Health and wellbeing boards: public health decision making bodies or political pawns?

Greaves, Z.; McCafferty, Sara

doi:10.1016/j.puhe.2016.10.025

Cited by 6 publications

(8 citation statements)

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“…Different funding rules—health care being free at the point of access and social care being means‐tested—have been found to cause confusion and inequities 93 and prove challenging for care coordination. In England, policy solutions to these problems have included strategies to integrate health and social care through joint governance arrangements (including joint commissioning, 97 joint health and well‐being boards, 98 and devolution initiatives 99 ) that seek to tackle complex problems collaboratively.…”

Section: Resultsmentioning

confidence: 99%

Rethinking Integrated Care: A Systematic Hermeneutic Review of the Literature on Integrated Care Strategies and Concepts

2020

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Integrated care is best understood as an emergent set of practices intrinsically shaped by contextual factors, and not as a single intervention to achieve predetermined outcomes. Policies to integrate care that facilitate person‐centered, relationship‐based care can potentially contribute to (but not determine) improved patient experiences. There can be an association between improved patient experiences and system benefits, but these outcomes of integrated care are of different orders and do not necessarily align. Policymakers should critically evaluate integrated care programs to identify and manage conflicts and tensions between a program's aims and the context in which it is being introduced. Context Integrated care is a broad concept, used to describe a connected set of clinical, organizational, and policy changes aimed at improving service efficiency, patient experience, and outcomes. Despite examples of successful integrated care systems, evidence for consistent and reproducible benefits remains elusive. We sought to inform policy and practice by conducting a systematic hermeneutic review of literature covering integrated care strategies and concepts. Methods We used an emergent search strategy to identify 71 sources that considered what integrated care means and/or tested models of integrated care. Our analysis entailed (1) comparison of strategies and concepts of integrated care, (2) tracing common story lines across multiple sources, (3) developing a taxonomy of literature, and (4) generating a novel interpretation of the heterogeneous strategies and concepts of integrated care. Findings We identified four perspectives on integrated care: patients’ perspectives, organizational strategies and policies, conceptual models, and theoretical and critical analysis. We subdivided the strategies into four framings of how integrated care manifests and is understood to effect change. Common across empirical and conceptual work was a concern with unity in the face of fragmentation as well as the development and application of similar methods to achieve this unity. However, integrated care programs did not necessarily lead to the changes intended in experiences and outcomes. We attribute this gap between expectations and results, in part, to significant misalignment between the aspiration for unity underpinning conceptual models on the one hand and the multiplicity of practical application of strategies to integrate care on the other. Conclusions Those looking for universal answers to narrow questions about whether integrated care “works” are likely to remain disappointed. Models of integrated care need to be valued for their heuristic rather than predictive powers, and integration understood as emerging from particular as well as common contexts.

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Section: Resultsmentioning

confidence: 99%

Rethinking Integrated Care: A Systematic Hermeneutic Review of the Literature on Integrated Care Strategies and Concepts

2020

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“…The remaining nine “specific” papers had a greater focus on the prioritisation of specific public health interventions and policies and frequently cited criteria relating to “social considerations” ( n = 7), as well as “equity/fairness/ethics/equality,” “political considerations” and the “feasibility” and “cost-effectiveness” of the programmes/interventions/policies ( n = 6 each) ( 4 , 16 , 18 , 19 , 28 , 33 , 39 , 46 , 47 ). Studies categorised as “generic” ( n = 26) had a broader focus on public health interventions or multiple disease areas/risk factors ( 3 , 5 , 8 , 10 , 15 , 17 , 20 – 24 , 26 , 29 , 30 , 34 – 38 , 41 – 45 , 48 , 49 ). These studies frequently cited criteria relating to “burden of disease” ( n = 23), “health impacts of the intervention” ( n = 22), and “social considerations” ( n = 19).…”

Section: Resultsmentioning

confidence: 99%

“…This varied from the 24 studies that prioritised programmes/interventions or policies, which most frequently reported utilising criteria pertaining to the “health impacts of the programme/intervention” domain ( n = 20) ( 8 , 15 , 16 , 18 – 20 , 23 , 24 , 26 , 28 , 29 , 33 , 35 , 36 , 38 , 39 , 41 , 43 – 49 ).…”

Section: Resultsmentioning

confidence: 99%

“…“Health & well being impacts of the intervention” ( n = 13) and “burden of disease” ( n = 12) were the most frequently cited domains amongst the 16 “generic” studies that prioritised programmes/interventions ( 8 , 15 , 20 , 23 , 24 , 26 , 29 , 35 , 36 , 38 , 41 , 43 – 45 , 48 , 49 ). In the nine studies that focused on interventions/programmes or policies within specific sub-areas “cost-effectiveness,” “social aspects” (such as public acceptability), and “feasibility of implementation” were the most commonly cited domains ( n = 6 each) ( 4 , 16 , 18 , 19 , 28 , 33 , 39 , 46 , 47 ).…”

Section: Resultsmentioning

confidence: 99%

“…Ten papers used qualitative or observational methods to identify the criteria decision-makers had used in actual public health priority-setting ( 3 – 5 , 18 – 22 , 24 , 26 ). These papers considered domains such as “burden of disease” ( n = 10), “budget impact,” “social considerations” and “political considerations” ( n = 9), followed by “organisational/provider/ industry considerations” ( n = 8) and “feasibility of implementation” ( n = 7).…”

Section: Resultsmentioning

confidence: 99%

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Prioritisation processes for programme implementation and evaluation in public health: A scoping review

Atwal

Schmider²,

Buchberger³

et al. 2023

Front. Public Health

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BackgroundProgramme evaluation is an essential and systematic activity for improving public health programmes through useful, feasible, ethical, and accurate methods. Finite budgets require prioritisation of which programmes can be funded, first, for implementation, and second, evaluation. While criteria for programme funding have been discussed in the literature, a similar discussion around criteria for which programmes are to be evaluated is limited. We reviewed the criteria and frameworks used for prioritisation in public health more broadly, and those used in the prioritisation of programmes for evaluation. We also report on stakeholder involvement in prioritisation processes, and evidence on the use and utility of the frameworks or sets of criteria identified. Our review aims to inform discussion around which criteria and domains are best suited for the prioritisation of public health programmes for evaluation.MethodsWe reviewed the peer-reviewed literature through OVID MEDLINE (PubMed) on 11 March 2022. We also searched the grey literature through Google and across key websites including World Health Organization (WHO), US Centers for Disease Control and Prevention (CDC), European Centre for Disease Prevention and Control (ECDC), and the International Association of National Public Health Institutes (IANPHI) (14 March 2022). Articles were limited to those published between 2002 and March 2022, in English, French or German.ResultsWe extracted over 300 unique criteria from 40 studies included in the analysis. These criteria were categorised into 16 high-level conceptual domains to allow synthesis of the findings. The domains most frequently considered in the studies were “burden of disease” (33 studies), “social considerations” (30 studies) and “health impacts of the intervention” (28 studies). We only identified one paper which proposed criteria for use in the prioritisation of public health programmes for evaluation. Few prioritisation frameworks had evidence of use outside of the setting in which they were developed, and there was limited assessment of their utility. The existing evidence suggested that prioritisation frameworks can be used successfully in budget allocation, and have been reported to make prioritisation more robust, systematic, transparent, and collaborative.ConclusionOur findings reflect the complexity of prioritisation in public health. Development of a framework for the prioritisation of programmes to be evaluated would fill an evidence gap, as would formal assessment of its utility. The process itself should be formal and transparent, with the aim of engaging a diverse group of stakeholders including patient/public representatives.

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Geospatial Technology for Human Well-Being and Health: An Overview

Faruque

2022

Geospatial Technology for Human Well-Being and Health

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Health and wellbeing boards: public health decision making bodies or political pawns?

Cited by 6 publications

References 10 publications

Rethinking Integrated Care: A Systematic Hermeneutic Review of the Literature on Integrated Care Strategies and Concepts

Rethinking Integrated Care: A Systematic Hermeneutic Review of the Literature on Integrated Care Strategies and Concepts

Prioritisation processes for programme implementation and evaluation in public health: A scoping review

Geospatial Technology for Human Well-Being and Health: An Overview

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