Russell Mannion, Frederick Hassan Konteh and Rowena Jacobs
This study aims to compare and contrast the core organisational processes across high and low performing mental health providers in the English National Health Service (NHS).
Abstract
Purpose
This study aims to compare and contrast the core organisational processes across high and low performing mental health providers in the English National Health Service (NHS).
Design/methodology/approach
A multiple case study qualitative design incorporating a full sample of low and high performing mental health providers.
Findings
This study suggests that the organisational approaches used to govern and manage mental health providers are associated with their performance, and the study’s findings give clues as to what areas might need attention. They include, but are not limited to: developing appropriate governance frameworks and organisational cultures, ensuring that staff across the organisation feel “psychologically safe” and able to speak up when they see things that are going wrong; a focus on enhancing quality of services rather than prioritising cost-reduction; investing in new technology and digital applications; and nurturing positive inter-organisational relationships across the local health economy.
Originality/value
Highlights considerable divergence in organisation and management practices that are associated with the performance of mental health trusts in the English NHS
Details
Keywords
Maria Goddard, Panagiotis Kasteridis, Rowena Jacobs, Rita Santos and Anne Mason
The purpose of this paper is to explore the link between one aspect of primary care in England – the annual review by general practitioners for dementia patients – and length of…
Abstract
Purpose
The purpose of this paper is to explore the link between one aspect of primary care in England – the annual review by general practitioners for dementia patients – and length of hospital stay (LoS). The annual review should identify the needs of both patients and carers and co-ordinate services across health and social care to address those needs. If this is done well, timely discharge from hospital may be facilitated.
Design/methodology/approach
The study uses linked national data from 2006/2007 to 2010/2011 on over 36,000 patients, employing sophisticated statistical techniques to isolate the effect of the annual dementia review on LoS.
Findings
Hospital patients discharged to the community have significantly shorter stays if they are cared for by practices that reviewed a higher percentage of their patients with dementia. However, this effect is small and is not evident for patients discharged to care homes or who died in hospital. Longer LoS is associated with a range of co-morbidities, markers of low availability of social care and with intensive provision of informal care.
Practical implications
Although the dementia review has only a modest effect on LoS, the components of the review could improve the health and well-being of those with dementia and their carers.
Originality/value
The study is the first to employ a robust methodology to investigate the impact of the annual dementia review on hospital LoS, an important aspect of the interface between primary and secondary care. There are implications for clinical and financial aspects of health and social care policy.