Whose outcomes are they anyway? Report of the pilot evaluation of a joint service\ud

Health and social care partnership working is often predicated on the notion that it improves outcomes for service users. Yet there is a lack of evidence linking partnerships to changes in outcomes. Against this background, the Health Services Management Centre at the University of Birmingham designed the Partnership Outcomes Evaluation Toolkit (POET) specifically to evaluate health and social care partnerships in terms of service user outcomes. This paper reports on the field testing of POET with Sandwell Integrated Support Service. This research provided a number of interesting insights into this service, and indicated some dissonance between staff and service user and carer expectations

The importance of being efficacious: English health and social care partnerships and service user outcomes

The need for health and social care agencies and their professionals to work in partnership is a central component of contemporary English health and social care policy. Partnership is predicated on the notion that this way of working improves services and outcomes for service users. However, as there is little evidence that partnerships improve service user outcomes, some commentators suggest that this indicates either a failure of the policy or a deficit in terms of implementation. This thesis investigates the link between health and social care partnerships and service user outcomes. Rather than adopting the types of rationalist and instrumental approach which the majority of studies in this field have done, the thesis develops a new conceptual framework for partnership which is interpretive and performative. This framework is developed and tested in four exploratory case study sites and concludes that partnership is not necessarily simply an instrument of improvement in a traditional sense. The power of partnership lies in its cultural and symbolic value. This takes partnership beyond traditional discussions of partnership and governance; rather than representing a particular mode of governance, instead arguing that partnership is an active tool of governance

Greater than the sum of our parts? Emerging lessons for UK health and social care

Background and introduction: Although most developed countries are currently pursuing greater integration of health and social care, the current evidence base is limited by a number of key weaknesses in the existing literature. Chief amongst these is the tendency to focus on issues of process (‘how well are we working together’?) not on outcomes (does it make any difference to people who use services?). As a result, there is a danger that integration can become an end in itself, rather than a means to an end (of better services and better outcomes). <br><br> Understanding context, process and outcomes: To guard against this danger, this policy paper sets out a number of theoretical and conceptual frameworks to help policy makers, managers and practitioners remain focused on the outcomes that their joint work is meant to achieve. This includes different approaches to being clear about what integration is trying to deliver (outcomes), understanding where we are now (context) and how we get from where we are now to where we want to be (process). <br><br> Conclusion: Rather than assume that integration is automatically a ‘good thing’, the frameworks presented in this paper suggest a more critical approach in which policy makers, managers and practitioners focus in more detail on what they are trying to achieve for the people they serve, viewing integration as a means to an end and never an end in itself

Dental anxiety prevalence and surgery environment factors: A questionnaire-based survey of attenders in Ireland

Aim: To identify and quantify anxious dental patientsand dental office environment factors that may influence anxiety. Objective: To develop and implement a questionnaire toinvestigate dental anxiety and identify factors thatenhance or lessen dental anxiety in the surgery setting. Methods: Data was collected from patients by a self completed questionnaire when attending dentists at a general dental practice and hospital clinics. Results: The estimated prevalence of dental anxiety in the totalsample was 17.0%. A higher proportion of females were highly anxious. Those attending the Dental Hospital were less likely to be anxious than those who were attending the Dental Practice. An inverse relationship between frequency of dental attendance and dental anxiety was found. Anxiety was significantly higher forthose respondents that indicated that a delay in their appointment would make them more anxious. Of the reported fears regarding their dental visit, 60% of respondents claimed that they were afraid it s going tohurt . When compared to non-anxious patients, more anxious patients feared feeling out of control , a negative experience , the needle, the drill, and being bothered by the smell associated with dental materials.The majority of respondents had a preference for a dentist that was young, friendly, talkative and native English speaking. In general, patients preferred the surgery temperature to be slightly cool. Regardless of anxiety level, 31.0% of patients said that they would prefer the chairside mouth rinse to be plain water with 49.1% not having a preference. Conclusions: This study demonstrates that a significant proportion of patients experience anxiety about visiting the dentist. Many of them have preferences about dentists and the surgery environment which may be modulators of their anxiety. Awareness by the dental profession of the causes of dental anxiety and measures taken by dentists tominimise these trigger factors could have a substantial impact on anxious patients

Historical Sketch Of the Christian Woman\u27s Board of Missions

https://digitalcommons.acu.edu/crs_books/1119/thumbnail.jp

Designing whole-systems commissioning: lessons from the English experience

The paucity of formal evidence, allied to the requirement for strategies that are sensitive to local history and context, means that a ‘blueprint’ for successful strategic commissioning is not currently available for adoption. We are therefore confined to proposing ‘design principles’ for those seeking to embark upon a transition towards a whole systems approach to strategic commissioning. People and relationships are of critical importance all the way through the chain from strategic commissioning to micro-commissioning. Most crucially, experience suggests that structural solutions alone cannot deliver effective relationships and will not be effective when relationships are neglected. The need to ensure staff, partner and political buy-in suggests that relationship management and consensus-building are an integral component of the leadership role in moving toward strategic commissioning. As with any major re-organisation, the move to strategic commissioning is essentially a change management initiative and therefore will stand or fall according to whether it adheres to good practice in the change management process. Central to this, and to achieving commissioning outcomes, is the requirement for meaningful service user and public engagement. Effective commissioning emphasizes individual capabilities as well as needs, and community assets as well as deficits and problems. Adoption of strategic commissioning approaches is still at the developmental and learning stage and arguably all structural arrangements should be regarded as transitional

Historcial Sketch of the Christian Woman\u27s Board of Missions

A revised brief history on the acquisition of the Morehead Normal School by the Christian Woman\u27s Board of Missions in 1900.https://scholarworks.moreheadstate.edu/college_histories/1342/thumbnail.jp