts and Policy Tensions
Authors: Hudson Bob
Published: August 2011

Partnership working appears to be a key principle of public services reform in both England and Scotland, but there are important contextual differences between the two countries. Whereas the Scottish agenda is relatively consistent, in England there are competing policy imperatives at work that could undermine improved partnering. This article examines the public services reform context in England and Scotland, and suggests that English policy is a complex mixture of network, market and hierarchy which gives rise to tensions that remain unaddressed.
Engaging Hearts and Minds… And the Spirit
Authors: Gilbert Peter
Published: August 2011

Since the tragic events of 9/11, faith has become an important discourse in society as a whole. This article explores aspects of that discourse in our multicultural society with special reference to mental health and well‐being, and describes a conference set up by NIMHE/Staffordshire University and the National Forum on Spirituality and Mental Health to explore how belief systems can affect people's well‐being and their recovery from mental illness.
Shifting End of Life Care Back into the Community
Authors: Shiner Alice , Stothard Jennifer
Published: August 2011

National evidence shows that around 60% of patients would prefer to receive end of life care and die at home, but in 2005 in North Derbyshire only 20% of patients were supported to do so. This article discusses the tools used to improve end of life care services in the community and explores the enablers and barriers.
The Independent Living Funds — What does the Future Hold?
Authors: Henwood Melanie , Hudson Bob
Published: August 2011

At a time when there is much debate about the nature of self‐directed support and the development of individual budgets, the role of the Independent Living Funds comes into question. This article reports on the findings of an independent review of the ILF undertaken for the Department for Work and Pensions. It is argued that, while in many ways ahead of its time at its creation in 1988, the ILF is no longer at the leading edge of policy and practice in supporting independent living such as have been promoted under the auspices of In Control.There is much that can be done to improve the operation of the ILF and the experience which people have of using it, and the report made multiple recommendations for change. However, in the longer term the case is made that the ILF should not have an ongoing and separate existence, and there is a presumption of full incorporation within individualised budgets.
Care Management and Self‐Directed Support
Authors: Duffy Simon
Published: August 2011

Care management is a central part of the current health and social care system, but the development of Self‐Directed Support raises significant questions about the future of this function. Moreover, if the current design of the care management function is to change, then this will raise significant challenges and opportunities for those professionals who currently act as care managers. These changes may even allow social workers to return to a way of working that fits better with their professional ethos.
Governance of Health Act Partnerships
Authors: Dow John
Published: August 2011

Many of the problems of governance of Health Act partnerships arise from a poor understanding of the legal basis for the partnership arrangements. This article examines the legal framework and focuses on some of the areas of misunderstanding.
The Emerging Role of the Domiciliary Pharmacist in Devon
Authors: Dilks Sara
Published: August 2011

A new model of multidisciplinary team working with health and social care is being developed in Exeter. This article describes how inclusion of a domiciliary pharmacist in the team has improved medicines management for patients with long‐term conditions and for adult patients identified as needing support with their medicines. Initial results are discussed, case studies are described and future developments for the service are outlined.
Equality, Diversity and Housing: Future Prospects
Authors: Matharoo Darshan , Davis Sarah
Published: August 2011

This article looks at the importance of community‐based organisations in delivering culturally sensitive services, and how the pressures of efficiency may challenge this approach and the viability of small providers. It explores some ways in which providers and commissioners are trying to meet this challenge. It examines the developing local government framework in providing a way forward.
Knowledge Management and Staff Expertise in Health and Social Care
Authors: Watson Mark
Published: August 2011

This article provides an overview of a range of techniques and processes used in knowledge management to surface the tacit knowledge held by staff in an organisation. Examples from health and social care are provided.
The Use of Collaboration to Produce More Effective Serious Incident Inquiry Reports
Authors: Hitchen Sherrie
Published: August 2011

A collaborative approach, involving family members, was taken to writing an inquiry report following the death of a patient with serious mental illness. This paper sets out the outcomes of producing a mutually agreed report recommending the process as an effective means of organisational learning.
Are Caring Professions Restricting Employment of Disabled People?
Authors: Sin Chih , Fong Janice
Published: August 2011

The Disability Rights Commission's Formal Investigation into the impact of professional regulation on disabled people's access to nursing, social work and teaching professions identified that unclear regulatory fitness requirements and their inconsistent implementation can have discriminatory effects. This article explores the relevance of the Investigation's findings for other health and social care professions, demonstrating that they similarly have a range of regulatory fitness requirements that may be interpreted and implemented in different ways, potentially discouraging disabled people from entering the professions or from disclosing their conditions. Regulations and guidance across health and social care professions need to be reviewed, bringing them up to date with current disability and anti‐discrimination legislation. A more proactive stance towards disability equality is required if the professions are to achieve the aim of a more diverse workforce.
Adult Care Joint Ventures: The Art of the Possible
Authors: Freeman Tim , Peck Edward
Published: August 2011

In this first of two articles, the authors assess the implications of policy developments in partnership and contestability, commissioning and procurement, and local jurisdiction for adult services joint ventures. They argue for creative responses to service delivery in which policy implementation is seen as an opportunity for local health and social care agencies to honour the history of, and future aspirations for, local partnerships. A second article will detail the very different responses to the policy agenda of four case study sites, exploring the local contours and aspirations underlying their decisions, with the intention of provoking discussion about the art of the possible in the broader community of interest.The papers draw on the authors' work funded by the Integrated Care Network (ICN) and Care Services Improvement (CSIP), which comprised a series of workshops to inform the further development of the plans of four local health and social care communities ‐ Portsmouth, Wolverhampton, Barnsley and Milton Keynes ‐ for commissioning and provision of adult care services, providing a community of interest in which aspirations, challenges and emerging solutions were exchanged and explored. Here we summarise transferable learning for the broader community of interest, drawn from the more detailed reports available from the ICN (Freeman & Peck, 2006, 2007).
Single Shared Assessment: The Limits to ‘Quick Fix’ Implementation
Authors: Eccles Andrew
Published: August 2011

Joint working between health and social services has been a key focus of policy in recent years, albeit ‐ underneath the protocols and partnership agreements ‐ integrated processes have developed unevenly. A single shared assessment tool has been one of the concrete expressions of policy on the ground. This paper explores the implementation of the shared assessment process in Scotland. It discusses the broader policy agenda, before exploring the introduction of the shared assessment tool in a large urban authority. Based primarily on interviews with front‐line staff in health and social work and managers charged with delivering shared assessment, the paper suggests a lack of engagement on issues such as working cultures and equity of workloads, while some of the main reasons behind the implementation of shared assessment, such as overcoming duplication, have not generally materialised for staff. Overall, single shared assessment has been driven by process rather than by engagement with wider ideas about joint working, which has led to uneven and at times unwilling implementation.
Well‐Being for Refugees and Asylum Seekers through Holistic Practice
Authors: Maffia Cath
Published: August 2011

People who come to the UK seeking asylum from wars and persecution may sometimes be perceived as having mental health problems. This article examines a project which attempted to address the wider determinants of mental health and well‐being in a non‐stigmatising, culturally appropriate manner.
Social Networking: An Opportunity for Health and Social Care?
Authors: Watson Mark
Published: August 2011

Following on from previous articles which looked at knowledge management and electronic networking, this article looks at social networking as a further opportunity for health and social care to make use of the expertise of the workforce.
Self‐Directed Support: Watching out for the Pitfalls
Authors: Jones Ray
Published: August 2011

In the recent government Comprehensive Spending Review there is a promise of a Green Paper on social care services for disabled and, especially, older people. The platform on which any new proposals will be built is likely to be heavily influenced by the Government's personalisation agenda for public services. It is timely, therefore, to reflect not only on the strengths but also on the potential pitfalls of a major stream, self‐directed support, for the personalisation agenda in adult social care. Anticipating and guarding against unintended consequences of policy are as important as championing the positive opportunities promoted by the policy.
A Case of Response Rate Success
Authors: Lyon David , Lancaster Gillian , Dowrick Chris
Published: August 2011

Postal questionnaires are increasingly being used to gather health and research information. Various techniques have been shown to increase the response rate. This study used several of these techniques and also benefited from close working with general practitioners and their practices. Cross‐checking address and age against practice records reduced the number of wasted invitations to participants. The GP signature on the letter personally inviting patients to participate contributed to a response rate of 83%. Researchers carrying out postal questionnaire studies will benefit from engaging with primary care.
Individual Budgets and Personalisation: A New Model for Integration?
Authors: Henwood Melanie , Hudson Bob
Published: August 2011

The adult social care system will increasingly be characterised by ‘personalisation’. Maximising choice, control and power over the support services that people access is to be achieved principally by development of personal budgets. Already there are signs that the Government wants to extend the model from adult social care and to apply it to other areas of public service. The most obvious areas where the model could be transferred are health services (particularly in respect of long‐term conditions), and support for disabled children and their families. This article draws on findings from an in‐depth study on self‐directed support commissioned by the Department of Health. It highlights some of the challenges and opportunities which arise for authorities attempting to engage with personalisation and to develop more integrated responses to people's support needs. It is clear that the ‘Total Transformation’ to which many aspire will not be achieved overnight, but equally this is an area of policy change which cannot simply be left to the enthusiasts.
Professional Identity in Multi‐Disciplinary Teams: The Staff Speak
Authors: Workman Ann , Pickard Jeremy
Published: August 2011

This paper reflects on the experience of an integrated multi‐disciplinary team over three years. We argue that initial anxieties about dilution of professional identity have not been realised in practice, partly because they were over‐stated in the first place, partly because of good planning and partly because the benefits of integrated working are so evident to professional staff that their confidence in their contribution is enhanced. We also suggest that new roles can make a substantial contribution to integrated working. The evidence for these conclusions is mainly the views of the staff involved. The article concludes with two individual case studies which highlight improved user outcomes.
Not Throwing out the Partnership Agenda with the Personalisation Bathwater
Authors: Dickinson Helen , Glasby Jon
Published: August 2011

The personalisation agenda currently appears as a key strand of the Government's approach to health and social care services. On the face of it this offers an exciting new future where service users drive the way services are joined up, which for some may be welcome given the paucity of evidence to show that the organisationally‐driven partnership working of the past decade has delivered real and tangible outcomes for service users. There is some suggestion that in the future any talk about partnerships will be about this citizen‐state interaction, rather than one between health and social care agencies. This paper argues that there is a real danger in suggesting that personalisation negates the need for health and social care agencies to work together in partnership; instead this interface is more imperative than ever. In this paper we provide an overview of the debates around personalisation and partnership and set out the case why partnership should not be forgotten, and indeed will be key, in the success of the personalisation agenda.
What Comes Around Goes Around: On the Language and Practice of ‘Integration’ in Health and Social Care in Scotland
Authors: Bell Kate , Kinder Tony , Huby Guro
Published: August 2011

Rhetoric and reality lead separate lives when it comes to integrating health and social services in Scotland, and it is making planning and implementation difficult for practitioners of integration. This paper is a collaboration between a practitioner and two academics who teach, research and write about integration. It explores the views of other integration practitioners about the policy, language and nature of integration, and the issues practitioners are currently grappling with, especially how the policy language of ‘integration’ fails to connect with integration in practice. It appears that ‘integration’ has less to do with broad policy aspirations and principles of service (re)organisation, than with the specific aims, objectives and outcomes of individual projects delivered in very specific circumstances. Acknowledging the localisation of integration, and allowing the time for productive problem solving which can generate a new language, ought to be essential elements of integration.
Partnership Working Towards Achieving National Outcomes: The Scottish and English Experiences
Authors: Freeman Isobel
Published: August 2011

Use of local area agreements (LAAs) has been developing in England since 2004. Single outcome agreements have been a more recent innovation in Scotland. These agreements provide a vehicle for developing integrated planning and service delivery, and can support local integrated working. This article compares the English and Scottish approaches. It draws on earlier OLM research into the LAA programme and provides a description of the current Scottish approach.
Promoting Continence and Managing Incontinence with People with Dementia Living at Home: One More Challenge for Integration
Authors: Drennan Vari , Cole Laura
Published: August 2011

Mental health problems in old age have attracted policy attention in the UK over the past decade. An important issue is how to improve services for people who have both mental health and other problems. This article sets out some of the challenges facing planners and commissioners in developing integrated services for older adults, by using the case study of people with dementia and incontinence problems. It uses integrated service models and observations from the EVIDEM‐C study to suggest some incremental actions that would help develop the long‐term strategy for integrated services.
Whose Outcomes are They Anyway? Report of the Pilot Evaluation of a Joint Service
Authors: Dickinson Helen , Glasby Jon , Miller Robin , McCarthy Linda
Published: August 2011

Health and social care partnership working is often predicated on the notion that it improves outcomes for service users. Yet there is a lack of evidence linking partnerships to changes in outcomes. Against this background, the Health Services Management Centre at the University of Birmingham designed the Partnership Outcomes Evaluation Toolkit (POET) specifically to evaluate health and social care partnerships in terms of service user outcomes. This paper reports on the field testing of POET with Sandwell Integrated Support Service. This research provided a number of interesting insights into this service, and indicated some dissonance between staff and service user and carer expectations.
Methodological issues in the measurement of multinationality of US firms
Authors: Rugman Alan M. , Hoon Oh Chang
Published: August 2011

Purpose

The purpose of this paper is to provide a critical discussion of the scope and correct scale metrics used in the measurement of multinationality.

Design/methodology/approach

There are two ways of measuring the degree of multinationality (sometimes called the international diversification) of firms. The literature is reviewed using both types of metric, and then both are applied to tests of the regional nature of international business.

Findings

It is found that the correct method is to use a scale metric which captures the degree of multinationality, such as the ratio of foreign to total sales. This paper provides empirical evidence that the scope metric, which counts the number of countries in which a firm has a foreign subsidiary, is unsatisfactory.

Originality/value

The paper provides a new scale metric of the intra‐regional activities of large US firms.
The home‐region orientation of Spanish exporting firms
Authors: Almodóvar Paloma
Published: August 2011

Purpose

Building on the recent literature on regionalization, the purpose of this paper is to explore the home‐region orientation of Spanish new multinationals in the manufacturing sector and investigate the impact of the liability of foreignness (LOF) on Spanish firms.

Design/methodology/approach

The source of the empirical work is the Survey on Business Strategies from 2000 to 2008. The sample is fully representative of exporting Spanish manufacturing firms and collects more than 1,000 firms per year on average. The study defines and calculates the regionalization and multinationality ratios of home‐region oriented firms. Three moderating factors that affect the international behaviour of Spanish firms are introduced and analysed – the degree of foreign ownership, the level of advertising intensity and the level of research intensity.

Findings

The results demonstrate a strong home‐region orientation for Spanish exporting firms in manufacturing and that the three moderating factors are critical to their regional orientation and degree of multinationality. Furthermore, the results are linked to the LOF.

Originality/value

The paper sheds light on the regionalization topic, so far unexplored in the Spanish context. The original triad defined by Rugman is modified by dividing the world into three groups – the European Union, Latin America and the rest of the world – in order to fit Spanish interests. This paper contributes to understanding how firm specific advantages affect firms' behaviour and how they are related to the LOF.
Self‐help/mutual aid in promoting mental health at work
Authors: Backwith Dave , Munn‐Giddings Carol
Published: August 2011

This article relates one aspect of an action research project on work related stress and mental health problems to its wider context. It is argued that self‐help/mutual aid, including self‐management, could make an important contribution to tackling the current epidemic of work‐related stress in the UK and elsewhere. Initiatives such as the government's Work‐Life Balance campaign indicate that the policy context is appropriate. An overview of the causes, costs of, and policy responses to work‐related stress is followed by a discussion on the nature of self‐help/mutual aid and the benefits that the sharing of experiential knowledge can bring to participants. This includes a specific, structured form of self‐help: self‐management programmes as led and used by mental health user groups. We conclude that self‐help initiatives can make a valuable contribution to addressing work‐related stress if employers support them. Beyond simply ameliorating staff retention problems, the experiential learning communities that could be created could be an asset, particularly in seeking to change workplace cultures to minimise work‐related mental stresses.
Conceptualisations of agoraphobia: implications for mental health promotion
Authors: Callard Felicity
Published: August 2011

Agoraphobia emerged as a named disorder in the 1870s. Since then a wide variety of models ‐ both clinical and non‐clinical ‐ have been devised to explain it. This paper describes four of these models to demonstrate and explore the significance for mental health promotion of their different conceptualisations of agoraphobia in relation to the city, to public space and to the individual. Of particular interest is the shift in the gendering of agoraphobia: while late 19th century accounts tended to feature men, by the mid 20th century the archetype of someone who experiences agoraphobia had become female. The implications of this variance and subsequent decisions about intervention and cure, it is argued, demonstrate the importance of conceptualisation in debates about mental health promotion.
South Asian women in Britain: their mental health needs and views of services
Authors: Kumari Nirmal
Published: August 2011

This paper describes a survey carried out by a South Asian women's voluntary organisation to identify the physical and mental health needs of its users. The results confirm research findings that suggest a high proportion of South Asian women suffer from psychological and somatic symptoms that are commonly associated with anxiety and depression. A considerable number had experienced racial discrimination and several had suffered sexual discrimination. Problems reported by participants included eating disorders, marital difficulties and domestic violence. The majority did not know where to seek help for mental health problems. Respondents wanted confidential talking and complementary therapies to be provided in services run by South Asian staff, and for health education and health promotion to be provided in their own ethnic language. The paper ends with a consideration of the implications of these findings for the delivery of mainstream mental health services, from health promotion through primary care to specialist services.
Making an impact? Mental health improvement training in Scotland
Authors: Halliday Emma , Friedli Lynne , McCollam Allyson , Hogg Emma
Published: August 2011

The current interest in evidence‐based practice has led to a growing literature on the role of education and training in getting evidence to inform professional practice. This report outlines the findings of an evaluation of a series of evidence‐into‐practice training workshops designed to strengthen evidence‐based practice in the delivery of mental health improvement in Scotland. Evaluation was conducted in two phases, in order to assess the extent to which the training had influenced practice. The findings suggest that, in addition to providing high quality learning opportunities for mental health improvement, considerable attention needs to be given to the barriers that inhibit putting learning into practice. These barriers may need to be taken much more fully into account in the design and delivery of evidence‐into‐practice training.