N. Stock, Fabio Zucchelli, Vanessa Hammond, N. Hudson, D. Sell
Despite published standards of care, inequities and variations in specialist care delivery in the UK have been identified. Using cleft lip and palate services as an example, this study aims to identify potential facilitators and common barriers to delivering an optimal specialist service. Individual interviews were conducted with 50 specialist clinicians, representing all 16 NHS cleft lip and palate services in the UK. Responses were analysed thematically. A range of barriers to optimal care were identified, including working within a restrictive medical model, declining resources and an insufficient evidence base. To facilitate optimal care delivery, participants described a need to share best practice, partner with academics to demonstrate service effectiveness, use technology in clinic and authentically integrate patient-centred care. Commissioners need to work more closely with specialist teams to ensure that resources are allocated based on need, with the view of optimising service delivery and patient outcomes.
{"title":"Facilitators and barriers to delivering an optimal specialist service: an example from cleft lip and/or palate care","authors":"N. Stock, Fabio Zucchelli, Vanessa Hammond, N. Hudson, D. Sell","doi":"10.12968/bjhc.2021.0051","DOIUrl":"https://doi.org/10.12968/bjhc.2021.0051","url":null,"abstract":"Despite published standards of care, inequities and variations in specialist care delivery in the UK have been identified. Using cleft lip and palate services as an example, this study aims to identify potential facilitators and common barriers to delivering an optimal specialist service. Individual interviews were conducted with 50 specialist clinicians, representing all 16 NHS cleft lip and palate services in the UK. Responses were analysed thematically. A range of barriers to optimal care were identified, including working within a restrictive medical model, declining resources and an insufficient evidence base. To facilitate optimal care delivery, participants described a need to share best practice, partner with academics to demonstrate service effectiveness, use technology in clinic and authentically integrate patient-centred care. Commissioners need to work more closely with specialist teams to ensure that resources are allocated based on need, with the view of optimising service delivery and patient outcomes.","PeriodicalId":35342,"journal":{"name":"British Journal of Health Care Management","volume":"41 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41247393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Headaches are common conditions, but can represent a significant burden to patients, healthcare services and the wider economy. Gordon et al outline how headache services could be made more effective and equally accessible in the UK.
{"title":"Headache service management: a new approach to providing more robust and equitable care across the UK","authors":"Alexander Gordon, D. Lashley, S. Weatherby","doi":"10.12968/bjhc.2022.0007","DOIUrl":"https://doi.org/10.12968/bjhc.2022.0007","url":null,"abstract":"Headaches are common conditions, but can represent a significant burden to patients, healthcare services and the wider economy. Gordon et al outline how headache services could be made more effective and equally accessible in the UK.","PeriodicalId":35342,"journal":{"name":"British Journal of Health Care Management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48461402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In this two-part series, John Edmonstone discusses the origins of organisation development in the NHS. This first instalment explores the historical context and early development of this systematic approach to organisational performance and culture.
{"title":"The genesis of organisation development in the NHS: part one—origins","authors":"J. Edmonstone","doi":"10.12968/bjhc.2021.0093","DOIUrl":"https://doi.org/10.12968/bjhc.2021.0093","url":null,"abstract":"In this two-part series, John Edmonstone discusses the origins of organisation development in the NHS. This first instalment explores the historical context and early development of this systematic approach to organisational performance and culture.","PeriodicalId":35342,"journal":{"name":"British Journal of Health Care Management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42215335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The NHS is the largest employer of Black, Asian and minority ethnic staff in the UK. However, 15% of staff from these ethnic backgrounds have reported experiencing discrimination at work. Reverse mentoring programmes have been trialled as way of raising awareness and understanding of issues relating to equality, diversity and inclusion, particularly among senior management. However, these programmes have drawn some criticism. Instead, a programme based on reciprocal mentoring could be a more effective means of creating a more inclusive NHS culture. This article explores how such an approach could work in practice, with discussion of a pilot reciprocal mentoring programme that was implemented at Chelsea and Westminster Hospitals NHS Foundation Trust from September 2020 to May 2021.
{"title":"Beyond black and white: an inclusive reciprocal mentoring model to promote diversity, engagement and understanding","authors":"Harry Sarsah, Michielle Abraham, D. Leech","doi":"10.12968/bjhc.2021.0125","DOIUrl":"https://doi.org/10.12968/bjhc.2021.0125","url":null,"abstract":"The NHS is the largest employer of Black, Asian and minority ethnic staff in the UK. However, 15% of staff from these ethnic backgrounds have reported experiencing discrimination at work. Reverse mentoring programmes have been trialled as way of raising awareness and understanding of issues relating to equality, diversity and inclusion, particularly among senior management. However, these programmes have drawn some criticism. Instead, a programme based on reciprocal mentoring could be a more effective means of creating a more inclusive NHS culture. This article explores how such an approach could work in practice, with discussion of a pilot reciprocal mentoring programme that was implemented at Chelsea and Westminster Hospitals NHS Foundation Trust from September 2020 to May 2021.","PeriodicalId":35342,"journal":{"name":"British Journal of Health Care Management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46235796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Various factors, including the ageing population, have led to an increasing demand for healthcare delivered in the patient's own home. This study explored perceptions of home care among nurses, including the potential benefits to patients and nursing careers. A cross-sectional exploratory study was performed. A questionnaire was designed and distributed to 200 home healthcare nurses from one agency in India, of which 152 responded. The questionnaire asked respondents to rate their agreement to 12 items regarding their perceptions of home healthcare on a 5-point Likert scale. Factor analysis was carried out to identify themes. Mean scores were calculated for each questionnaire item to determine levels of agreement. Respondents generally had a positive view of home healthcare, with most agreeing that it allowed the nurse to carry out a holistic assessment of the patient (4.40/5) and provide preventative care (4.33/5). Many also agreed that home healthcare could prevent hospitalisation (4.15/5). However, respondents were less sure about the appropriateness of home healthcare for patients with terminal illnesses (3.96/5) and stated that home healthcare providers and hospitals needed to work together to ensure continuity of care (4.47/5). Home healthcare is a promising field and nurses within this profession are generally aware of the potential benefits to patients. It is important to raise the profile of home healthcare in India to make it more accessible and ensure that other healthcare professionals are able to refer patients when appropriate.
{"title":"Attitudes of nurses towards home healthcare in a developing economy","authors":"Ankit Singh","doi":"10.12968/bjhc.2021.0062","DOIUrl":"https://doi.org/10.12968/bjhc.2021.0062","url":null,"abstract":"Various factors, including the ageing population, have led to an increasing demand for healthcare delivered in the patient's own home. This study explored perceptions of home care among nurses, including the potential benefits to patients and nursing careers. A cross-sectional exploratory study was performed. A questionnaire was designed and distributed to 200 home healthcare nurses from one agency in India, of which 152 responded. The questionnaire asked respondents to rate their agreement to 12 items regarding their perceptions of home healthcare on a 5-point Likert scale. Factor analysis was carried out to identify themes. Mean scores were calculated for each questionnaire item to determine levels of agreement. Respondents generally had a positive view of home healthcare, with most agreeing that it allowed the nurse to carry out a holistic assessment of the patient (4.40/5) and provide preventative care (4.33/5). Many also agreed that home healthcare could prevent hospitalisation (4.15/5). However, respondents were less sure about the appropriateness of home healthcare for patients with terminal illnesses (3.96/5) and stated that home healthcare providers and hospitals needed to work together to ensure continuity of care (4.47/5). Home healthcare is a promising field and nurses within this profession are generally aware of the potential benefits to patients. It is important to raise the profile of home healthcare in India to make it more accessible and ensure that other healthcare professionals are able to refer patients when appropriate.","PeriodicalId":35342,"journal":{"name":"British Journal of Health Care Management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48299519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Recovery through innovation: strategic thinking in trying times","authors":"B. Mcintosh, M. Fascia","doi":"10.12968/bjhc.2022.0095","DOIUrl":"https://doi.org/10.12968/bjhc.2022.0095","url":null,"abstract":"","PeriodicalId":35342,"journal":{"name":"British Journal of Health Care Management","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41293154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Tack, L. Holdsworth, A. Wilson, Euan McComiskie, Pippa McCabe, W. Wilkinson, Mathew King
The need to develop digital skills and confidence among NHS staff is reflected in research and government strategies across the UK. This study aimed to measure the confidence, motivation and competence of the allied health professional workforce in relation to data and digital technology. A quantitative, cross-sectional design was used, with an online survey distributed to measure respondents' characteristics and their self-rating of confidence, motivation and experience in data and digital technology, and of competence relative to the domains of the Health Education England allied health professions digital competency framework. Mean scores were calculated to measure self-rated confidence, motivation and experience. Mean scores on confidence and motivation to use digital technologies at work were moderate to high (7.34/10 and 8.33/10 respectively). High degrees of competence and applicability were reported in the ‘general’ and ‘data management and clinical informatics’ domains. Conversely, in the ‘decision support’ domain, 79.6% (n=490) of respondents reported that the competencies were applicable, but also had low competency rates (64.6%, n=397). In the domains of ‘meta competency’ and ‘records, assessments and plans’, 48.3% and 91% of respondents respectively reported low competence. Allied health professions have a moderate–high degree of confidence and motivation towards engaging with digital technologies in practice. However, self-perceived competence in some aspects of the domains of the digital competency framework is lacking. Workforce development programmes should consider learning needs related to electronic health records, decision support and use of machine learning or artificial intelligence. Focus should also be directed towards the development of digital leadership and strategy development skills.
{"title":"Digital competency: a survey of UK allied health professionals","authors":"C. Tack, L. Holdsworth, A. Wilson, Euan McComiskie, Pippa McCabe, W. Wilkinson, Mathew King","doi":"10.12968/bjhc.2021.0123","DOIUrl":"https://doi.org/10.12968/bjhc.2021.0123","url":null,"abstract":"The need to develop digital skills and confidence among NHS staff is reflected in research and government strategies across the UK. This study aimed to measure the confidence, motivation and competence of the allied health professional workforce in relation to data and digital technology. A quantitative, cross-sectional design was used, with an online survey distributed to measure respondents' characteristics and their self-rating of confidence, motivation and experience in data and digital technology, and of competence relative to the domains of the Health Education England allied health professions digital competency framework. Mean scores were calculated to measure self-rated confidence, motivation and experience. Mean scores on confidence and motivation to use digital technologies at work were moderate to high (7.34/10 and 8.33/10 respectively). High degrees of competence and applicability were reported in the ‘general’ and ‘data management and clinical informatics’ domains. Conversely, in the ‘decision support’ domain, 79.6% (n=490) of respondents reported that the competencies were applicable, but also had low competency rates (64.6%, n=397). In the domains of ‘meta competency’ and ‘records, assessments and plans’, 48.3% and 91% of respondents respectively reported low competence. Allied health professions have a moderate–high degree of confidence and motivation towards engaging with digital technologies in practice. However, self-perceived competence in some aspects of the domains of the digital competency framework is lacking. Workforce development programmes should consider learning needs related to electronic health records, decision support and use of machine learning or artificial intelligence. Focus should also be directed towards the development of digital leadership and strategy development skills.","PeriodicalId":35342,"journal":{"name":"British Journal of Health Care Management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44595151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jennie Burch, head of gastrointestinal nurse education at St Mark's Hospital, discusses stoma pathways, emphasising the need for regular review post discharge to avoid readmission and achieve optimal outcomes.
{"title":"Optimising stoma care through effective pathways: an overview","authors":"J. Burch","doi":"10.12968/bjhc.2022.0073","DOIUrl":"https://doi.org/10.12968/bjhc.2022.0073","url":null,"abstract":"Jennie Burch, head of gastrointestinal nurse education at St Mark's Hospital, discusses stoma pathways, emphasising the need for regular review post discharge to avoid readmission and achieve optimal outcomes.","PeriodicalId":35342,"journal":{"name":"British Journal of Health Care Management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48228727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Griffiths, Philippa Large, T. Lewis, Angharad Smiriglia, Chantal Thomas, Karen Thomas, Sally Waters-Foster, Lynne Watkins, Sian Willard, Sharon J. Williams
Care aims is a population-based, person-centred approach which provides a strategy encompassing the management of a service, informing the population, empowering the workforce around the service user and supporting the person and their family to manage their own lives wherever possible. This pilot study implemented the care aims framework into children's services using quality improvement methods. An audit of baseline data identified the referral process as an area for improvement in the service. Quality improvement techniques were used to design and test small cycles of change. The results of the audit showed up to 25% of ‘requests for help’ received from various referrers were not appropriate for several reasons, including old forms and incomplete information. Five tests of change were implemented, which had a mixed impact. This pilot study can help other multidisciplinary teams who are implementing the care aims approach and looking to improve their referral processes in order to improve access to care.
{"title":"Implementing the care aims approach in children's services: a quality improvement pilot study","authors":"S. Griffiths, Philippa Large, T. Lewis, Angharad Smiriglia, Chantal Thomas, Karen Thomas, Sally Waters-Foster, Lynne Watkins, Sian Willard, Sharon J. Williams","doi":"10.12968/bjhc.2020.0183","DOIUrl":"https://doi.org/10.12968/bjhc.2020.0183","url":null,"abstract":"Care aims is a population-based, person-centred approach which provides a strategy encompassing the management of a service, informing the population, empowering the workforce around the service user and supporting the person and their family to manage their own lives wherever possible. This pilot study implemented the care aims framework into children's services using quality improvement methods. An audit of baseline data identified the referral process as an area for improvement in the service. Quality improvement techniques were used to design and test small cycles of change. The results of the audit showed up to 25% of ‘requests for help’ received from various referrers were not appropriate for several reasons, including old forms and incomplete information. Five tests of change were implemented, which had a mixed impact. This pilot study can help other multidisciplinary teams who are implementing the care aims approach and looking to improve their referral processes in order to improve access to care.","PeriodicalId":35342,"journal":{"name":"British Journal of Health Care Management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46099763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Registered dietitian Natalie Taylor discusses the burden of malnutrition on patients and healthcare services, outlining strategies to improve nutrition in the community setting.
{"title":"Managing malnutrition in the community setting","authors":"N. Taylor","doi":"10.12968/bjhc.2022.0065","DOIUrl":"https://doi.org/10.12968/bjhc.2022.0065","url":null,"abstract":"Registered dietitian Natalie Taylor discusses the burden of malnutrition on patients and healthcare services, outlining strategies to improve nutrition in the community setting.","PeriodicalId":35342,"journal":{"name":"British Journal of Health Care Management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44595088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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