The extension of user involvement in different aspects of service
delivery in
health and social care has been a central element of care in the community
policy. Purchasers and providers of such services for older people have
been
exploring ways of tailoring services to meet individual need and ensure
that
the quality of the service reflects user preference rather than service-provider
requirements. This article describes a project involving residents from
a
random proportionate sample of nursing homes and residential homes for
older people in the City of Manchester. The project was designed to bring
user
views about quality into the service contract specification for the purchase
of
residential and nursing home care. The process and the outcomes are
described. Factors which appear to promote the movement of user involvement
into the mainstream of service specification and service development are
identified. The role of small-scale initiatives is discussed.
SYNOPSISThe characteristics of patients and information-gathering processes in general practice consultations producing prescriptions for antibiotics and psychotropic drugs are discussed. The contribution of patients presenting symptoms and the exploration of these by the general practitioner in the prescribing of psychotropic drugs, is compred with that of diagnosis.
SUMMARY
Children in two large Group Cottage Homes were rated on standard behaviour ratings scales by both their house parents and their teachers. They were found to be significantly more maladjusted than their peers living at home. Attempts were made to relate the behavioural ratings to a variety of indices of the childrens' separation experiences.
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