Search

Purpose: The purpose of this paper is to explore government efforts to enhance the autonomy of community health services (CHS) in England through the creation of Foundation Trusts status. It considers why some CHS elected to become nascent Community Foundation Trusts (CFTs) while others had not and what advantages they thought increased levels of autonomy offered.Design/methodology/approach: Data are drawn from the evaluation of the Department of Health's CFT pilot programme. Participants were purposively selected from pilot sites, as well as from comparator non-pilot organisations. A total of 44 staff from 14 organisations were interviewed.Findings: The data reveals that regardless of the different pathways that organisations were on, they all shared the same goal, a desire for greater autonomy, but specifically within the NHS. Additionally, irrespective of their organisational form most organisations were considering an almost identical set of initiatives as a means to improve service delivery and productivity.Research Limitations/implications: Despite the expectations of policy makers no CFTs were established during the course of the study, so it is not possible to find out what the effect of such changes were. Nevertheless, the authors were able to investigate the attitudes of all the providers of CHS to the plans to increase their managerial autonomy, whether simply by separating from PCTs or by becoming CFTs.Originality/value: As no CFTs have yet been formed, this study provides the only evidence to date about increasing autonomy for CHS in England. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to provide an update to a review of the joint working literature in the field of health and social care for adults, with particular emphasis given to the experiences of users and carers. Design/methodology/approach – The aims of the literature review remained largely the same as those of the original, they were to identify: models of joint working, evidence of effectiveness and cost-effectiveness and the factors promoting or hindering the models. However, to reflect the growing interest in the experiences of users and carers a fourth aim was added to map these experiences. Given their prominence in terms of policy debates about integration, the review focused on jointly organised services for older people and people with mental health problems in the UK only. Findings – The review demonstrates tentative signs that some initiatives designed to join-up or integrate services can deliver outcomes desired by government. Importantly some studies that report the experiences of users of services and carers suggest that they perceive benefits from efforts to join-up or integrate services. However it is our contention that the evidence is less than compelling and does not justify the faith invested in the strategy by current or previous governments. Originality/value – The study updates our knowledge of the impact of joint working in the field of health and social care for adults. Importantly the paper highlights what is known about the experiences of users and carers of joint/integrated services. [ABSTRACT FROM AUTHOR]

Purpose -- Appropriate housing for the growing population of older adults is becoming an international concern. The purpose of this paper is to report on a review of UK and international literature carried out as part of a project exploring the commissioning and delivery of social care in housing with care settings. The paper also considers housing with care in the context of UK policy and practice. Design/methodology/approach -- The peer literature review process used a range of academic databases as well as government and third sector web sites, drawing on relevant material in English published from 1990 to 2012. Findings -- Findings are presented within three main themes: how care and support is provided; the role of the built environment; and the benefits for resident well-being. The review found a paucity of literature focusing specifically on care and support in housing with care settings, particularly in terms of how social care is delivered, but the evidence base suggests that housing with care is in a strong position to deliver on most if not all UK government aspirations. Practical implications -- Despite a growing literature both in the UK and internationally exploring the characteristics and benefits of housing with care for older people, substantial gaps remain in the research evidence. Originality/value -- This paper presents an up to date review of the housing with care literature in the context of current UK policy. [ABSTRACT FROM AUTHOR]

Purpose -- This article aims to consider recent changes to policy and practice in relation to joint working by returning to the authors' original article published in 2003 to ask what has happened in the intervening years. Design/methodology/approach -- The original article was based on research commissioned by the NHS shortly after New Labour came into office, at a time of increasing interest in the role of joint working in the provision of public services. The authors were commissioned to conduct a systematic review of the existing research literature about joint working in adult services between health and social services in order to identify broad lessons, which could inform future activity in this area. Here, they undertake an informal review of the progress made. Findings -- Having reviewed the original research, the authors move on to consider the reforms implemented by New Labour to better support joint working and the recent policies of the Coalition government. They argue that whilst the focus of government policy remains largely the same, some subtle changes have emerged. Finally, they consider more recent reviews of the evidence base which suggest that, whilst some progress may have been made, certain difficulties remain, specifically with regards the evaluation of the outcomes of joint working. Originality/value -- Having been approached by the Editor of JICA, the authors submit this paper for the 20th anniversary issue of the journal because of the impact and continuing relevance of their original article. [ABSTRACT FROM AUTHOR]

A better understanding of experiences of the end of life in old age is important for practitioners, but there are considerable methodological and ethical challenges to research in this area. An interdisciplinary team at the University of Bristol conducted a pilot study of 100 people aged over 80, over the course of a year. The study focused on significant events in the lives of participants, the vast majority of whom were living ordinary lives in the community. Data were gathered from participants and their relatives and, where relevant, from health and social care professionals. In this paper key findings are presented and the implications for research and practice considered. [ABSTRACT FROM AUTHOR]