If telecare is the answer, what was the question? Storyline, tensions and the unintended consequences of technology-supported care

This document is the Accepted Manuscript version. The final, definitive version of this paper has been published in Critical Social Policy, March 2018, published by SAGE Publishing. Content in the UH Research Archive is made available for personal research, educational, and non-commercial purposes only. Unless otherwise stated, all content is protected by copyright, and in the absence of an open license, permissions for further re-use should be sought from the publisher, the author, or other copyright holder.Telecare—services employing technology to monitor people’s movement, medication and home environment at a distance—has emerged as a key component of global social care and health policies. The relationship between policies about telecare and the experiences and aspirations of service users has been under-interrogated. This paper draws on findings from an organisational case study involving people living with complex conditions using various telecare devices and employs Hajer’s (1995) concept of argumentative discourse analysis to identify two key storylines arguing that telecare improves people’s quality of life and promotes independence. While these storylines point to seemingly logical and incontestable objectives, uncritical policy and practice fails to recognise and prioritise the aspirations of service users, leading to unintended consequences that can deepen people’s isolation and minimise organisational benefits.Peer reviewedFinal Accepted Versio

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

A liberated NHS – but will it lead Health and Social Care together or force them apart?

This article is based on a leadership seminar held by the National Skills Academy (Social Care) in July 2010 at which delegates representing local authorities, the independent social care sector, voluntary organisations, central government and academia considered the impact of integrated working on social care leadership. The views expressed in the article are solely those of the authors

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