Partnership working and outcomes: Do health and social care partnerships deliver for users and carers?

Institute for Research and Innovation in Social Services (IRISS), Glasgow, UK.
Health & Social Care in the Community (Impact Factor: 1.15). 05/2013; 21(6). DOI: 10.1111/hsc.12050
Source: PubMed


Working in partnership, both across social care and health and with service users, has been a persistent theme of the health and social care modernisation agenda in the United Kingdom. Despite a relatively underdeveloped evidence base, the development of health and social care partnerships has continued to feature in recent policy and legislative initiatives in the United Kingdom. At the same time there has been a major shift in focus towards the outcomes that support services deliver. A central question remaining is whether the policy initiatives driving the development of health and social care partnerships are delivering improved outcomes, particularly the outcomes valued by people who use services. This article outlines research designed to explore this issue across 15 health and social care partnerships in England and Scotland, building from previous research by the Social Policy Research Unit based at the University of York. It sought to assess the extent to which health and social care partnerships deliver the outcomes that people who use services value, and to determine the features of partnership working associated with the delivery of these outcomes. A robust outcomes framework was defined, which provided the basis for interviews with those receiving support from partnerships. Working with three user-researcher organisations, interviews were completed with 230 individuals in 2006. On the basis of this, some service users were able to identify features of partnership that particularly contributed to improved outcomes. These included continuity of staff and sufficient staff and a range of resources, including the availability of long-term and preventative services. Given the definitional and methodological complexity surrounding partnership working, and the challenges of attribution, the study faced some limitations in its ability to make wider inferences about partnership and outcomes. A theory of change should be employed in future studies of this type.

Download full-text


Available from: Emma Miller
  • Source
    • "Nevertheless, current health and social care policies advocate care co-ordination, i.e. inter-professional working between health and social care professionals to respond to the complex and multiple needs of older people. This proves to be a promising approach to address loneliness (Dowling et al. 2004, Øvretveit 2011, Petch et al. 2013, Van Orden et al. 2013, Ledesma 2014). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Loneliness is especially frequent among older people in Southern Europe. Furthermore, promoting social capital to tackle loneliness and its health effects is an understudied intervention strategy. Therefore, a complex intervention was piloted in Spain in a pre-post study with a 2-year follow-up. Its aims were to explore the feasibility of the intervention and its short- and long-term effects. It was conducted in one mixed rural-urban and two urban areas of diverse socioeconomic levels from 2011 to 2012. The intervention framework was based on social capital theory applying a behaviour change model and care co-ordination. The intervention comprised: (i) a co-ordinated action aimed at building a network between primary healthcare centres and community assets in the neighbourhood and (ii) a group-based programme, which promoted social capital among lonely older people, especially social support and participation. Older people active in senior centres volunteered as gatekeepers. The main outcome domain was loneliness. Secondary outcome domains were participation, social support, self-perceived health, quality of life, depressive symptoms and use of health resources. Pre-post changes were assessed with t-test, Wilcoxon signed-rank test and McNemar's test. Differences between the three time points were assessed with a one-way ANOVA with repeated measures. Social workers and nurses were successfully involved as group leaders, 10 volunteers took part and 38 participants were included. After the intervention, loneliness decreased while social participation and support significantly increased. Furthermore, the number of visits to nurses increased. Exactly 65.8% of the participants built social contacts within the group and 47.4% became engaged in new activities. Two years later, social effects were maintained and depressive symptoms had decreased. Exactly 44.7% of the participants continued to be in contact with at least one person from the group and 39.5% continued participating. The intervention contributes a novel and feasible social capital-based approach for alleviating loneliness among older adults while prompting meaningful changes in their lives.
    Full-text · Article · Sep 2015 · Health & Social Care in the Community
  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose ‐ It is well recognised that individuals have much to contribute to the care that they receive, with attendant benefits on outcomes and reduction in cost. The recognition of individuals who access care services as interdependent citizens embedded in both formal and informal support networks is a shift that acknowledges their active role as partners in management of their own care and in service innovation and development. The purpose of this paper is therefore to explore and illustrate some of the domains of co-production. Design/methodology/approach ‐ In this paper, the authors review the literature, both peer-reviewed and professional, in order to provide a broad and contemporary commentary on this emergent approach. This literature is critically summarised and presented along with a narrative that discusses the context in Wales, where the authors are based. The approach to this paper is to bring together existing knowledge and also propose potential avenues for further research and practise development. Findings ‐ There is a diverse literature on this topic and the application of co-production appears potentially transformational within health and social care. Implementation of the principles of co-production has the potential to improve health and social care services in a range of settings. Real changes in outcomes and experience and reduction in societal cost can be achieved by making the people of Wales active partners in the design and delivery of their own health and social care. Originality/value ‐ This review offers a readily accessible commentary on co-production, which may be of value to a wide range of professional groups and policy makers. This paper also reflects an original attempt to summarise knowledge and propose further areas for work. Most importantly, this paper offers a start point for co-production to become a reality for service provision with all the attendant benefits that will arise from this development.
    No preview · Article · Mar 2014 · Quality in ageing: policy, practice and research
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: The purpose of this paper is to reflect upon the method of using a participatory action research (PAR) approach and offer some insight into the processes of integrated working with service users and carers. The Public Bodies (Joint Working) (Scotland) Bill, 2013 (The Scottish Government, 2013) is focused on integrated and partnership working within the systems of health and social care. The author begins with a person-centred approach and explore the value of placing service user engagement for successful integrated practice. Through these reflections on PAR, the author offers some new lessons about what integration means to practitioners at the front line of service delivery. Design/methodology/approach: This paper offers insights from a practitioner-research project which the author conducted within the author's own practice. It is a reflection on the process of using PAR with five people with dementia and their carers in a research project on the use of music to increase wellbeing for both the person with dementia and their carer. PAR helps to gain service user views but supports service users and providers to work in an integrated way. Findings: This paper offers insights from a practitioner-research project which the author conducted within the author's own practice. It is a reflection on the process of using PAR with five people with dementia and their carers in a research project on the use of music to increase wellbeing for both the person with dementia and their carer. PAR helps to gain service user views but supports service users and providers to work in an integrated way. Originality/value: A person-centred approach to service user participation in the research process has valuable insights for the integration of service users in the design and delivery of health and social care. The insights offered here highlight the complex processes which make-up effective engagement with service users and carers. It offers concrete details on the challenges which practitioners may face when they work to integrate service users and carers into the planning process. It also highlights the benefits of shared problem-solving and control. Practitioners already play an invaluable role in providing integrated care. This paper serves a reminder of much of what we already know and do. It also asks us to reconsider the focus of integration as a person-centred process.
    Preview · Article · Jun 2014 · Journal of Integrated Care
Show more