Showing papers by "Rod Sheaff published in 2009"
TL;DR: Case management was highly valued by patients and their carers, but there were few major differences in outcomes between Evercare and other models.
Abstract: Objective:To assess the impacts of different forms of case management for people aged over 65 years at risk of unplanned hospital admission, in particular the impacts upon patients, carers and health service organization in English primary care; and, in these respects, compare the Evercare model with alternatives.Methods:Multiple qualitative case studies comparing case management in nine English Primary Care Trusts which piloted the Evercare model of case management and four sites which implemented alternative forms of case management between 2003 and 2005. Data were obtained from 231 interviews with patients, carers and other key informants, and from content analysis of documents and observation of meetings.Results:All the projects established functioning case management services, but none led to major service reorganization or savings elsewhere in the health care system. Many informants reported examples of admissions which case management had prevented, but overall hospital admissions did not significa...
66 citations
TL;DR: Drawing on multiple case studies in English primary health care from 1998 to 2005 and on published studies, Therborn's theory of power is used to make a framework analysis of how these reforms redistributed power between medicine and management in NHS primary care.
Abstract: How power is distributed between managers and care professionals is a central question in social policy. Since 1990 English NHS primary care has had three main ‘reforms’ of organizational and governance structures and many smaller alterations. This chapter explores how they have altered the balance of power between the two most powerful occupational groups, managers and doctors, and some implications for organizational theory.
20 citations
TL;DR: Whether, as a profession, English child-care social workers are well prepared in terms of their knowledge, ideological beliefs and professional acculturation to implement such changes to their practice is explored.
Abstract: Infancy is a crucial time for interventions to reduce later developmental difficulties. In England, recent policy has required children's service delivery to be redesigned to attend to infant mental health across all four tiers of NHS provision through inter-agency networks of child-care professionals....
10 citations
TL;DR: In this article, an analysis of 61 organizational innovations in nine English NHS primary care trusts suggests that while the majority of innovations were not politicized in this way, a substantial minority were.
Abstract: Evidence-based adoption of organizational innovations requires explicit definition of the outcomes the innovations are intended to produce. Implementation theory, however, suggests that organizational innovations are often politicized in the sense that the prospect of implementing them provokes conflicts of interests among the parties affected. Then the intended outcomes of the innovation are liable to be formulated ambiguously, misleadingly or not at all, which makes evidence-based organizational innovation unattainable. Analysis of 61 organizational innovations in nine English NHS primary care trusts suggests that while the majority of innovations were not politicized in this way, a substantial minority were. Innovations whose adoption is motivated by evidence can therefore be differentiated from politicized innovations whose adoption is not so motivated, even when they nevertheless do have evidential support.
7 citations
TL;DR: The online availability and accessibility of the minutes of directors' board meetings in a number of foundation trusts, non-foundation trusts and PCTs is described.
Abstract: Foundation trusts have boards of directors that are responsible for the day-to-day running of the organisation, planning services and developing strategy. Unlike non-foundation trusts and primary care trusts (PCTs), foundation trusts are not obliged to hold directors' board meetings in public. This article describes the online availability and accessibility of the minutes of such meetings in a number of foundation trusts, non-foundation trusts and PCTs. The implications for transparency in the NHS are also discussed.
5 citations