Katie Barnes, Philip Longfield, Katie Jones, Gill Littlemore, Claire McDonough, Archie McIntyre, Jo Robertson, Neil Turton, Kevin Urdhin and Melanie McLaughlin
The purpose of this paper is to show how the new arrangements for commissioning services in the English NHS can facilitate innovations in service delivery leading to improvements…
Abstract
Purpose
The purpose of this paper is to show how the new arrangements for commissioning services in the English NHS can facilitate innovations in service delivery leading to improvements in outcomes and cost effectiveness.
Design/methodology/approach
The study uses cost modelling based upon the Hospital Episodes Statistics compiled by the NHS Information Centre to calculate recent expenditure upon treatment of routine childhood illnesses managed as short stay hospital admissions, and then uses a case study of a children's walk‐in centre to show how an alternative service can be provided, and a new service embedded in general practice to show a further alternative type of provision.
Findings
The study finds that large sums are currently being spent on inappropriate treatment of routine childhood conditions, especially in large urban conurbations. It demonstrates that in the case studies, the alternative provision can provide a viable and effective alternative.
Research limitations/implications
The research is based upon historical data by necessity. The new commissioning groups are not co‐located with the historical PCTs on which this study is based. The data are collected by providers and co‐ordinated by the NHS Information Centre. Therefore the investigators do not have control over the data quality. The second case study is a new service and therefore is used as an illustration of other service types.
Practical implications
This study suggests that paediatric ambulatory services can be provided at lower cost with better outcomes.
Social implications
This study provides the basis for a pilot study in Salford, where additional social benefits are targeted including better school attendance and increased self‐awareness over child health amongst local families.
Originality/value
The study provides quantitative evidence for commissioning alternative paediatric ambulatory services.
Details
Keywords
Jan Lees, Rex Haigh and Sarah Tucker
The purpose of this paper is to highlight theoretical and clinical similarities between therapeutic communities (TCs) and group analysis (GA).
Abstract
Purpose
The purpose of this paper is to highlight theoretical and clinical similarities between therapeutic communities (TCs) and group analysis (GA).
Design/methodology/approach
Literature review shows comparison of TC and group-analytic concepts with illustrative case material.
Findings
Findings reveal many similarities between TCs and GA, but also significant divergences, particularly in practice.
Practical implications
This paper provides theoretical basis for TC practice, and highlights the need for greater theorising of TC practice.
Social implications
This paper highlights the importance of group-based treatment approaches in mental health.
Originality/value
This is the first paper to review the relevant literature and compare theory and practice in TCs and GA, highlighting their common roots in the Northfields Experiments in the Second World War.