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Latest developments in stakeholder management literature focus on dynamic stakeholder engagement and disengagement practices, and how these are facilitated towards reaching systemic outcomes. However, limited evidence support that this network-level approach can positively influence project success. The paper analyses this issue by considering the practices (how and when), rationales (why) and outcomes (so what) that evolve in the dynamic management of external stakeholders in dementia-friendly environments. This is a crucial area to explore as the ageing population and rising dementia prevalence has increased the need to engage external stakeholders, such as people living with dementia, to develop dementia-friendly health and social environments. The empirical study of the 2013/2014 Department of Health National Dementia Capital Investment Programme involved a statistical and qualitative analysis of 98 pilot projects' final lessons learnt reports. The analysis advances the dynamic process of timely engaging and disengaging external stakeholders in a context not previously explored in the literature related to dementia-friendly environments. Eight recurring practices and six rationales, the latter characterized by their temporal dimension, are presented in a processual model of stakeholder management. [ABSTRACT FROM AUTHOR]

Introduction In the Italian Region of Puglia, the prevalence of people with chronic care conditions is recorded as 40% of the population and the available resources to enable the delivery of care are used up to 80%. To improve the care management of chronic patients, Puglia Region introduced the Integrated Care (IC) Model "Puglia Care". In 2020, the Regional Agency for Health and Social Care AReSS Puglia assessed the IC maturity level of the Local Health Authorities (LHAs) using the EU Health Programme funded SCIROCCO Exchange (SE) Tool. Theory/Methods The SE online Tool is a 12-dimensions online tool to assess the provision of IC, structured as a 12 questions survey, each of which is associated to a particular "dimension". The maturity level of each dimension is assessed on a 0 (minimum) to 5 (maximum) rating scale. The methodology included: selection of five key role stakeholders for each LHA (General Director; Integrated Health and Social care Community Centre Director; Care Manager; IT specialist; Patients' Representative); individual assessments through the online SE Tool; consensus workshops for each LHA among the involved stakeholders. The outcomes of the assessment were captured in the form of radar diagrams, highlighting Puglia LHAs' strengths and weaknesses in IC. Results The research has provided qualitative and quantitative multi-stakeholders representation of the IC maturity level of Puglia LHAs. The level of maturity of each LHA varies from medium to high. The outcomes of the six consensus workshops have brought to evidence space for improvement in the IC on three dimensions: 1.Finance & Funding; 2.Removal of Inhibitors; 3.Evaluation Methods. Discussion The data gathered have provided evidence of the presence of several e-Health good practices still on the verge of being scaled up as a result of a positive assessment by the Regional HTA centre. Inhibitors are still present and require systematic actions to be removed. Conclusions (comprising key findings) Capacity building is the dimension that stakeholders emphasised as the solution to foster progress in the other dimensions of the SE Tool. The following key findings are significant to build up an improvement plan: 1)Communication, both inside and outside the organisations, is the best solution to promote collaborative capacity among multiple stakeholders in the IC chain; 2) Culture has emerged as crucial factor for effective change and modernisation of the organisations' IC model; 3)Citizen empowerment: citizens are very much willing to take responsibility for their own care even if lack of information and ICT knowledge do not ease this process. Lessons learned The research demonstrated the need for: a novel communication platform for stakeholders to discuss, compare, and share visions to foster multidisciplinarity; a continuous plan to carry out knowledge exchange activities and multi-stakeholders education and training for IC. Limitations The research does not aim to be exhaustive due to the limited number of involved stakeholders within one Region. Suggestions for future research This work shall provide the basis for the systematic use of enabling practices and tools (e.g. SE online Tool) to put in place corrective actions against identified gaps. [ABSTRACT FROM AUTHOR]

NHS Trusts in England must adopt appropriate levels of continued investment in routine and backlog maintenance if they are to ensure critical backlog does not accumulate. This paper presents the current state of critical backlog maintenance within the National Health Service (NHS) in England through the statistical analyses of 115 Acute NHS Trusts. It aims to find empirical support for a causal relationship between building portfolio age and year-on-year increases in critical backlog. It makes recommendations for the use of building portfolio age in strategic asset management. The current trend across this sample of NHS Trusts may be typical of the whole NHS built asset portfolio and suggests that most Trusts need to invest between 0.5 and 1.5 per cent of income (depending upon current critical backlog levels and Trust age profile) to simply maintain critical backlog levels. More robust analytics for building age, condition and risk-adjusted backlog maintenance are required. [ABSTRACT FROM AUTHOR]

With an ageing population in many countries, health and social care providers are under growing pressure to improve the quality and safety of care environments for older people, and ensure they are fit-for-purpose for caring for those with age-related conditions, including dementia. Health Building Note 08-02: Dementia-friendly health and social care environments, recently published, is the first HBN to offer specific guidance on the subject. Here Loughborough University research associates, Efthimia Pantzartzis and Federica Pascale, and Andrew Price, who is Professor of Project Management at the University, explain the background to the new HBN, and offer insights into its structure and content. June's HEJ reported on 115 Department of Health-funded pilot projects undertaken throughout England in 2013-2014 aimed at creating more 'dementia-friendly' environments in health and social care settings implemented under the DH Capital Programme, Improving the environment of care for people with dementia. The results and findings helped shape the new HBN guidance.