Care coordination for adults and older people

Abstract

Purpose The purpose of this paper is to provide new insights into the contribution and experiences of non-statutory sector (voluntary) services delivering care coordination. Design/methodology/approach This qualitative study, based on face-to-face semi-structured interviews with 17 managers from a range of non-statutory sector services, used thematic data analysis supported by a framework approach. Findings Four themes emerged: commissioning arrangements undermined non-statutory sector development; working relationships between statutory and non-statutory services required time and energy to navigate and sustain; the establishment of a niche role in the larger network of provision; and tensions relating to future developments. The non-statutory sector was found to provide a mix of services, including specialist provision targeting specific communities that complemented or substituted for those provided by the state. Managers wanted their services to be recognised by the statutory sector as equal partners in the delivery of care coordination and were also keen to retain their independence. Practical implications Findings provide information for service commissioners and managers from statutory and non-statutory sectors indicating a complex set of experiences and views regarding the role of the latter. This is particularly salient in a political landscape which has increasing expectations of their involvement in the provision of care coordination. Originality/value This study considers the work of the non-statutory sector in the delivery of care coordination to adults and older people, an area under-reported to date. It suggests that there are opportunities available for these services to become embedded within a wider social care system and to excel by retaining or developing specialist roles and services.

Recognition: key to the entrepreneurial strategies of rural coalitions in advancing access to health care

“…This is one of the first studies to draw attention to recognition as a key barrier to coalition success even though recognition from other stakeholders has been identified as necessary for organizational success [23]. Lack of coalition recognition was similarly found in a recent study of 17 non-statutory organizations in the United Kingdom [24], in which organizations reported challenges in building and retaining partnerships with statutory organizations. They perceived that statutory organizations lacked awareness of their existence and understanding of their expertise, didn’t engage in two-way attempts to improve the situation, and supported effective information exchange to formal mechanisms only.…”

Care Coordination for Older People in the Non-Statutory Sector: Activities, Time Use and Costs

“…Transaction costs can include and vary according to: contract length; service complexity and degree of specificity; procurement processes; managing, reviewing and monitoring the contract (Sasse et al 2019). Some of these issues were identified by agencies in the wider study (Abendstern et al 2016b(Abendstern et al , 2019 with demands for contract monitoring consuming management time and short-term contracts affecting staff security and retention and thereby service stability. Nonetheless, a primary finding is that there were substantial cost variations between services and within particular settings.…”

“…This suggests that in their current form they are unlikely to be sustainable to replace statutory provision more comprehensively. This is particularly so given the short-term nature of funding and, as a consequence, relatively precarious staff contracts (Abendstern et al 2016b;. Longer term contracts are a precondition for such services to be stable and sustainable (Hardy & Wistow, 1998) permitting workforce development to shape quality care (Lewis & West, 2014).…”

“…It was part of a broader mixed methods research project investigating the provision of care coordination for older people in the non-statutory sector in England. The study included: a scoping review of literature and policy (Abendstern et al 2018); a structured internet search of organisations in the non-statutory sector providing care coordination for older people (Jasper et al 2016) and a national survey of these organisations ; the development of a set of care coordination standards relating to both organisational and practice arrangements (Abendstern, et al 2016a) and fieldwork with a small number of organisations to explicate the range and content of care coordination activities undertaken, investigate the costs and validate the standards (Abendstern et al 2016b;Jasper et al 2017;Abendstern et al 2019). The work reported here is from the fieldwork stage of this project, specifically addressing staff activities, time use and cost.…”