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
Three distinctive domains of inquiry in comparative and international education (CIE) point to epistemic fault lines that simultaneously enable and disable the possibilities for…
Abstract
Three distinctive domains of inquiry in comparative and international education (CIE) point to epistemic fault lines that simultaneously enable and disable the possibilities for social transformation in the cultural ecologies that demarcate, but also entangle, the so-called Global South and the North. Historically, these domains of inquiry – language/multilingualism, education, and development – engage arenas in which ideas about wellbeing, social arrangements, and the politics of knowledge (and of power) are constantly constructed, contested, and renegotiated. This analysis pinpoints some of the discursive technologies, which guarantee that active scholarly innovations and differentiation proceed in ways that ultimately leave intact the territorialized regionalizations of development differences. It reflects on ongoing fieldwork from the South to highlight three spheres of social control, and struggle, illustrative of the coloniality of difference and the expanding institutionalization of learning (as schooling) in an era of global interventionism. These loci – the sources of knowledge traditions, the sites of its enactment, and the power of knowledge transactions – represent overlapping activation points through which education interventions both stimulate and stultify social transformations. Specifically, the sources, sites, and power of knowledge offer empirical and discursive tools for historiographic reconsideration of the role of linguistic diversity and education in social change processes, and, crucially, for shifting critical focus from merely the occidentality of contemporary education traditions to the universalism of its social imaginaries. In this critical reading of new understandings of language(s) as invention, therefore, lies analytic opportunities for rethinking epistemic dilemmas in linking education and “development” in CIE scholarship.