Bob Erens, Gerald Wistow, Nicholas Mays, Tommaso Manacorda, Nick Douglas, Sandra Mounier-Jack and Mary Alison Durand
All areas in England are expected by National Health Service (NHS) England to develop integrated care systems (ICSs) by April 2021. ICSs bring together primary, secondary and…
Abstract
Purpose
All areas in England are expected by National Health Service (NHS) England to develop integrated care systems (ICSs) by April 2021. ICSs bring together primary, secondary and community health services, and involve local authorities and the voluntary sector. ICSs build on previous pilots, including the Integrated Care Pioneers in 25 areas from November 2013 to March 2018. This analysis tracks the Pioneers’ self-reported progress, and the facilitators and barriers to improve service coordination over three years, longer than previous evaluations in England. The paper aims to discuss these issues.
Design/methodology/approach
Annual online key informant (KI) surveys, 2016–2018, are used for this study.
Findings
By the fourth year of the programme (2017), KIs had shifted from reporting plans to implementation of a wide range of initiatives. In 2018, informants reported fewer “significant” barriers to change than previously. While some progress in achieving local integration objectives was evident, it was also clear that progress can take considerable time. In parallel, there appears to have been a move away from aspects of personalised care associated with user control, perhaps in part because the emphasis of national objectives has shifted towards establishing large-scale ICSs with a particular focus on organisational fragmentation within the NHS.
Research limitations/implications
Because these are self-reports of changes, they cannot be objectively verified. Later stages of the evaluation will look at changes in outcomes and user experiences.
Originality/value
The current study shows clearly that the benefits of integrating health and social care are unlikely to be apparent for several years, and expectations of policy makers to see rapid improvements in care and outcomes are likely to be unrealistic.
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Bob Erens, Gerald Wistow, Sandra Mounier-Jack, Nick Douglas, Tommaso Manacorda, Mary Alison Durand and Nicholas Mays
Integrating health and social care is a priority in England, although there is little evidence that previous initiatives have reduced hospital admissions or costs. In total, 25…
Abstract
Purpose
Integrating health and social care is a priority in England, although there is little evidence that previous initiatives have reduced hospital admissions or costs. In total, 25 Integrated Care Pioneers have been established to drive change “at scale and pace”. The early phases of the evaluation (April 2014-June 2016) aimed to identify their objectives, plans and activities, and to assess the extent to which they have overcome barriers to integration. In the longer term, the authors will assess whether integrated care leads to improved outcomes and quality of care and at what cost. The paper aims to discuss these issues.
Design/methodology/approach
Mixed methods involving documentary analysis, qualitative interviews and an online key informant survey.
Findings
Over time, there was a narrowing of the integration agenda in most Pioneers. The predominant approach was to establish community-based multi-disciplinary teams focussed on (older) people with multiple long-term conditions with extensive needs. Moving from design to delivery proved difficult, as many barriers are outside the control of local actors. There was limited evidence of service change.
Research limitations/implications
Because the findings relate to the early stage of the 5+ years of the Pioneer programme (2014-2019), it is not yet possible to detect changes in services or in user experiences and outcomes.
Practical implications
The persistence of many barriers to integration highlights the need for greater national support to remove them.
Originality/value
The evaluation demonstrates that implementing integrated health and social care is not a short-term process and cannot be achieved without national support in tackling persistent barriers.
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Jill Manthorpe, Anthea Tinker, Claudine McCreadie, Simon Biggs, Melanie Doyle, Bob Erens and Amy Hills
The findings of the UK prevalence study of abuse and neglect among older people provide unique opportunities for adult protection systems to consider possible changes to their…
Abstract
The findings of the UK prevalence study of abuse and neglect among older people provide unique opportunities for adult protection systems to consider possible changes to their priorities, activities, services and publicity. This article reports first on the contribution of adult protection coordinators to the design and execution of the research. It then sets out potential uses for the evidence provided by the study by the adult protection community in the UK. The article outlines some of the media reactions to the study that adult protection workers will also have to understand and navigate. It concludes with some suggestions for future research and service development in the UK context.
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Claudine McCreadie, Anthea Tinker, Simon Biggs, Jill Manthorpe, Madeleine O'Keeffe, Melanie Doyle, Amy Hills and Bob Erens
The article outlines the background to the recently commissioned UK national study of the prevalence of elder abuse and explains the methodology adopted in Stages 1 and 2 of the…
Abstract
The article outlines the background to the recently commissioned UK national study of the prevalence of elder abuse and explains the methodology adopted in Stages 1 and 2 of the research. This is being funded by Comic Relief with co‐funding from the Department of Health and carried out by a team of researchers at King's College London and the National Centre for Social Research. Stage 1, the development work, was completed in autumn 2005. Stage 2, which began in March 2006, is a national survey of the private residential population of the United Kingdom.
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Summarizes the results of a 1995 survey of over 2,000 UK academics. The main objective was to look at how well university libraries meet research needs and at the possible…
Abstract
Summarizes the results of a 1995 survey of over 2,000 UK academics. The main objective was to look at how well university libraries meet research needs and at the possible consequences for research of recent library developments. The results suggest that library collections are perceived by their users to be deteriorating, gaining access to important journals is becoming increasingly difficult and, as a result, satisfaction with libraries is declining. Academics are relying more now on inter‐library loan and on purchasing their own materials. The growing use of electronic services has, to some extent, mitigated the potentially detrimental effects for research of deteriorating collections. Electronic services permit easier access to a wide range of information, a view which has led to increasing satisfaction with library services over time. However, views vary by university and by discipline, and it appears that a significant minority of academics (perhaps as many as one in four) believe that recent research has suffered.
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Paul Outlet. International organisation and dissemination of knowledge: selected essays of Paul Otlet translated and edited with an introduction by W. Boyd Rayward. Amsterdam…
Abstract
Paul Outlet. International organisation and dissemination of knowledge: selected essays of Paul Otlet translated and edited with an introduction by W. Boyd Rayward. Amsterdam: Elsevier, 1990. xi, 256 pp. $115.50/Dfl.225. 0 444 88678 8. (fid 684) Paul Otlet was born in Brussels in August 1868 and died there in December 1944. A lawyer who grew to be ‘bored with the law’ and became absorbed with books, libraries and information, he is probably principally remembered in connection with the Universal Decimal Classification (UDC).
When you admit that you do research on information and communication in the humanities disciplines, a common response is ‘Why on earth do you do that? Surely there is nothing…
Abstract
When you admit that you do research on information and communication in the humanities disciplines, a common response is ‘Why on earth do you do that? Surely there is nothing worth knowing that isn't already obvious.’ What the sceptical listener is telling you is that he believes humanist research and scholarship are still firmly wedded to methods, sources and subject matter that have not changed in the centuries since the Middle Ages ended and the Age of Humanism began. The people who tell you this are not fools; they are just as likely to be distinguished librarians or researchers as they are to be outsiders forgivably ignorant of what actually happens in the humanities. The idea that you really need to do very little to help humanist scholarship achieve its ends, and that you certainly don't need to do anything much which is new, follows only too logically from this initial scepticism. Fortunately, it has not been necessary for researchers in Britain to overcome such scepticism to obtain support for investigations in the humanities because the British Library Research and Development Department (BLRDD), the nation's chief information research funding body, has been a committed promoter of such research. Indeed, it has often been ahead of the information research community in its concern for humanities issues.
This chapter considers the influence of horror on the production of commercial gay pornography. I see this influence reflected especially in the production and popularity of gay…
Abstract
This chapter considers the influence of horror on the production of commercial gay pornography. I see this influence reflected especially in the production and popularity of gay pornographic films inspired by horror franchises from the slasher and ‘torture porn’ cycles that have been remade in recent decades. Nine texts are selected for analysis – from the slasher genre: Bryan Kenny’s 2010 A Nightmare on Twink Street (inspired by the A Nightmare on Elm Street series), Andy Kay’s 2012 Black XXXmas (inspired by Black Christmas), Frank Fuder and Angel Skye’s 2009 Halloweiner: Friday the Fuckteenth and Chi Chi LaRue’s 2016 Scared Stiff (both inspired by the Friday the 13th series), Bromo’s 2017 Cream for Me (Scream series); and from the torture porn genre: Jett Blakk’s 2006 Bonesaw, John Bruno’s 2006 Rammer and Bryan Kenny’s 2010 Raw I and 2011 (with Andy Kay) Raw II (inspired by the Saw franchise). The specificity of the horror genre is addressed, as is the importance of gender. But particular focus is directed toward the structural aspects of gay porn parodies and the degree to which horror parodies in particular have the potential to blend pornographic homosex with graphic violence, perhaps most extreme in the slasher and torture porn horror variants. Other potentialities are also explored, such as for the easing of narrative/sex porn tensions.
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Tuncay Odabaş and Esra Gökçen Kaygısız
The “VUCA world” is an environment characterized by unprecedented levels of volatility, uncertainty, complexity, and ambiguity (VUCA). In such a turbulent environment, corporate…
Abstract
The “VUCA world” is an environment characterized by unprecedented levels of volatility, uncertainty, complexity, and ambiguity (VUCA). In such a turbulent environment, corporate entrepreneurship is key for all businesses, especially family firms. Corporate entrepreneurship is a concept that enables innovation, growth, and competitive advantage over competitors. It is a driving force for organizations to make changes in their structures and operations to respond to changes by using the limited resources they have in the environments in which they operate and to reduce the negative effects of shortening product life cycles. Family firms, which have an important place in the economies of countries, are indispensable players in economic activities, they need to think more strategically, and innovative and have an entrepreneurial perspective in ensuring their adaptation for competitive and growth purposes. In this study, the relationship between the place of family firms in the VUCA world and corporate entrepreneurship was tried to be established, and the corporate entrepreneurship of family firms was examined in line with their corporate logic. For this purpose, the news on the corporate websites of seven family companies operating in Türkiye and included in the 2023 Family Business Index was analyzed by content analysis method. Data were coded with thematic coding and findings were revealed. Common types of logic in family firms are market logic and efficiency and savings logic, with a hybrid characteristic consisting of a combination of market logic and efficiency and savings logic.