partnership models for social welfare advice in health care
TRANSCRIPT
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Partnership models for social welfare advice in
health careMarch 24th 2021
Sarah Beardon
UCL Department of Applied Health Research
UCL Faculty of Laws
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Background
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Background
PhD question:
“How can health-justice partnerships be implemented successfully”?
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Methods
Study design: Comparative Case Study (n=9)
Data collection: Semi-structured interviews (n=39)
Analysis: Qualitative & theoretical
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Inclusion criteria
• Welfare benefits• Debt• Housing• Employment• Education• Immigration• Community care
• Action on behalf of clients• Appeals and challenges• Court / tribunal
representation
• Physical links• Remote links
Social welfare law
Casework
Linked with healthcare
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How were the partnerships designed?
9 case studies
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PRIMARY CARE
1 2
3 4
Setting: GP practices Setting: GP practices
Setting: GP practices Setting: GP practices
Sites: 99 Sites: 8
Sites: 55 Sites: 1
Delivery: Telephone Delivery: Face-to-face
Delivery: Face-to-face Delivery: Face-to-face
Co-location: On rotation Co-location: On rotation
Co-location: None Co-location: Full time
Funding: University
Funding: NHS (CCG)
Funding: Joint NHS & Local authority
Funding: Local authority (Public health)
LONDON
LONDONNORTH WEST
EAST MIDLANDS
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SECONDARY / TERTIARY CARE
5 6
7 8
Funding: CharityFunding: Charity
Funding: Multi-stream (NHS, LA & Charity) Funding: Local authority
Setting: Children’s hospital Setting: Cancer care (hospitals, hospices)
Setting: Mental health (hospitals, AMHTs)
Setting: HIV service (hospital)
Sites: 1Sites: 6
Sites: 11 Sites: 1
Delivery: Face-to-faceDelivery: Face-to-face
Delivery: Face-to-faceDelivery: Face-to-face
Co-location: Full timeCo-location: On rotation
Co-location: On rotationCo-location: Full time
EAST OF ENGLAND
LONDON
NORTH EAST
SOUTH EAST
Multi-disciplinary
team
Multi-agency partnership
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9
MIXED CARE SETTINGS
LONDON
Setting: Borough-wide
Sites: Open to all health and social care teams
Delivery: Telephone
Funding: Joint NHS & Local authority
Multi-agency partnership
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Design issues
Referral sources
Accessibility
Demand & capacity
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Service models
Recommendations:
• Consider who is best placed to identify need
• Consult key groups in design and development
• Encourage local needs assessment as a basis
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What makes for good collaborative working?
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Joint activities
Making referrals
Exchanging information
Identifying need
Coordinating case input
Consulting each other
Providing feedback
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Determinants of collaborative working
Confident
Engagement
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Collaborative working
Recommendations:
• Create environments conducive to collaboration
• Address barriers to collaboration (knowledge, physical, administrative)
• Broker relationships between agencies
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What influences sustainability?
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Trajectories
> DECADE
< DECADE
ENDEDONGOING
“Long runners”
N=3
“Late casualties”
N=2
“Successful starters”
N=3
“Early exiters”N=1
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Determinants of resourcing decisions
Confident
Resourcing
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Sustainability
Recommendations:
• Seek out joint resourcing & support in kind
• Focus on evaluation and promotion
• Develop and strengthen leadership
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What difference did the partnerships make?
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The difference for patients
Access to advice
Welfare outcomes
Mental health
Patient experience
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How were services being evaluated?
Processes Outcomes Impacts
• Referral numbers• Referral sources• Welfare issues• Work undertaken
(contacts, casework)• Client demographics• Client health status• Promotional
activities
• Financial outcomes• Other welfare outcomes• Case histories• Patient feedback• Staff feedback
• Self-report wellbeing surveys
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Evaluation
Recommendations:
• Evaluate according to funder goals
• Develop evaluation framework and guidance
• For impact research: studies using routine healthcare data
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Conclusions
• Findings and recommendations are new –consultations will follow
• A time of instability for health-justice partnerships
• BUT also a time of opportunity
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Supervision team:
Professor Rosalind Raine
Professor Dame Hazel Genn
Dr Charlotte Woodhead
Dr Silvie Cooper