Challenges and Insights in Inter-Organizational Collaborative Healthcare Networks: An Empirical Case Study of a Place-Based Network

Purpose Public sectors have responded to grand societal challenges by establishing Collaboratives – new inter-organisational partnerships to secure better quality health services. In the UK, a proliferation of collaboration-based healthcare networks exists that could help to both enhance the value of investments in quality improvement programmes. The nature and organisational form of such improvements is still a subject of debate within the public-sector literature. Placed-based collaboration has been proposed as a possible solution. In response, this research paper presents the results and findings of a placed-based collaborative network, highlighting challenges and insights. Design/methodology/approach This study adopted a social constructionist epistemological approach, using a qualitative methodology. A single case study was used, and data collected in three different stages over a two-year period. Findings The study finds that leadership, data-enabled learning through system-wide training and development, and the provision of an enabling environment that is facilitated by an academic partner, can go a long way in the managing of healthcare networks for improving quality. Research limitations/implications Regardless of the tensions and challenges with placed-based networks, they could still be a solution in maximising the public value required by government investments in the healthcare sector since they offer a more innovative structure that can help to address complex issues beyond the remit of hierarchical structures. This research is limited by the use of a single case study. Practical implications Across countries health systems are moving away from markets to collaborative models for health care delivery and from individual services to population based approaches. This paper provides insights to inform leaders of collaborative health models in the design and delivery of these new collaborations. Social implications As demand rises (as a result of increasing complexity and demographics) in the western world, health systems are seeking to redefine the boundaries between health service provision and community self-reliance and resilience. This paper provides insights into the new partnership between health institutions and communities, providing opportunities for more social-based and solidarity-based healthcare models which place patients and the public at the heart of change

Longitudinal Study of the Impact of the London Darzi fellowship Programmes years 1-8.

This report is based on a retrospective evaluation of the Darzi Fellows in Clinical Leadership Programme, supporting multidisciplinary clinicians and allied healthcare professionals (AHPs) in project-based attachments to NHS organisations across London. The Darzi Alumni and London South Bank University collaborated to develop a longer-term review of the impact of the Darzi programme (currently in Cohort 9). This evaluation complements the in-programme evaluations of each cohort demonstrating the immediate success of eight previous cohorts of ‘Darzi’ Fellowships in London. The fellowship combines a work-based change project and a Leadership Development Programme incorporating a Post Graduate Certificate over the course of a year. This longitudinal study demonstrates that overall there is much evidence that the Darzi programme has practically and intuitively shown Fellows how to think first and then act differently for alternative outcomes. Fellows are much more proactive than reactive because of the programme. Many responses carried a central message of empowered, enlightened and highly skilled individuals who are actively and uniquely challenging the status quo. Thus, there is clear evidence that the Darzi programme has created a plethora of systems thinkers and doers, with a greater understanding of how to use data to bring about system change. A picture emerged of often bold individuals with a determination to actively instigate change across London and beyond. There is evidence that many Fellows are emerging as leaders, acting as catalysts for sustainable change in the healthcare environment. By any reasonable measurement, the Darzi programme continues to be successful with learning and behavioural change sustained after the Fellowship year

Can Volunteering Help Create Better Health and Care. An evidence review.

This report was commission by Sir Thomas Hughes-Hallett founder of HelpForce in March 2017 to review the current evidence on the effectiveness, deployment and impact of volunteers in the NHS, to support the organisation’s work in maximizing the potential of volunteering in health and social care. This report’s remit was to pull together evidence to help answer the following questions: 1. What volunteer / lay roles are effective in health and care? 2. What do we know about the effective recruitment, management and deployment of volunteers (in any setting)? 3. What evidence is there about the impact of volunteers in health and social care, within England health and social care organisations, and from voluntary sector initiatives working into health and social care

Innovation and Sustainability in Large-Scale Healthcare Improvement Collaborative – Seven Propositions for Achieving System-wide Innovation and Sustainability

Change and reform in the Healthcare system, and policy determination to reduce costs has now necessitated a rethink and more innovation for this sector. In the healthcare sector, leadership needs to strengthen professionals who have the dual responsibility for ensuring the quality and effectiveness of healthcare and this requires new organisational forms beyond the traditional hierarchical organisational structures. Drawing upon strategic management and leadership discourse to underpin the study into sustainable and high performing systems, we then look at seven key lessons (propositions) from a mixed-methods study of a live city-wide large-scale collaborative in Leeds, UK. These seven propositions are framed in the context of leadership and strategy, however interesting and emergent findings also emerged as a result of the study. We thereby illuminate the challenges and opportunities to the collaboratives development in the context of global government calls for better healthcare management within the sector. We found that in the sustainability of such collaboratives, requires a more effective structure could be local city-wide collaborative in contrast to national or regional collaborative, however there are also several unknowns in such novel organisational structures. The shared and distributive form of leadership is underpinned with an energetic strategic leader who holds the centre whilst inspiring and empowering the collective nature of all members. This is also effectively achieved through promotion of a professional culture that is sustained through structured organisational learning. This paper adds to the small but growing body of knowledge in Improvement Collaboratives in the Health sector

The Asset Based Health Inquiry: How best to develop social prescribing

Phrases like ‘social prescribing’ and ‘coproduction’ speak to missing elements from mainstream healthcare – the need for broader than pharmacological solutions (social prescribing) and for sharing the responsibilities for maintaining and recovering health (coproduction). Neither of these approaches have yet been able to make the required impact on mainstream health services. The social prescribing initiative set out under the NHS long-term plan that is now being put into practice by NHS England (2019), is in some respects a vindication of our approach, developed by the Health Systems Innovation Lab at LSBU, where we have studied and promoted more humane approaches to healthcare, working closely with many of the pioneers of social prescribing in the UK. But on closer examination, we were not quite so sure the match was complete. Some of the key people who have developed the most important social innovations in primary care were nervous about it. It was not clear whether they were nervous about the language of ‘social prescribing’ or about the organisation of social prescribing, as set out in NHS policy. We organised this brief Inquiry in order to find ou

Introducing a Peoples Academy into Higher Education: A coproduction approach to sustained wellbeing

Purpose: The introduction of a People’s Academy within the School of Health and Social Care at London South Bank University has created ripples across the pond that is Higher Education. Approach: Working as a coproduction innovation hub, the People’s Academy celebrates inclusion of those with a lived experience of health and social care services into the academic community as valued members of the teaching and learning team. In it’s second year the People’s Academy has gained attention and achieved a ‘highly commended’ status from external regulating bodies. Findings: In this paper we report on aspects arising from an entrepreneurial education approach. First, is the work based learning experience students achieve within the Higher Education Institution setting, preparing them for clinical placements and client encounters. Second are ripples of activity the People’s Academy workstreams have sent throughout the academic staff via critically creative working practices as a process of entrepreneurial education. Conclusions focus on a sustainable approach to recovery and resilience (whether physical or psychological) and overall wellbeing that People’s Academy members recognise as a raised level of compassion for sustainable health and wellbeing for all. Originality: The work and enthusiasm of the People’s Academy as an authentic social engagement process rippling across the ‘University’ experience; whether for students in the classroom or when working alongside academic staff, is identifiable in all aspects of academic activities. Most importantly is a positive gain in terms of knowledge, skills and confidence for the People’s Academy members themselves and their own wellbeing enhancement

Human cloning laws, human dignity and the poverty of the policy making dialogue

BACKGROUND: The regulation of human cloning continues to be a significant national and international policy issue. Despite years of intense academic and public debate, there is little clarity as to the philosophical foundations for many of the emerging policy choices. The notion of "human dignity" is commonly used to justify cloning laws. The basis for this justification is that reproductive human cloning necessarily infringes notions of human dignity. DISCUSSION: The author critiques one of the most commonly used ethical justifications for cloning laws – the idea that reproductive cloning necessarily infringes notions of human dignity. He points out that there is, in fact, little consensus on point and that the counter arguments are rarely reflected in formal policy. Rarely do domestic or international instruments provide an operational definition of human dignity and there is rarely an explanation of how, exactly, dignity is infringed in the context reproductive cloning. SUMMARY: It is the author's position that the lack of thoughtful analysis of the role of human dignity hurts the broader public debate about reproductive cloning, trivializes the value of human dignity as a normative principle and makes it nearly impossible to critique the actual justifications behind many of the proposed policies

Simulating the influences of groundwater on regional geomorphology using a distributed, dynamic, landscape evolution modelling platform

A dynamic landscape evolution modelling platform (CLiDE) is presented that allows a variety of Earth system interactions to be explored under differing environmental forcing factors. Representation of distributed surface and subsurface hydrology within CLiDE is suited to simulation at sub-annual to centennial time-scales. In this study the hydrological components of CLiDE are evaluated against analytical solutions and recorded datasets. The impact of differing groundwater regimes on sediment discharge is examined for a simple, idealised catchment, Sediment discharge is found to be a function of the evolving catchment morphology. Application of CLiDE to the upper Eden Valley catchment, UK, suggests the addition of baseflow-return from groundwater into the fluvial system modifies the total catchment sediment discharge and the spatio-temporal distribution of sediment fluxes during storm events. The occurrence of a storm following a period of appreciable antecedent rainfall is found to increase simulated sediment fluxes

Maturation of the gut microbiome and risk of asthma in childhood

Colonization of commensal bacteria is thought to impact immune development, especially in the earliest years of life. Here, the authors show, by analyzing the development of the gut microbiome of 690 children, that microbial composition at the age of 1 year is associated with asthma diagnosed in the first 5 years of life

Research campaigns in the UK National Health Service: patient recruitment and questions of valuation

The National Institute for Health Research (NIHR) aims to improve national ‘health and wealth' by providing infrastructural support to enable clinical research in National Health Service settings in England and Wales. Cognisant of the consequences of studies' failure to achieve required numbers of participants, it also actively campaigns to promote patient awareness of research, and willingness to participate in trials. In this paper, we analyse recent NIHR campaigns and policies designed to encourage patients to participate in clinical research to interrogate how they are implicated in the national bioeconomy. In doing so we expand the notion of ‘clinical labour' to include the work of patient recruitment and highlight an emergent obligation on patients to contribute to research processes. Whereas once patient knowledge and experience may have been devalued, here we draw on the concept of ‘assetisation' (Birch 2012) to explore the emergent relationship between healthcare system and patient as research participant. We consider how patients' contribution goes beyond the provision of standardised objects of valuation so that patients themselves may be perceived as assets to, not only recipients of, the national healthcare system