How do managers and leaders in the National Health Service and social care respond to service user involvement in mental health services in both its traditional and emergent forms? The ENSUE study – NHS National Institute for Health Research – April 2014

Posted on May 27, 2014. Filed under: Mental Health Psychi Psychol, Patient Participation | Tags: |

How do managers and leaders in the National Health Service and social care respond to service user involvement in mental health services in both its traditional and emergent forms? The ENSUE study – NHS National Institute for Health Research – April 2014

Rose D, Barnes M, Crawford M, Omeni E, MacDonald D, Wilson A. How do managers and leaders in the National Health Service and social care respond to service user involvement in mental health services in both its traditional and emergent forms? The ENSUE study. Health Serv Deliv Res 2014;2(10). DOI 10.3310/hsdr02100

Background: This study set out to measure the extent and perceived impact of service user involvement (SUI) in mental health services and to explore different forms of SUI, both collective and individual. The focus was on service users’ (SUs’) interactions with managers and other key decision-makers in the UK NHS and social care. The theoretical frameworks used were organisational theory and new social movement theory.

Objectives: To explore the impact of service user involvement in mental health on shaping policy agendas and delivery specifically in terms of their impact on key decision-makers.

Design: A mixed-methods design was used.

Setting: The study took place in three NHS foundation trusts (FTs): two metropolitan and one rural.

Methods: The methods included surveys, interviews, ethnographies, case studies and focus groups.

Results: In the first phase of the study, which took the form of surveys, it was found that ‘ordinary’ SUs had a relatively high level of involvement in at least one service domain and that where they were involved they believed this had produced a positive impact on service development and delivery. Likewise a majority of front-line staff encouraged SUI and thought this had a positive impact although social workers were more likely to have directly participated in SUI initiatives than nurses. In the second phase of the study, which used qualitative methods, an ethnography of user-led organisations (ULOs) was conducted, which showed that ULOs were being forced to adapt in an organisational climate of change and complexity, and that decision-makers no longer claimed the high moral ground for working with ULOs, but expected them to work within a system of institutional behavioural norms. This posed many challenges for the ULOs. In phase 2 of the research we also examined the role of SU governors in NHS FTs. We posed the question of whether or not SU governors represented a shift away from more collective forms of organisation to a more individual form. It was found that SU governors, too, had to work within a system of norms deriving from the organisational structure and culture of the NHS, and this impacted on how far they were able to exercise influence. There was also evidence that user governors were beginning to organise collectively. In respect of individual forms of involvement we also attempted to run focus groups of people in receipt of personal budgets but concluded that, as yet, they are not embedded in mental health services.

 

Advertisements
Read Full Post | Make a Comment ( Comments Off on How do managers and leaders in the National Health Service and social care respond to service user involvement in mental health services in both its traditional and emergent forms? The ENSUE study – NHS National Institute for Health Research – April 2014 )

Variations in outcome and costs among NHS providers for common surgical procedures: econometric analyses of routinely collected data – Health Services and Delivery Research – January 2014

Posted on January 10, 2014. Filed under: Health Economics, Orthopaedics, Surgery | Tags: |

Variations in outcome and costs among NHS providers for common surgical procedures: econometric analyses of routinely collected data – Health Services and Delivery Research – January 2014

DOI 10.3310/hsdr02010 NHS National Institute for Health Research

Street A, Gutacker N, Bojke C, Devlin N, Daidone S. Variations in outcome and costs among NHS providers for common surgical procedures: econometric analyses of routinely collected data. Health Serv Deliv Res 2014;2(1)

“Background: It is important that NHS resources are used to their full extent, but efforts to reduce costs may have an adverse effect on patient outcomes. Our research is designed to provide a better understanding of the inter-relationship between costs and health outcomes among NHS providers (hospitals) for common surgical procedures.

Objectives: In England, patient-reported outcomes measures (PROMs) are collected from patients undergoing one of four elective procedures: unilateral hip replacement, unilateral knee replacement, groin hernia repair and varicose vein surgery. We identify variation in patient-reported outcomes (PROs) across hospitals, assess the relationship between the cost and outcomes among NHS hospitals for these procedures, and determine the extent to which variations in outcomes and costs are due to differences in hospital performance.

Data sources: We link Hospital Episode Statistics (HES) data with reference cost data and PROM data for patients having the four treatments between April 2009 and March 2010.

Methods: The first part of the empirical analysis focuses on variation in different dimensions of self-reported health status. We argue that each of the EuroQol-5D questionnaire (EQ-5D; European Quality of Life-5 Dimensions) dimensions should be assessed separately. Our graphical summary of the differential impact that hospitals have on PROs indicates the probability of reporting a given health outcome and shows how these probabilities vary across EQ–5D dimensions and hospitals. The second part of the empirical analysis focuses on the performance of hospitals and the inter-relationship between PROs and resource use.

Results: We find that poorer post-treatment health status is associated with lower initial health status, higher weighted Charlson score, more diagnoses and lower socioeconomic status. We find significantly unexplained variation among hospitals in outcomes for patients undergoing hip replacement, knee replacement or varicose vein surgery, but not for hernia patients. For all four treatments we find significant unexplained variation in resource use among hospitals, whether measured by cost of treatment or length of stay. This suggests that hospitals can improve their utilisation of resources.

Limitations: Our analyses are based on the HES. If data are missing from the medical record, or extracted and coded inaccurately, HES will contain errors. Hospitals should minimise these errors. Our study suffers from a large number of missing data, mainly because some hospitals were better than others at administering the baseline survey.”

Read Full Post | Make a Comment ( Comments Off on Variations in outcome and costs among NHS providers for common surgical procedures: econometric analyses of routinely collected data – Health Services and Delivery Research – January 2014 )

Are We There Yet? Models of Medical Leadership and their effectiveness: An Exploratory Study – NHS National Institute for Health Research – April 2013

Posted on April 30, 2013. Filed under: Health Mgmt Policy Planning, Medicine | Tags: , |

Are We There Yet? Models of Medical Leadership and their effectiveness: An Exploratory Study – NHS National Institute for Health Research – April 2013

Executive summary

Dickinson H, Ham C, Snelling I, Spurgeon P. Are We There Yet? Models of Medical Leadership and their effectiveness: An Exploratory Study. Final report. NIHR Service Delivery and Organisation programme; 2013

Chris Ham: Models of medical leadership and their effectiveness – King’s Fund – 29 April 2013

Read Full Post | Make a Comment ( Comments Off on Are We There Yet? Models of Medical Leadership and their effectiveness: An Exploratory Study – NHS National Institute for Health Research – April 2013 )

We do clinical research – NHS National Institute for Health Research, Clinical Research Network – February 2013

Posted on March 11, 2013. Filed under: Research | Tags: |

We do clinical research – NHS National Institute for Health Research, Clinical Research Network – February 2013

A guide to support materials that help Trusts promote clinical research in the NHS

“The aim of this booklet is to help you increase research awareness within your Trust and promote the local research opportunities available to your patients.

It features a range of materials that you can order at low cost, which will help your staff and patients gain a better understanding of what research is, its benefits and how they can get involved.

You will also find examples of good practice that will help you develop your Trust’s research culture. There are many other examples of good practice in the NHS and those presented in this booklet are intended as a useful insight to inspire your own ideas.”

Read Full Post | Make a Comment ( Comments Off on We do clinical research – NHS National Institute for Health Research, Clinical Research Network – February 2013 )

Evidence in management decisions (EMD) – advancing knowledge utilization in healthcare management – NHS National Institute for Health Research – August 2012

Posted on September 14, 2012. Filed under: Evidence Based Practice, Health Mgmt Policy Planning | Tags: |

Evidence in management decisions (EMD) – advancing knowledge utilization in healthcare management – NHS National Institute for Health Research – August 2012

Read Full Post | Make a Comment ( Comments Off on Evidence in management decisions (EMD) – advancing knowledge utilization in healthcare management – NHS National Institute for Health Research – August 2012 )

A novel performance monitoring framework for health research systems: experiences of the National Institute for Health Research in England – 24 March

Posted on April 5, 2011. Filed under: Research | Tags: , |

A novel performance monitoring framework for health research systems: experiences of the National Institute for Health Research in England
Anas El Turabi , Michael Hallsworth , Tom Ling  and Jonathan Grant
Health Research Policy and Systems 2011, 9:13doi:10.1186/1478-4505-9-13
Published: 24 March 2011

“Abstract (provisional)

Background
The National Institute for Health Research (NIHR) was established in 2006 with the aim of creating an applied health research system embedded within the English National Health Service (NHS). NIHR sought to implement an approach for monitoring its performance that effectively linked early indicators of performance with longer-term research impacts. We attempted to develop and apply a conceptual framework for defining appropriate key performance indicators for NIHR.

Method
Following a review of relevant literature, a conceptual framework for defining performance indicators for NIHR was developed, based on a hybridisation of the logic model and balanced scorecard approaches. This framework was validated through interviews with key NIHR stakeholders and a pilot in one division of NIHR, before being refined and applied more widely. Indicators were then selected and aggregated to create a basket of indicators aligned to NIHR’s strategic goals, which could be reported to NIHR’s leadership team on a quarterly basis via an oversight dashboard.

Results
Senior health research system managers and practitioners endorsed the conceptual framework developed and reported satisfaction with the breadth and balance of indicators selected for reporting.

Conclusions
The use of the hybrid conceptual framework provides a pragmatic approach to defining performance indicators that are aligned to the strategic aims of a health research system. The particular strength of this framework is its capacity to provide an empirical link, over time, between upstream activities of a health research system and its long-term strategic objectives.”

Read Full Post | Make a Comment ( None so far )

The impact of incentives on the behaviour and performance of primary care professionals – NHS National Institute for Health Research – Service Delivery and Organisation programme – 4 August 2010

Posted on September 14, 2010. Filed under: General Practice, Health Economics, Primary Hlth Care | Tags: |

The impact of incentives on the behaviour and performance of primary care professionals – NHS National Institute for Health Research – Service Delivery and Organisation programme – 4 August 2010

“Aims: To explore and explain the impact of incentives in primary care on professional behaviours and performance. To examine these impacts on primary care professionals (PCPs) as providers of primary care and as commissioners of primary care and other services.” …continues

Commissioning brief Download (PDF 123Kb)
Executive summary Download (PDF 37Kb)
Final report Download (PDF 924Kb)

Read Full Post | Make a Comment ( None so far )

Liked it here?
Why not try sites on the blogroll...