Axel Kaehne, Andrea Beacham and Julie Feather
The purpose of this paper is to outline the current thinking on co-production in health and social care, examine the challenges in implementing genuine co-production and argue for…
Abstract
Purpose
The purpose of this paper is to outline the current thinking on co-production in health and social care, examine the challenges in implementing genuine co-production and argue for a pragmatic version of co-production that may assist programme managers in deciding which type of co-production is most suitable for which programme.
Design/methodology/approach
A discussion paper based on the professional and academic knowledge and insights of the authors. A focus group interview schedule was used to guide discussions between authors.
Findings
The authors argue for a pragmatic approach to co-production within integrated care programmes. The authors set out the basic parameters of such an approach containing procedural rather than substantive standards for co-production activities leaving sufficient room for specific manifestations of the practice in particular contexts.
Practical implications
The authors put forward a pragmatic model of co-production that defines the essential elements of a process for ensuring services are designed to meet with the needs of patients yet allowing the process itself to be adapted to different circumstances.
Originality/value
The paper summarises the discussion on co-production in relation to integration programmes. It formulates a pragmatic model of co-production that may assist programme managers in establishing good practice co-production frameworks when designing or implementing integrated health and social care services.
Details
Keywords
The purpose of this paper is to report the findings of a horizontal integration programme in the South West of England. The programme was unusual insofar as it included the full…
Abstract
Purpose
The purpose of this paper is to report the findings of a horizontal integration programme in the South West of England. The programme was unusual insofar as it included the full range of public services being provided in a single town. It was a place-based system framed by the concept that a person’s wellbeing includes their health, economic status and living environment and that they are inextricably linked. As well as aiming for broader system integration, the programme utilised a person-centred approach using service-user perceptions to influence design. It was implemented through a local governance structure using a set of collaborative principles.
Design/methodology/approach
The paper presents personal reflections of the programme manager about the efficacy of the model, its sustainability and the problems encountered. It sets out the principles defining the model and the extent to which the principles were followed in practice.
Findings
Creating a holistic public service based on integration to tackle deep seated problems within a population requires reducing complexity at the interface between citizens and services. A local system model that includes all public services allows for collective responsibility for meeting the service needs of the population augmenting the connections and bridging the gaps between services. There was a recognition amongst participants that service redesign does not require wholesale organisational restructuring but does require creating shared aims and objectives and the participation of leaders with the ability to implement change within their services. A user-led, bottom-up approach provides deeper understanding and traction on the ground but should be combined with top-down strategic support to provide structural sustainability and the ability to scale out.
Originality/value
The paper demonstrates that horizontal service integration based on the concept of wellbeing is possible but faces significant challenges. The benefits and complexities of inter-agency collaboration multiply when enhancing the outcome focus from improving population health to general wellbeing. New theories of implementation and transformation are needed that relate to this important emerging service theme.
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Keywords
David Kimera and Fillemon Nduvu Nangolo
The purpose of this paper is to review maintenance practices, tools and parameters for marine mechanical systems that can be classified as plant, machinery and equipment (PME). It…
Abstract
Purpose
The purpose of this paper is to review maintenance practices, tools and parameters for marine mechanical systems that can be classified as plant, machinery and equipment (PME). It provides an insight for the maintenance crew on which maintenance parameters and practices are critical for a given PME systems.
Design/methodology/approach
The review paper characterizes the various maintenance parameters and maintenance practices used onshore and offshore for PME and identifies the possible gaps.
Findings
A variety of maintenance techniques are being used in the marine industry such as corrective maintenance, preventive maintenance and condition-based maintenance. As marine vehicles (MV) get older, the most important maintenance parameters become maintenance costs, reliability and safety. Maintenance models that have been developed in line with marine mechanical systems have been validated using a single system, whose outcome could be different if another PME system is used for validation.
Research limitations/implications
There is a limited literature on MV maintenance parameters and maintenance characterization regarding mechanical systems. The maintenance practices or strategies of marine mechanical systems should be based on maintenance parameters that suit the marine industry for a given PME.
Originality/value
Based on the available literature, the paper provides a variety of maintenance framework, parameters and practices for marine mechanical systems. The paper further gives an insight on what maintenance parameters, strategies and platforms are given preference in the shipping industry.