Mapping the Status of Healthcare Improvement Science through a Narrative Review in Six European Countries

With the aim to explore how improvement science is understood, taught, practiced, and its impact on quality healthcare across Europe, the Improvement Science Training for European Healthcare Workers (ISTEW) project “Improvement Science Training for European Healthcare Workers” was funded by the European Commission and integrated by 7 teams from different European countries. As part of the project, a narrative literature review was conducted between 2008 and 2019, including documents in all partners’ languages from 26 databases. Data collection and analysis involved a common database. Validation took place through partners’ discussions. Referring to healthcare improvement science (HIS), a variety of terms, tools, and techniques were reported with no baseline definition or specific framework. All partner teams were informed about the non-existence of a specific term equivalent to HIS in their mother languages, except for the English-speaking countries. A lack of consensus, regarding the understanding and implementation of HIS into the healthcare and educational contexts was found. Our findings have brought to light the gap existing in HIS within Europe, far from other nations, such as the US, where there is a clearer HIS picture. As a consequence, the authors suggest further developing the standardization of HIS understanding and education in Europe.The research conducted until 2015 was funded by the European Union funded ERASMUS Lifelong Learning Project, ISTEW: Improvement Science Training for European Healthcare Workers (Project No. 539194-LLP-1-2013-1-UK-ERASMUS-EQR)

Making it easy to do the right thing in healthcare: Advancing improvement science education through accredited pan European higher education modules

Background: Numerous international policy drivers espouse the need to improve healthcare. The application of Improvement Science has the potential to restore the balance of healthcare and transform it to a more person-centred and quality improvement focussed system. However there is currently no accredited Improvement Science education offered routinely to healthcare students. This means that there are a huge number of healthcare professionals who do not have the conceptual or experiential skills to apply Improvement Science in everyday practise. Methods: This article describes how seven European Higher Education Institutions (HEIs) worked together to develop four evidence informed accredited inter-professional Improvement Science modules for under and postgraduate healthcare students. It outlines the way in which a Policy Delphi, a narrative literature review, a review of the competency and capability requirements for healthcare professionals to practise Improvement Science, and a mapping of current Improvement Science education informed the content of the modules. Results: A contemporary consensus definition of Healthcare Improvement Science was developed. The four Improvement Science modules that have been designed are outlined. A framework to evaluate the impact modules have in practise has been developed and piloted. Conclusion: The authors argue that there is a clear need to advance healthcare Improvement Science education through incorporating evidence based accredited modules into healthcare professional education. They suggest that if Improvement Science education, that incorporates work based learning, becomes a staple part of the curricula in inter-professional education then it has real promise to improve the delivery, quality and design of healthcare.Erasmus+ Life long Learning Programme

Consumer education in the UK : new developments in policy, strategy and implementation

Consumer education is an integral part of the European Community's consumer policy. It plays a key role in consumer empowerment, helping consumers gain the skills, attitudes and knowledge they need to be able to gear the choices they make as consumers to their economic interests and to protect their health and safety. In its policy statement, the Directorate General for Health and Consumer Protection states that the European Community is aware that joint measures at national and Community levels should be more structured, in order to achieve maximum effectiveness. This paper aims to set out the current policy and strategic context for consumer education and empowerment in the UK; review the role of UK government bodies and other agencies concerned with developments; review recent literature; present the results of interviews with an extensive range of key stakeholders and the results of a survey of service heads for trading standards throughout the UK. It will consider implementation, partnership, resources, ideas and opportunities. The research found that the agenda for consumer education in the UK is at an interesting stage of development. The Enterprise Act 2002 gives the Office of Fair Trading (OFT) a statutory power to carry out educational activities. Consumer education is also moving up the agenda in the trading standards service. In addition, the teaching of citizenship in English schools is already stimulating new developments in consumer education. The paper will consider the need for organizations like these to work together to build on these policy developments and ensure that consumer education gains the profile it needs to influence consumer attitudes and behaviour.div_BaMTrading Standards Institute ( 2003) Consumer Education in the UK. Trading Standards Institute, Essex. 2. National Consumer Council ( 2003) Creating Consumer Confidence: Consultation on Consumer Education. London . [WWW document]. URL http://www.ncc.org.uk/policy/education.htm (accessed 28 May 2003). 3. Department of Trade and Industry ( 2003) Consumer and Competition Policy Directorate Website . [WWW document]. URL http://www.dti.gov.uk/ccp/topics1/advice.htm (accessed 28 May 2003). 4. National Consumer Council ( 2001) Consumer Education: Beyond Consumer Information. National Consumer Council, London. 5. Office of Fair Trading ( 2000) Consumer Detriment. Office of Fair Trading , London. 6. Office of Fair Trading ( 2000) Low Earners Suffer Greater Detriment. Office of Fair Trading, London . 7. European Module in Consumer Education . [WWW document]. URL http://www.consumermodule.net/european/4The%20Objectives.htm (access 9 June 2002). 8. [WWW document]. URL http://europa.eu.int/comm/consumers/policy/developments/cons_educ/index_en.html 9. Department of Trade and Industry ( 1999) Modern Markets: Confident Consumers. HMSO, London . 10. Department of Trade and Industry ( 1999) Consumer Support Networks: Getting Connected. Department of Trade and Industry, London. 11. HMSO ( 2002) The Enterprise Act 2002. HMSO/Department of Trade and Industry , London. 12. Office of Fair Trading (2003) The Annual Plan 2003/4 Consultation Paper. Office of Fair Trading, London. 13. Office of Fair Trading ( 2003) It's your call. Fair Trading . pp. 5- 6. Office of Fair Trading, London. 14. National Consumer Council ( 2002) Trading Information: The Case for a One-Stop-Shop Information Service Based on the Track Records of Traders. National Consumer Council, London . 15. Scottish Consumer Council ( 2003) Knowledge of Consumer Rights in Scotland . pp. 10- 11. Scottish Consumer Council, Glasgow . 16. Northern Ireland General Consumer Council ( 2000) Consumer Education Manifesto . [WWW document]. URL http://www.gccni.org.uk/education (accessed 28 May 2003). 17. Welsh Consumer Council ( 2002) Consumer Education Website . [WWW document]. URL http://www.consumereducation.org.uk (accessed 28 May 2003). 18. Financial Services Authority ( 2000) Consumer Research 1: Better Informed Consumers . [WWW document]. URL http://www.fsa.gov.uk/pubs/consumer-research/crpr01.pdf (accessed 16 June 2003). 19. Consumers Association and Edge Hill College ( 1994) Consumer Education Development Project 1991-1994. Consumers Association, London , p. 49. 20. Atherton, M. & Wells, J. ( 1998) Consumer education: learning for life. Consumer Policy Review, 8. 21. Coppack, M. ( 2002) Complementing information and advice. Adviser, May/June, 49- 52. 22. National Consumer Education Partnership ( 1999) A Framework for the Development of Consumer Skills and Attitudes. [WWW document]. URL http://www.ncep.org.uk/pages/framework.htm (accessed 16 June 2003).28pub79pub

The impact of personal budgets on unpaid carers of older people

Summary This paper focuses on the impact of a personal budget – either in the form of a direct payment or managed personal budget – on the role of unpaid carers of older budget holders. Data were collected via postal survey of 1500 unpaid carers and semi-structured interviews with 31 carers. Findings Unpaid carers played a central role in supporting older budget holders irrespective of the type of budget received. The allocation of a personal budget may have decreased the amount of ‘hands-on’ care they provided, enabling them to do different things for and with the person cared for, but most did not relinquish direct involvement in care provision. Both kinds of personal budget provided greater flexibility to juggle caring tasks with other roles, such as childcare or paid employment. However, carers supporting direct payment users did experience higher levels of stress. This seemed linked to the additional responsibilities involved in administering the direct payment. Carers seemed relatively unsupported by their local Adult Social Care Department: the survey found that only one in five said they had ever received a carer assessment. Application The findings offer a detailed exploration of the impact of personal budgets on carers, suggesting that even in countries with relatively well-developed systems of support for carers such as England their impact remains overlooked. The paper may be of interest to social work practitioners, managers, academics and social work policy specialists working in countries that have, or are about to introduce, personal budgets or other forms of cash-for-care scheme. </jats:sec

Do direct payments improve outcomes for older people who receive social care? Differences in outcome between people aged 75+ who have a managed personal budget or a direct payment

ABSTRACTDirect payments – cash for people eligible for adult social care and spent by them on care and support – are claimed to enable care to better reflect user preferences and goals which improve outcomes. This paper compares outcomes of older direct payment users and those receiving care via a managed personal budget (where the budget is spent on the recipients behalf by a third party). The study adopted a retrospective, comparative design using a postal questionnaire in three English councils with adult social care responsibilities in 2012–13. Included in the study were 1,341 budget users aged 75+, living in ordinary community settings. The overall response rate was 27.1 per cent (339 respondents). Three validated scales measured outcomes: EQ-5D-3L (health status), the Sheldon–Cohen Perceived Stress Scale and the Adult Social Care Outcomes Toolkit (social care-related quality of life). The study found that direct payment users appreciated the control conferred by budget ownership, but in practice, for many it did not ‘translate’ into improved living arrangements. It also found no statistically significant difference in outcomes between direct payment and managed personal budget users. The paper argues that despite policy and other guidance and research evidence about effective implementation of direct payments for older people, the absence of evidence for better outcomes may at least in part be attributable to values underpinning policies relating to personalisation and personal budgets.</jats:p