Sylvia Bernard, Fiona Aspinal, Kate Gridley and Gillian Parker
This paper aims to report results from a national survey of primary care trusts (PCTs) that explored the strategic, organisational and practice context of services for people with…
Abstract
Purpose
This paper aims to report results from a national survey of primary care trusts (PCTs) that explored the strategic, organisational and practice context of services for people with long‐term neurological conditions (LTNCs). It seeks to provide benchmarks for integrated service provision and to discuss possible reasons for the variability in progress.
Design/methodology/approach
Earlier phases of the research identified three models of care that promoted continuity of care for people with LTNCs: community interdisciplinary neurological rehabilitation teams, nurse specialists and pro‐active day opportunities. Based on this evidence, a benchmarking questionnaire was developed and a telephone survey of PCTs in England undertaken in 2009.
Findings
The survey found that the prevalence of models of good practice varied widely across and within PCT areas. Strategic support and commissioning arrangements were also variable. A little over half of responding PCTs had completed a joint strategic needs assessment (JSNA) that included a reference to LTNCs and a quarter of PCTs had no joint commissioning arrangements in place for LTNCs. The complex interplay between strategy, organisational structures and models of delivery, in a context of competing priorities, may account for this variation and patchy progress.
Originality/value
Service provision for people with LTNCs is an under‐researched area, despite having major implications for long‐term care and support. The paper will be valuable to policy makers and commissioners in benchmarking organisational activity and models of good practice for integrated services.
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Kate Gridley, Fiona Aspinal, Sylvia Bernard and Gillian Parker
This paper seeks to report key findings of a study, whose purpose was to: understand what helps or hinders the commissioning and provision of integrated services for people with…
Abstract
Purpose
This paper seeks to report key findings of a study, whose purpose was to: understand what helps or hinders the commissioning and provision of integrated services for people with long‐term neurological conditions (LTNCs); identify models of best practice from the perspectives of people with LTNCs and the professionals who work with them; and develop a benchmarking system to assess the extent to which these models are available in England.
Design/methodology/approach
The research had three main components: a rapid systematic literature review of evidence; in‐depth case studies of six neurology “service systems”; and a survey of all English PCTs to audit progress towards implementation of the National Service Framework (NSF) for LTNCs.
Findings
A number of elements that contribute to the experience of continuity and three service models that incorporate these elements were identified: community interdisciplinary neurological rehabilitation teams; nurse specialists and proactive, holistic day opportunities services. The survey results reinforced many of the case study findings, particularly around the varying levels of service available depending on diagnosis and location, and problems of access even where high‐quality services existed. The paper concludes that the systematic approach to delivering treatment and care for people with LTNCs envisaged in the NSF has not yet been achieved.
Originality/value
This study uses a mix of methods to assess progress towards national service improvement, based on evidence from people with LTNCs and those who work with them. As such, it provides a comprehensive benchmark at a critical point in the implementation of the NSF for LTNCs.
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Aversion to liberalism and socialism was indeed a trademark of Catholic economic thought from Rerum Novarum onwards and therefore many Catholic economists are to be found among…
Abstract
Aversion to liberalism and socialism was indeed a trademark of Catholic economic thought from Rerum Novarum onwards and therefore many Catholic economists are to be found among those looking for a third way. François Perroux and Maurice Byé were among the most prominent of them. They partook a closeness to the Catholic church and a good knowledge of Brazil through their missions in this country. But they differed in their methodology and in their approach to the European Union. Byé remained firmly rooted in the methodological individualism whereas Perroux’ approach seem too fuzzy to be characterized. These differences are obvious in their treatment of the European issues where Perroux’ stance for a Europe without shores contrasts with Byé’s successful recommendations for a step-by-step construction of the Little Europe. After six decades it is time to bring Byé out of the shadows.
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Ashley Sanders-Jackson, Christopher Clemens and Kristen Wozniak
Purpose: Lesbian, gay, and bisexual (LGB) young adults smoke at rates much higher than the general population. Young adults, in general, are less likely to seek medical help for…
Abstract
Purpose: Lesbian, gay, and bisexual (LGB) young adults smoke at rates much higher than the general population. Young adults, in general, are less likely to seek medical help for smoking cessation and LGB individuals are less likely to seek health care generally. Alternative methods to encourage smoking cessation are necessary. This research seeks to establish whether LGB young adults in California would be willing to use social media for smoking cessation.
Approach: We conducted 41 qualitative interviews among LGB young adults in the San Francisco Bay Area and Los Angeles in Fall 2014.
Findings: The results suggest that our participants were interested in a LGB-focused social media intervention, as long as the intervention was private or anonymous and moderated. Further, across topical areas our participants spoke extensively about the import of social connections. We may be able to leverage these connections to encourage cessation.
Research Limitations: This is a qualitative, non-generalizable dataset from a fairly limited geographic area.
Public Health Implications: Online smoking cessation interventions aimed at young adults would benefit from further testing with LGB young adults to ensure efficacy among this population. In addition, states and localities concerned about young adult LGB smoking might benefit from investing in an online socially mediated cessation forum. Online interventions could be scalable and might be useful for other groups who regularly face discrimination, stigma, or other stressors that make successful smoking cessation difficult.