The purpose of this paper is to provide a summary of some of the lessons about implementing different types of integrated care.
Abstract
Purpose
The purpose of this paper is to provide a summary of some of the lessons about implementing different types of integrated care.
Design/methodology/approach
The author used evidence from the author’s own evaluations and the findings of other researchers to identify some important lessons for policy makers and practitioners.
Findings
The author identifies eight high-level lessons which may be of interest to policy makers and practitioners working in the field.
Research limitations/implications
The lessons outlined in the paper provide only a starting point for those designing interventions or evaluation.
Practical implications
The changes required to implement integrated care are complex and are embedded in a complex context. Change of this type is difficult and generally takes longer to deliver than expected. The evaluation of these models often requires longer than is often available and needs to focus on the impact on the whole system rather than narrow measures, e.g. hospital utilisation.
Originality/value
This is a viewpoint paper synthesising evidence from the English pilot programmes in integrated care.
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Angus Ramsay, Naomi Fulop and Nigel Edwards
This paper reviews the evidence base for vertical integration in health care. We describe its impact on organisational structures, on how services are provided, and on such…
Abstract
This paper reviews the evidence base for vertical integration in health care. We describe its impact on organisational structures, on how services are provided, and on such outcomes as cost, clinical outcomes and patient experience. We also outline conditions that support successful integration.
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Paul Smith, Libby Hampson, Jonathan Scott and Karen Bower
The aim of this paper is to examine the introduction of innovation as part of a management development programme at a primary care organisation, a legal form known as a Primary…
Abstract
Purpose
The aim of this paper is to examine the introduction of innovation as part of a management development programme at a primary care organisation, a legal form known as a Primary Care Trust (PCT), in the UK.
Design/methodology/approach
The paper draws on experience of managing a successful management development programme for a PCT. The report of the case study analyses the key events that took place between 2008 and 2010, from direct observation, surveys, discussion and documentary evidence.
Findings
The Northern PCT has partnerships with a number of educational providers to deliver their leadership and management development programmes. A close working relationship had developed and the programme is bespoke – hence it is current and of practical use to the UK's National Health Service (NHS). In addition, there are regular meetings, with module leaders gaining a firsthand understanding of the organisation's needs and aspirations. This has resulted in a very focused and personalised offering and a genuine involvement in the programme and individuals concerned.
Research limitations/implications
The research was conducted among a relatively small sample, and there is a lack of previous literature evidence to make significant comparisons.
Practical implications
The paper identifies key implications for practitioners and educators in this area.
Originality/value
This paper is one of few to investigate innovation and improvement in the NHS, and is unique in that it uses the lenses of a management development programme to explore this important, and under‐researched, topic.
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The publication of performance ratings for NHS Trusts (star ratings) is an important part of NHS policy. There are significant benefits to a Trust in being awarded the top rating…
Abstract
The publication of performance ratings for NHS Trusts (star ratings) is an important part of NHS policy. There are significant benefits to a Trust in being awarded the top rating of three stars. The methodology for awarding stars to acute hospitals is explained. The most significant areas of performance in determining a hospital's star rating are identified. The Department of Health claimed that performance in 2002 was better than in 2001, against standards that are getting tougher. This claim is assessed but no clear evidence is found to substantiate it. An alternative performance rating system using the same data is developed and compared with the official version to illustrate the importance of methodology – this system used only the outcome measures of hospital services included within the star ratings system, and not process measures. Only 41 per cent of hospitals would have received the same number of stars as their official rating. Some implications of the system of performance ratings are discussed.