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The development of a chronic conditions management service: A case study of health and social care integration. / Benjamin Duxbury
Swansea University Author: Benjamin Duxbury
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Abstract
This thesis explores integrated working in chronic conditions management (CCM). With recent demographic change witnessing a significant worldwide growth in the numbers of people living with chronic conditions (World Health Organization, 2014), these are people whose care needs, many argue, are best...
| Published: |
2015
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| Institution: | Swansea University |
| Degree level: | Doctoral |
| Degree name: | Ph.D |
| URI: | https://cronfa.swan.ac.uk/Record/cronfa42892 |
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| Abstract: |
This thesis explores integrated working in chronic conditions management (CCM). With recent demographic change witnessing a significant worldwide growth in the numbers of people living with chronic conditions (World Health Organization, 2014), these are people whose care needs, many argue, are best served by way of integrated care (Goodwin et al., 2012). The latter’s organising principle, it is widely agreed, should be the service user perspective and its fundamental objective the improvement of their care (Goodwin et al., 2012). Existing research, however, has largely failed to take account of the views of service users and of the outcomes they value (Cameron et al., 2012). This thesis seeks to address these issues. It is a qualitative case study of the introduction of an integrated health and social care community CCM service in a Welsh locality during a Welsh Government initiative, focusing on the development of integrated care for people living with chronic conditions and the involvement of service users. It combined: non-participant observation of meetings; individual semi-structured interviews with lead-agency representatives, people living with chronic conditions, carers, referrers to the new service and voluntary/third sector representatives; focus groups with front-line health and social care professionals; and documentary research. The study incorporates an original combination of topics and examination of service user and carer perspectives, an examination of previously unexplored contextual factors and an original application of analytical and conceptual approaches. In so doing, it highlights the way in which inadequate funding, concurrent structural reform, conflicting strategies, unclear objectives and time-pressures militated against the involvement of service users and changes to their experience of care and that the initiative, consequently, did not deliver an integrated service. These factors point to a need for a more carefully considered governmental approach to CCM and integration and a requirement for more service user-focused research. |
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| Keywords: |
Chronic conditions, integrated care, health, social care community |
| College: |
Faculty of Medicine, Health and Life Sciences |