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
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Myron D. Fottler and Donna Malvey
Retail clinics in health care have been characterized as a “low-cost disruptive innovation” (Christensen, Anthony, & Roth, 2004). This article examines the retail clinic…
Abstract
Retail clinics in health care have been characterized as a “low-cost disruptive innovation” (Christensen, Anthony, & Roth, 2004). This article examines the retail clinic innovation, how it has grown and evolved over time, and the human resource implications of this phenomenon. The article provides a comprehensive literature review of both academic research and practitioner perspectives. Data regarding how retail clinics have impacted consumer access to health services, cost of health services, clinical outcomes, and customer satisfaction are examined. Even though retail clinics use lower cost staffing patterns than do traditional providers, data indicate positive outcomes and high levels of customer satisfaction with retail clinics. The evolution of retail clinics through multiple models and staffing patterns are discussed. The article concludes with implications for theory, health administration practice, public policy, and future research.
Mickey Losinski and Robin Parks Ennis
Repetitive and restrictive behaviors are one of the core components of diagnosing a child with an autism spectrum disorder. These behaviors may take the form of repetitive motor…
Abstract
Repetitive and restrictive behaviors are one of the core components of diagnosing a child with an autism spectrum disorder. These behaviors may take the form of repetitive motor movements or vocalizations, often referred to as stereotypical behaviors. These behaviors can impede the child’s educational and social opportunities, and have thus become a target for intervention. A variety of interventions have been used to reduce stereotypical behaviors with varied success. One of the most oft-used interventions is deep pressure therapy (e.g., weighted vests), a practice that enjoys substantial anecdotal but little empirical support. Conversely, interventions based on functional behavior assessment (FBA) have been shown to reduce these behaviors, but may not be used frequently within schools. Therefore, this chapter will provide a brief overview of stereotypical behaviors and compare these two intervention approaches, with a clear preference for FBA-based interventions due to their stronger empirical support.
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The succession of storms around the question of the disposal of the large quantities of corned beef called in or held up from the time of the Aberdeen Typhoid Epidemic can have…
Abstract
The succession of storms around the question of the disposal of the large quantities of corned beef called in or held up from the time of the Aberdeen Typhoid Epidemic can have done little to enhance the image of public administration. There was a profusion of statements, official and otherwise, and what seemed to be a fight between factions in the trade, with the position of the two Ministries involved none too clear; all this was thrown into a thorough ferment by political intervention by the Prime Minister himself. There can never have been anything quite like it in any branch of public health, not so much in what has been done, but in the way it was done.
Stephen Parker, Frances Dark, Gabrielle Vilic, Karen McCann, Ruth O'Sullivan, Caroline Doyle and Bernice Lendich
A novel integrated staffing model for community-based residential rehabilitation services is described. The purpose of this paper is to achieve synergistic gains through…
Abstract
Purpose
A novel integrated staffing model for community-based residential rehabilitation services is described. The purpose of this paper is to achieve synergistic gains through meaningful integration of peer support and clinical workers within rehabilitation teams. Key features include the majority of roles within the team being held by persons with a lived experience of mental illness, the active collaboration between peer and clinical workers throughout all stages of a consumer’s rehabilitation journey, and an organizational structure that legitimizes and emphasizes the importance of peer work within public mental health service delivery. This staffing model is not anticipated to alter the core rehabilitation function and service models.
Design/methodology/approach
The emergence of the integrated staffing model is described with reference to the policy and planning context, the evidence base for peer support, and the organizational setting. A conceptual and contextualized description of the staffing model in practice as compared to a traditional clinical staffing model is provided.
Findings
There is a potential for synergistic benefits through the direct collaboration between horizontally integrated peer and clinical specialists within a unified team working toward a common goal. This staffing model is novel and untested, and will be subjected to ongoing evaluation.
Originality/value
The integrated staffing model may provide a pathway to achieving valued and valuable roles for peer workers working alongside clinical staff in providing rehabilitation support to people affected by serious mental illness.