1
|
Kelleher E, Martin AM, Caples M, Wills T. Acute service and disability service providers experiences of joint working to improve health care experiences of people with an intellectual disability compared to non-joint working: A mixed-method systematic review. J Intellect Disabil 2023:17446295231209345. [PMID: 37864518 DOI: 10.1177/17446295231209345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2023]
Abstract
Persons with intellectual disabilities require frequent access to acute services. Many also access disability services within the community. Reports and enquiries have highlighted the sub-optimal healthcare provided to this group when accessing healthcare in acute services. Joint working between acute and disability services has been identified as a measure to improve healthcare for this group. A mixed method systematic review was undertaken to explore current evidence of joint working between both service providers. Twelve publications were included, and the data were analysed using thematic analysis. Confusion around responsibility and limited training in acute services prevented joint working from occurring. Information-sharing is pivotal in promoting joint-working, but measures which facilitated it were not always used. Albeit acute services demonstrated a strong commitment to deliver quality care to those with intellectual disabilities. Much of the available research captures the experiences of staff in acute services. There is a paucity of research available exploring experiences of disability service providers.
Collapse
|
2
|
Lezard R, Latham H. Advance planning for co-caring couples. Br J Community Nurs 2023; 28:198-206. [PMID: 36989202 DOI: 10.12968/bjcn.2023.28.4.198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
This article explores joint advance planning for co-caring couples in the community, a group growing in number and need. A health crisis for one, exposes the vulnerability of the other. Lack of planning for this eventuality leaves health and social care struggling to provide an adequate safety net in a short timeframe. This inability to adequately support, can lead to harm to the couple. The authors conducted a formal reflective investigation to discover themes that impacted on their ability to meet the needs of such a couple in their care. The themes were: the need for advanced care planning in co-caring situations; capacity assessed through different lenses; using safeguarding systems appropriately to support questions of capacity; challenges when care is not accepted; and compassion fatigue. These themes were then used to develop an action plan to improve ways of working to reduce risk in these situations.
Collapse
Affiliation(s)
- Ruth Lezard
- Advanced Clinical Practitioners for Long-Term Conditions, Sirona Care and Health, Bristol, UK
| | | |
Collapse
|
3
|
Khatib R. Hospital-pharma clinic partnerships: a bridge too far? Br J Cardiol 2022; 29:31. [PMID: 37332275 PMCID: PMC10270295 DOI: 10.5837/bjc.2022.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
|
4
|
Cortina MA, Shipman J, Saunders F, Day L, Blades R, Smith J, Wolpert M. Embedding interagency working between schools and mental health specialists: A service evaluation of the Mental Health Services and Schools and Colleges Link Programme workshops. Clin Child Psychol Psychiatry 2019; 24:906-920. [PMID: 31122035 DOI: 10.1177/1359104519849640] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
There is increasing focus on the need for schools to work more effectively with specialist mental health providers, but there have been historic challenges in embedding closer interagency working. This article reports the results of a service evaluation of a 2-day workshop designed to facilitate improved working between schools and children and young people's mental health services (CYPMHS). Mental health leads from 255 schools, mental health professionals and other key stakeholders all took part in one of 26 two-day workshops across the United Kingdom. The impact on interagency working was examined using changes in pre- and post-survey results, changes in self-reported aspects of interagency working and 10 local reviews of practice. The pre-post questionnaires showed improvements in interagency working (e.g. 55% of school leads reported being in 'monthly' or 'continuous' contact with the National Health Service (NHS) CYPMHS1 at follow-up, compared with 24% at baseline). The group-completed CASCADE framework showed an overall increase in collaborative working, although some areas continued to report significant challenges such as in relation to common outcome measures. The local reviews found positive changes in interagency working, in terms of building relationships, improved communication and sharing good practice. This service evaluation of the workshops found some evidence of improved interagency working between schools and CYPMHS, but more controlled research is needed to consider generalisability and scalability.
Collapse
Affiliation(s)
- Melissa A Cortina
- Evidence Based Practice Unit, UCL and Anna Freud National Centre for Children and Families, UK
| | - Judith Shipman
- Evidence Based Practice Unit, UCL and Anna Freud National Centre for Children and Families, UK
| | - Felicity Saunders
- Evidence Based Practice Unit, UCL and Anna Freud National Centre for Children and Families, UK
| | | | | | - Jaime Smith
- Anna Freud National Centre for Children and Families, UK
| | - Miranda Wolpert
- Evidence Based Practice Unit, UCL and Anna Freud National Centre for Children and Families, UK
| |
Collapse
|
5
|
Messent P. Test of time: 'Out of the mainstream - helping the children of parents with a mental illness'. Clin Child Psychol Psychiatry 2019; 24:712-716. [PMID: 30658536 DOI: 10.1177/1359104518822674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
6
|
Bendelow G, Warrington CA, Jones AM, Markham S. Police detentions of 'mentally disordered persons': A multi-method investigation of section 136 use in Sussex. Med Sci Law 2019; 59:95-103. [PMID: 30982426 DOI: 10.1177/0025802419830882] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This research was conducted in response to governmental and public concern regarding the escalating use of section 136 of the Mental Health Act (1983) nationally and of the excessive use of police custody as a place of safety in Sussex in particular. A retrospective analysis of all detentions in Sussex during 2012 was combined with qualitative data from 37 people with lived experience of detention, as well as police, National Health Service (NHS) and allied staff and volunteers. Predominantly, police used s136 as suicide prevention (80%) when no other services or help were available. During the period of study (2013-2016), effective joint working strategies, such as the street triage pilot, were able to reduce the overall rates of s136 detentions and to increase access to NHS place of safety suites markedly. Although the research acknowledges idiosyncratic local factors which contribute to the high rate of detentions across Sussex, the results have wider implications for national policy and practice.
Collapse
|
7
|
Krayer A, Robinson CA, Poole R. Exploration of joint working practices on anti-social behaviour between criminal justice, mental health and social care agencies: A qualitative study. Health Soc Care Community 2018; 26:e431-e441. [PMID: 29349844 DOI: 10.1111/hsc.12543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/15/2017] [Indexed: 06/07/2023]
Abstract
Although the police play an important role for people with mental health problems in the community, little is known about joint working practices between mental health, social care and police services. There is potential for tensions and negative outcomes for people with mental health problems, in particular when the focus is on behaviours that could be interpreted as anti-social. This study explores perceptions about joint working between mental health, social care and police services with regard to anti-social behaviour. We conducted a multi-method sequential qualitative study in the UK collecting data between April 2014 and August 2016. Data were collected from two study sites: 60 narrative police logs of routinely gathered information, and semi-structured interviews and focus groups with professionals from a range of statutory and third sector organisations (N = 55). Data sets were analysed individually, using thematic iterative coding before integrating the findings. We also looked at sequencing and turning points in the police logs. Findings mapped on a continuum of joint working practices, with examples more likely to be away from the policy ideal of partnership working as being central to mainstream activities. Joint working was driven by legal obligations and concerns about risk rather than a focus on the needs of a person with mental health problems. This was complicated by different perceptions of the police role in mental health. Adding anti-social behaviour to this mix intensified challenges as conceptualisation of the nature of the problem and agreeing on best practice and care is open to interpretations and judgements. Of concern is an evident lack of awareness of these issues. There is a need to reflect on joint working practices, including processes and goals, keeping in mind the health and welfare needs of people with mental health problems.
Collapse
Affiliation(s)
- Anne Krayer
- School of Social Sciences, Bangor University, Bangor, UK
| | | | - Rob Poole
- School of Social Sciences, Bangor University, Bangor, UK
| |
Collapse
|
8
|
Klinga C, Hansson J, Hasson H, Sachs MA. Co-Leadership - A Management Solution for Integrated Health and Social Care. Int J Integr Care 2016; 16:7. [PMID: 27616963 PMCID: PMC5015547 DOI: 10.5334/ijic.2236] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 05/11/2016] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Co-leadership has been identified as one approach to meet the managerial challenges of integrated services, but research on the topic is limited. In the present study, co-leadership, practised by pairs of managers - each manager representing one of the two principal organizations in integrated health and social care services - was explored. AIM To investigate co-leadership in integrated health and social care, identify essential preconditions in fulfilling the management assignment, its operationalization and impact on provision of sustainable integration of health and social care. METHOD Interviews with eight managers exercising co-leadership were analysed using directed content analysis. Respondent validation was conducted through additional interviews with the same managers. RESULTS Key contextual preconditions were an organization-wide model supporting co-leadership and co-location of services. Perception of the management role as a collective activity, continuous communication and lack of prestige were essential personal and interpersonal preconditions. In daily practice, office sharing, being able to give and take and support each other contributed to provision of sustainable integration of health and social care. CONCLUSION AND DISCUSSION Co-leadership promoted robust management by providing broader competence, continuous learning and joint responsibility for services. Integrated health and social care services should consider employing co-leadership as a managerial solution to achieve sustainability.
Collapse
Affiliation(s)
- Charlotte Klinga
- Medical Management Centre (MMC), Department of Learning, Informatics,
Management and Ethics, Karolinska Institutet, SE
- Department of Social Work, Karolinska University Hospital, SE
| | - Johan Hansson
- Medical Management Centre (MMC), Department of Learning, Informatics,
Management and Ethics, Karolinska Institutet, SE
| | - Henna Hasson
- Medical Management Centre (MMC), Department of Learning, Informatics,
Management and Ethics, Karolinska Institutet, SE
- Centre for Epidemiology and Community Medicine, Stockholm County
Council, SE
| | - Magna Andreen Sachs
- Medical Management Centre (MMC), Department of Learning, Informatics,
Management and Ethics, Karolinska Institutet, SE
| |
Collapse
|
9
|
Hay A, Majumder P, Fosker H, Karim K, O'Reilly M. The views and opinions of CAMHS professionals on their role and the role of others in attending to children who self-harm. Clin Child Psychol Psychiatry 2015; 20:289-303. [PMID: 24366958 DOI: 10.1177/1359104513514068] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Self-harm in young people is a common presentation to mental health services. There is little literature, however, on how professionals view their role and the role of others within the assessment of these young people, and the relative accountability. This study explored Child and Adolescent Mental Health Services (CAMHS) professionals' views of these roles utilising a qualitative framework. The interviews of 18 CAMHS professionals from different disciplines were analysed using a thematic approach. Findings showed participants to be clear regarding the remit of their own role and the purpose of the assessment process, but were less confident in the abilities of those outside their service. They commented on the ongoing problems of stigma in this area and the difficulties with multi-agency working. Findings suggested possible ways to ameliorate these problems; however, the current economic climate may not be conducive to this.
Collapse
Affiliation(s)
| | | | - Hannah Fosker
- East Midlands Healthcare Workforce Deanery, Leicester, UK
| | | | | |
Collapse
|
10
|
Cameron A, Lart R, Bostock L, Coomber C. Factors that promote and hinder joint and integrated working between health and social care services: a review of research literature. Health Soc Care Community 2014; 22:225-33. [PMID: 23750908 DOI: 10.1111/hsc.12057] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/26/2013] [Indexed: 05/12/2023]
Abstract
This article reports the results of a review of the research evidence related to joint working in the field of adult health and social care services in the UK. It explores whether recent reforms to joint working have met the objectives set by policy-makers. The review followed an established methodology: electronic databases were searched using predetermined terms, abstracts were screened against inclusion criteria, studies that met the criteria were read in full and assessed for inclusion and data were extracted systematically. The findings of the review suggest that there is some indication that recent developments, in particular the drive to greater integration of services, may have positive benefits for organisations as well as for users and carers of services. However, the evidence consistently reports a lack of understanding about the aims and objectives of integration, suggesting that more work needs to be done if the full potential of the renewed policy agenda on integration is to be realised. Additionally, while the review acknowledges that greater emphasis has been placed on evaluating the outcome of joint working, studies largely report small-scale evaluations of local initiatives and few are comparative in design and therefore differences between 'usual care' and integrated care are not assessed. This makes it difficult to draw firm conclusions about the effectiveness of UK-based integrated health and social care services.
Collapse
Affiliation(s)
- Ailsa Cameron
- School for Policy Studies, University of Bristol, Bristol, UK
| | | | | | | |
Collapse
|
11
|
Ng S, Stooke R, Regan S, Hibbert K, Schryer C, Phelan S, Lingard L. An institutional ethnography inquiry of health care work in special education: a research protocol. Int J Integr Care 2013; 13:e033. [PMID: 24179456 DOI: 10.5334/ijic.1052] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Revised: 05/06/2013] [Accepted: 07/04/2013] [Indexed: 11/20/2022] Open
Abstract
Background Special education for children with chronic health conditions or disabilities requires the integration of health care work with education. This phenomenon occurs in an understudied and challenging context for integrated care despite policies and protocols that outline work processes in this context. We are interested in an approach to inquiry that will allow us to address gaps in current literature and practices in integrated care, and move towards informing policy. Study design and data collection methods Institutional ethnography is an approach to inquiry that maps the actualities of what individuals do at an everyday local level, while examining this work activity in relation to the sociopolitical context. It has been used to change policy and local practice by highlighting disjunctures between policy and actuality. We are adopting institutional ethnography and its three common methods of data collection: document collection, interviews, and observation/shadowing. Informants to this inquiry are chosen from school-based teams, family-centred units and constellations of clinical professionals. Methods of analysis We are following work processes, verbally and visually mapping what is done and by whom. It is important to note that work includes ‘unofficial’ work, including the work of families and others who may not be assigned an official work role in a policy or protocol. The mediating role of texts in work processes is also being mapped in order to link the local work to the high-level social coordinators. To begin, analysis focuses on local, or micro-level, work processes; next, analysis identifies and explains the macro-level coordination of the local work (i.e. social and political structures). Conclusion A primary outcome of this study will be the creation of verbal and visual maps that demonstrate the social organisation of work processes occurring in the health care-special education interface. These maps will make invisible work visible, highlight disjunctures between policy and practice and identify opportunities for change. They will be useful for critical knowledge translation purposes, providing parents and professionals with an awareness of how their individual work fits in to the larger picture of integrating health care work in special education.
Collapse
|
12
|
Cameron A, Macdonald G, Turner W, Lloyd L. The challenges of joint working: lessons from the Supporting People Health Pilot evaluation. Int J Integr Care 2007; 7:e39. [PMID: 18043723 DOI: 10.5334/ijic.219] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2007] [Revised: 09/05/2007] [Accepted: 09/10/2007] [Indexed: 11/25/2022] Open
Abstract
Purpose This paper reports the findings of the evaluation of the Supporting People Health Pilots programme, which was established to demonstrate the policy links between housing support services and health and social care services by encouraging the development of integrated services. The paper highlights the challenges of working across housing, health and social care boundaries. Method The evaluation of the six health pilots rested on two main sources of data collection: Quarterly Project Evaluation Reports collected process data as well as reporting progress against aims and objectives. Semi-structured interviews—conducted across all key professional stakeholder groups and agencies and with people who used services—explored their experiences of these new services. Results The ability of pilots to work across organisational boundaries to achieve their aims and objectives was associated not only with agencies sharing an understanding of the purpose of the joint venture, a history of joint working and clear and efficient governance arrangements but on two other characteristics: the extent and nature of statutory sector participation and, whether or not the service is defined by a history of voluntary sector involvement. In particular the pilots demonstrated how voluntary sector agencies appeared to be less constrained by organisational priorities and professional agenda and more able to respond flexibly to meet the complex needs of individuals. Conclusion and discussion The pilots demonstrate that integrating services to support people with complex needs works best when the service is determined by the characteristics of those who use the service rather than pre-existing organisational structures.
Collapse
|