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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

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...

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Published: 2015
Institution: Swansea University
Degree level: Doctoral
Degree name: Ph.D
URI: https://cronfa.swan.ac.uk/Record/cronfa42892
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first_indexed 2018-08-02T18:55:47Z
last_indexed 2019-10-21T16:48:39Z
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spelling 2018-08-31T15:21:54.1504080 v2 42892 2018-08-02 The development of a chronic conditions management service: A case study of health and social care integration. d10d60501148e6d64f1ed522419690ff NULL Benjamin Duxbury Benjamin Duxbury true true 2018-08-02 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. E-Thesis Chronic conditions, integrated care, health, social care community 31 12 2015 2015-12-31 COLLEGE NANME Public Health and Policy Studies COLLEGE CODE Swansea University Doctoral Ph.D 2018-08-31T15:21:54.1504080 2018-08-02T16:24:30.7262035 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Public Health Benjamin Duxbury NULL 1 0042892-02082018162530.pdf 10821282.pdf 2018-08-02T16:25:30.0530000 Output 4524678 application/pdf E-Thesis true 2018-08-02T16:25:30.0530000 false
title The development of a chronic conditions management service: A case study of health and social care integration.
spellingShingle The development of a chronic conditions management service: A case study of health and social care integration.
Benjamin Duxbury
title_short The development of a chronic conditions management service: A case study of health and social care integration.
title_full The development of a chronic conditions management service: A case study of health and social care integration.
title_fullStr The development of a chronic conditions management service: A case study of health and social care integration.
title_full_unstemmed The development of a chronic conditions management service: A case study of health and social care integration.
title_sort The development of a chronic conditions management service: A case study of health and social care integration.
author_id_str_mv d10d60501148e6d64f1ed522419690ff
author_id_fullname_str_mv d10d60501148e6d64f1ed522419690ff_***_Benjamin Duxbury
author Benjamin Duxbury
author2 Benjamin Duxbury
format E-Thesis
publishDate 2015
institution Swansea University
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care - Public Health{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Public Health
document_store_str 1
active_str 0
description 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.
published_date 2015-12-31T03:53:51Z
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score 11.012678

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