“Sliding Doors”: innovative approaches to supporting culture change

2014 ◽  
Vol 22 (4) ◽  
pp. 154-164 ◽  
Author(s):  
Gill Walker ◽  
Laura Gillies

Purpose – Reshaping Care for Older People (RCOP) and Integration of Health and Social Care are central to providing a care system in Scotland that meets older people's current and future needs. Their implementation requires a workforce with the appropriate knowledge, skills and values to engage with older people across health and social care sectors, which requires a change in professionals’ thinking about services. The paper aims to discuss these issues. Design/methodology/approach – NHS Education for Scotland, the Scottish Social Services Council and a learning and development consultancy designed and delivered innovative education resources to support health and social care staff across Scotland to understand the new agenda and recognise its meaning for practice. Findings – Two related resources were developed: workshop using actors to depict scenarios from older people's lives to support participants to reflect on the new policy direction and outcomes-focused approaches; and an online resource using the same characters that can be delivered locally for groups and individuals. Participants were enabled to identify what they need to do differently and how they can support one another to make necessary changes. A formal evaluation has been commissioned. Originality/value – The resource characters represent the people the new policy is designed to affect. By following their lives through an educational drama approach, health and social care staff can understand the difference RCOP and the integration agenda can make and recognise their part in effecting change.

2017 ◽  
Vol 25 (4) ◽  
pp. 265-270 ◽  
Author(s):  
Stewart Greenwell ◽  
Daniel Antebi

Purpose The Social Services and Wellbeing (Wales) Act 2014 and the Well-being of Future Generations (Wales) Act 2015 provide a direction of travel for all public services in Wales and a framework for delivering the aspirations in the legislation. Although specifically referring to social care, both pieces of legislation are as relevant to the NHS as they are to other public bodies, providing an opportunity for NHS Wales and local government, in particular, to be equal partners in making a difference to the people and communities they serve. The paper aims to discuss these issues. Design/methodology/approach A viewpoint paper. Findings In Wales the time is right to do things differently in health and social care, so the authors will reflect on why current services are struggling and propose an approach that is rooted in communities rather than in specialities. The authors suggest developing a centre of gravity in the community through a multi-agency collaboration to achieve the greatest health, social care and economic impact. Originality/value Attention needs to be directed to supporting people, communities and frontline workers to become more resilient, rather than our current focus on specialist services.


2014 ◽  
Vol 27 (7) ◽  
pp. 562-572 ◽  
Author(s):  
Keith Hurst ◽  
Deirdre Kelley Patterson

Purpose – The purpose of this paper is to discuss the issues relating to getting the right health and social care staff with the right skills in the right place at the right time and at the right price. Design/methodology/approach – Key points arising from several master-classes with health and social care managers, supported by a literature review, generated remarkable insights into health and social care workforce planning and development (WP&D). Findings – Flawed methods and overwhelming data are major barriers to health and social care WP&D. Inefficient and ineffective WP&D policy and practice, therefore, may lead to inappropriate care teams, which in turn lead to sub-optimal and costly health and social care. Increasing health and social care demand and service re-design, as the population grows and ages, and services move from hospital to community, means that workforce planners face several challenges. Issues that drive and restrain their health and social care WP&D efforts are lucid and compelling, which leave planners in no doubt what is expected if they are to succeed and health and social care is to develop. One main barrier they face is that although WP&D definitions and models in the literature are logical, clear and effective, they are imperfect, so planners do not always have comprehensive tools or data to help them determine the ideal workforce. They face other barriers. First, WP&D can be fragmented and uni-disciplinary when modern health and social care is integrating. Second, recruitment and retention problems can easily stymie planners’ best endeavours because the people that services need (i.e. staff with the right skills), even if they exist, are not evenly distributed throughout the country. Practical implications – This paper underlines triangulated workforce demand and supply methods (described in the paper), which help planners to equalise workloads among disparate groups and isolated practitioners – an important job satisfaction and staff retention issue. Regular and systematic workforce reviews help planners to justify their staffing establishments; it seems vital, therefore, that they have robust methods and supporting data at their fingertips. Originality/value – This paper stock-takes the latest health and social care workforce planning and development issues.


2019 ◽  
Vol 23 (3) ◽  
pp. 127-141 ◽  
Author(s):  
Jill Manthorpe ◽  
Stephanie Bramley

Purpose The purpose of this paper is to review evidence about the role of education in supporting ex-service personnel to move to social care work with older people. Social care has long-standing, well-recognised problems of staff recruitment and retention in many jurisdictions. Within ageing societies, the need for more social care staff is predicted to rise. Therefore, policy makers and employers are exploring if there are untapped sources of potential employees. Some ex-service personnel may be interested in exploring a move to social care work with older people but may need to gain additional qualifications. Design/methodology/approach Databases and grey literature were searched systematically to provide an overview of the evidence on this topic. Six articles were included in the review. Findings A narrative analysis revealed two themes: preparing ex-service personnel for enrolment onto health and social care programmes, and supporting ex-service personnel during health and social care programmes. Research limitations/implications This review was confined to English language studies published between 2008 and 2018. Few mentioned specific user or client groups. Originality/value This review identified evidence gaps relating to whether the skills, education, training and experience gained in the armed services are transferable to civilian social care work with older people; the types of support which are offered to ex-service personnel who are interested in completing qualifications necessary for social care roles and the views of ex-service personnel about their experiences of completing educational courses to facilitate a transition into social care work with older people.


2018 ◽  
Vol 19 (4) ◽  
pp. 273-285 ◽  
Author(s):  
Charles Musselwhite

Purpose The purpose of this paper is to examine how older people who are almost entirely housebound use a view from their window to make sense of the world and stay connected to the outside space that they cannot physically inhabit. Design/methodology/approach Semi-structured interviews with 42 individuals were carried out who were living at home, were relatively immobile and had an interesting view outside they liked from one or more of their windows. Findings The findings suggest that immobile older people enjoy watching a motion-full, changing, world going on outside of their own mobility and interact and create meaning and sense, relating themselves to the outside world. Practical implications Findings suggest that those working in health and social care must realise the importance of older people observing the outdoors and create situations where that is enabled and maintained through improving vantage points and potentially using technology. Originality/value This study builds and updates work by Rowles (1981) showing that preference for views from the window involves the immediate surveillance zone but also further afield. The view can be rural or urban but should include a human element from which older people can interact through storytelling. The view often contains different flows, between mundane and mystery and intrigue, and between expected and random.


2018 ◽  
Vol 21 (3/4) ◽  
pp. 108-122
Author(s):  
Patricia Dearnaley ◽  
Joanne E. Smith

Purpose The purpose of this paper is to stimulate a wider debate around the coordination of workforce planning in non-statutory services (in this case, specialist housing for older people or those with long-term health and social care needs, such as learning disabilities). The authors argue that current NHS reforms do not go far enough in that they fail to include specialist housing and its workforce in integration, and by doing so, will be unable to optimise the potential efficiencies and streamlining of service delivery to this group. Design/methodology/approach The paper used exploratory study using existing research and data, enhanced by documentary analysis from industry bodies, regulators and policy think tanks. Findings That to achieve the greatest operational and fiscal impact upon the health care services, priority must be given to improving the efficiency and coordination of services to older people and those requiring nursing homes or registered care across the public and third sectors through the integration of service delivery and workforce planning. Research limitations/implications Whilst generalisable and achievable, the model proposed within the paper cannot be fully tested theoretically and requires further testing the in real health and social care market to evidence its practicality, improved quality of care and financial benefits. Originality/value The paper highlights some potential limitations to the current NHS reforms: by integrating non-statutory services, planned efficiency savings may be optimised and service delivery improved.


2015 ◽  
Vol 17 (2) ◽  
pp. 139-147
Author(s):  
Andrea Giordano ◽  
Alison Neville

Purpose – The purpose of the paper is to improve the consistency and quality of the response to vulnerable adults who experience abuse and neglect within NHS, independent healthcare and social care settings is noted by practitioners, agencies and patients. Health and social care policy frameworks promote principles of service improvement and consistency, along with a focus on outcomes and resource effectiveness and interagency collaboration. The Protection of Vulnerable Adults (POVA) coordinator role carries the responsibility of coordinating a response to individual referrals of abuse and neglect as described as part of the Designated Lead Manager role in the Wales Interim POVA Policy and Procedures for the POVA from abuse (Wales Adult Protection Coordinators Group, 2013). Design/methodology/approach – This paper will explore the benefits realised through a registered nurse being seconded from the Aneurin Bevan University Health Board into a newly created joint adult protection Health Coordinator post within the Caerphilly County Borough Council social services department POVA team. Findings – This is the first example of such partnership working in adult protection in Wales and has provided a number of benefits in relation to: providing adult protection advice; coordinating the response to referrals of vulnerable adult abuse and neglect within health and social care settings; carrying out or buddying others to complete adult protection investigations; facilitating the two day non-criminal POVA investigation training course and, awareness raising within the local Health Board. The development of a student nurse placement in the social services POVA team cements the multiagency collaborative approach that this development sought to achieve. Originality/value – The need to improve the consistency and quality of the response to vulnerable adults who experience abuse and neglect within NHS, independent healthcare and social care settings is noted by practitioners, agencies and patients.


2020 ◽  
Vol 21 (2) ◽  
pp. 129-139 ◽  
Author(s):  
Ailsa Cameron ◽  
Eleanor K. Johnson ◽  
Paul B. Willis ◽  
Liz Lloyd ◽  
Randall Smith

Purpose This paper aims to report the findings of a study that explores the contribution volunteers make to social care for older adults, identifying lessons for the social care sector and policymakers. Design/methodology/approach An exploratory multiple case study design was used to capture the perspectives and experiences of managers of services, volunteer co-ordinators, volunteers, paid care staff and older people. Seven diverse social care organisations took part in the study drawn from three locations in the South West of England. Findings This study identified three distinct models of volunteer contribution to social care services for older people. Although the contributions made by volunteers to services are valued, the study drew attention to some of the challenges related to their involvement. Research limitations/implications The organisations taking part in this small-scale study were all based in the South West of England, and the findings are therefore not generalisable but contribute to the growing evidence base related to this important field. Practical implications This study demonstrates the importance of the volunteer co-ordinator role and suggests that it is properly funded and resourced. It also confirms the importance of volunteers receiving appropriate training and support. Originality/value Given the increasing involvement of volunteers in the provision of social care, this paper provides lessons to ensure the role of volunteers in social care enhances rather than diminishes the quality of care provided.


2016 ◽  
Vol 24 (5/6) ◽  
pp. 282-299
Author(s):  
Jenny Billings ◽  
Alison Davis

Purpose Current debates surrounding the NHS contract in England are suggesting that it is in need of change to support an integrated health and social care transformation agenda that meets the needs of an ageing chronically ill population. The purpose of this paper is to describe a three-phase project in England that sought to develop and validate a whole systems contracting model for integrated health and social care focusing on older people with long-term conditions, and based on joint outcomes. Design/methodology/approach A participative mixed-method approach for the development of the contracting model was used; this consisted of a literature review, a design phase drawing on consensus method through stakeholder discussions and an international validation phase. Findings The final contracting model consists of four overarching and interrelated core elements: outcomes; partnership, collaboration and leadership; financial: incentives and risk; and legal criteria. Each core element has a series of more detailed contracting criteria, followed by further specifications attached to each criteria. Research limitations/implications While the policy environment appears to be conducive to change and encourages the adoption of new ways of thinking, there are difficulties with the implementation of new innovative models that challenge the status quo, and this is discussed. Practical implications The paper concludes with reflections on the way forward for local development and implementation. Originality/value There is currently much discussion for the need to realign contracting for integrated care that has a better fit for the transformation agenda, but until now, there have been no attempts to develop a whole systems approach that focusses on joint outcomes. This research bridges the gap but recognizes the challenges to implementation.


2019 ◽  
Vol 27 (1) ◽  
pp. 50-63 ◽  
Author(s):  
Sundari Joseph ◽  
Susan Klein ◽  
Samantha McCluskey ◽  
Penny Woolnough ◽  
Lesley Diack

Purpose Collaborative inter-agency working is of paramount importance for the public protection agenda worldwide. The purpose of this paper is to disseminate the findings from a research study on the inter-agency working within adult support and protection (ASP) roles in the police, health and social care. Design/methodology/approach This realistic evaluation study with two inter-related phases was funded by the Scottish Institute for Policing Research. This paper reports on Phase 1 which identified existing gaps in the implementation of effective inter-agency practice by reviewing the “state of play” in inter-agency collaboration between the police and health and social care professionals. In total, 13 focus groups comprising representatives from Police Scotland (n=52), Social Care (n=31) and Health (n=18), engaged in single profession and mixed profession groups addressing issues including referral and information exchange. Findings On analysing context-mechanism-outcome (CMO), gaps in joint working were identified and attributed to the professionals’ own understanding of inter-agency working and the expectations of partner agencies. It recommended the need for further research and inter-agency training on public protection. Research limitations/implications This unique Scottish study successfully identified the inter-agency practices of health, social services and police. By means of a modified realistic evaluation approach, it provides an in-depth understanding of the challenges that professionals face on a day-to-day basis when safeguarding adults and informed strategic recommendations to overcome the barriers to good practices in organisational working. The methods used to determine CMO could benefit other researchers to develop studies exploring the complexities of multi-causal effects of cross-boundary working. The use of the same case study in each focus group helped to neutralise bias. However, the voluntary nature of participation could have resulted in biased perceptions. The limited numbers of health professionals may have resulted in less representation of health sector views. Practical implications This paper reports on a Scottish study that focused on the coordinated and integrated practices amongst the police, health and social services’ professionals who support and protect adult members of society at risk of harm and has implications for their practice. Social implications Whilst the focus of this study has been on ASP, the conclusions and recommendations are transferable to public protection issues in many other contexts. Originality/value Studies on the joint-working practices amongst police and health and social services’ professionals who support and protect adult members of society at risk of harm are uncommon. This study investigated professionals’ perceptions of gaps and concerns pertaining to integrated working by means of a realistic evaluation approach. It recommended the need for further research and inter-agency training on public protection.


2014 ◽  
Vol 15 (4) ◽  
pp. 187-196 ◽  
Author(s):  
Anthea Tinker ◽  
Nesar Gilani ◽  
Isabella Luthra ◽  
Olivia Richardson ◽  
Alexander Howells ◽  
...  

Purpose – The purpose of this paper is to start a debate about older people who are in groups that are not readily visible to policy makers and practitioners. Design/methodology/approach – The paper is based on information obtained from academic literature, government statistics and other publications from relevant organisations. The authors investigated one “invisible” group each and comparisons and conclusions were then made collaboratively. Findings – Many groups of older people seem to be absent from statistics and from policy making. The paper suggests that there needs to be more research to identify the scale of any problems and how they may be solved. Research limitations/implications – This is not a systematic review but a preliminary account of the problem. Practical implications – There are practical implications for health and social care professionals if they do not recognise that there are groups in society about whom little is known. Lack of knowledge and empathy may affect their approach to these groups. Social implications – There are implications for society if these groups are not taken into account in decision making and especially over the allocation of resources. Originality/value – There is little written which brings together the lack of attention paid to these groups as a whole.


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