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ten - Reflections on an evaluation of partnerships to cope with winter pressures
- Edited by David Taylor, Susan Balloch
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- Book:
- The Politics of Evaluation
- Published by:
- Bristol University Press
- Published online:
- 20 January 2022
- Print publication:
- 19 January 2005, pp 153-174
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Summary
Introduction
This chapter reflects on an evaluation of partnership working between health and social care services in West Sussex. In evaluating projects to combat ‘winter pressures’, it outlines the mapping of the main relationships between stakeholders, findings from a questionnaire sent to senior, middle management and frontline staff and an analysis of evaluation forms. It shows how national policy drove the projects and how local politics contributed to as well as impeded their success.
Winter pressures are governmentally recognised special problems experienced in winter by both health and social services as a result of a higher incidence of illness, especially among older people, and a consequent increase in emergency admissions. Special funding to meet these pressures was introduced in 1997 for local health and social care communities through Local Winter Planning Groups (LWPGs).
The LWPG provided a prime example of partnership working. Its broad representation included the relevant Health Authority, Social Services Departments, Trusts (acute, mental health, community, learning disability and ambulance services), Primary Care Trusts and Groups, Local Representative Committees, Out of Hours’ Cooperatives, Deputising Services, NHS Direct, Community Health Councils (CHCs)/Patient/Public representatives and members of the voluntary and private sectors involved in health and social care.
National criteria for local winter planning required each health and social care community to submit a single local winter plan to its health and social care region at the end of the July of that year for agreement by the end of September (DH, 2000). In 2000 national criteria focused on flu immunisation, hospital services (critical care and acute services), community and mental health services, ambulance services, intermediate care, social care and primary care. Further issues covered included contingency plans for escalation/control procedures, human resources and communications.
Six broad areas of action being taken to prepare for winter, as set out in the ‘Winter Plan’
• Promoting self-care and preventing ill health;
• investment in capacity and change;
• service improvement and design;
• staffing;
• better preparations and strengthened partnerships; and
• managing the winter.
The Winter Report 2000-01 found many examples of good progress, as well as areas still requiring considerable attention. Its recommendations, however, signalled a greater focus on year round capacity planning as the key to improved services:
Local planning for winter should explicitly include preparations to manage elective as well as emergency demand. LWPGs should operate all year round. (DH, 2001a, para 58)
seven - Promoting independence: a partnership approach to supporting older people in the community
- Edited by Susan Balloch, Marilyn Taylor
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- Book:
- Partnership Working
- Published by:
- Bristol University Press
- Published online:
- 20 January 2022
- Print publication:
- 11 July 2001, pp 143-164
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Summary
This chapter examines partnership as a strategy for supporting vulnerable older people who wish to continue living in their own homes. It outlines the ways in which notions of partnership have been applied to working with older people and identifies effective strategies for achieving inclusive partnerships that focus on serving the interests of older people.
Contemporary social policy reflects the tensions created by the different ways in which older people are perceived in this society. One view, that sees them as a drain on resources, a burden on society, focuses attention on the costs of caring for older people with complex health and social care needs (DoH, 2000). A second view sees older people as undervalued and excluded victims of a discriminatory, ageist society (Harding, 1997). Responses to this view have heightened the profile of anti-discriminatory and anti-oppressive practice with older people (Age Concern, 1999; Titley, 1997). A third view that has been promoted through the campaigning activities of voluntary sector organisations and the increasingly influential voice of the user movement (Morris, 1994), sees older people as active agents of their own health and well-being, with rich potential to contribute to society (Shakespeare, 2000). New Labour has responded to this view with broad initiatives such as Better government for older people (Cabinet Office, 1998).
The recurrence of partnership as a theme in social policy has been outlined in the Introduction to this volume. With particular relevance for older service users, Building partnerships for success (DoH, 1995) argued that effective practice depends on three main elements: a commitment to the involvement and empowerment of service users and carers; a clear emphasis on outcomes as well as processes; and the importance of developing partnerships with other agencies, creating new forms of service delivery and strengthening arrangements for care management by emphasising sensitive, unbureaucratic assessments and providing services based on appropriate responses to need.
Supporting older people to maintain the degree of independence they seek requires the effective orchestration of a range of players. But, as Servian (1996) has noted, the world of community care is suffused with contradictions and tensions in power relations between carers, users, workers and managers, and the nature of partnerships is highly variable.