Biomedical subjects
Edward Peck
Publications and source records attributed to Edward Peck.
PCT merger. Building bridges.
Primary care trusts can be torn between the need for critical mass and the danger of losing local vision and ownership; mergers are politically unpopular and fraught with difficulty. A review of Trafford South PCT stakeholders enabled a range of organisational models to be tested. The result was the creation of a 'joint and integrated management structure' for the two Trafford PCTs.
Joint commissioning. Going halves.
Joint commissioning and provision of mental health services in Somerset failed to produce significant benefits to users over its first two years. Users considered access to services deteriorated and concerns remain that there is no alternative to hospital admission in crises. Users and carers were included as non-voting members of the commissioning board, but users felt less involved in care planning than previously. The combined health and social care trust does not seem to have delivered anything which has not been achieved elsewhere without the transfer of social care staff to a new employer.
Governance of partnership between health and social services: the experience in Somerset.
As one part of a larger study of the integration of mental health and social care, the present paper explores the role of the Joint Commissioning Board in the governance arrangements for health and social partnership in Somerset, UK. A short review of the literature on joint planning and joint commissioning revealed that such partnership has proved problematic, and that the role of non-executive directors and councillors is usually overlooked. Furthermore, the research on corporate boards suggests that their performance does not match the prescriptions made for them. Following a description of the methodology of the study, the present paper reports the findings of the activity of the Joint Commissioning Board from three data sources: (1) observation of meetings; (2) analysis of documentation; and (3) participant interviews. All three sources support the view, put forward in the Discussion section, that the Board does not play a proactive role in the setting and monitoring of policy and priorities. Nonetheless, it is argued, the Board plays a central and constructive role in the governance of partnership: as the symbol of interagency partnership; as the vehicle for sustaining commitment to mental health; and as the method of bringing additional elements of public accountability to the commissioning and providing of health and social care. Locating this ritual function of the Board within the broader sociological literature, the Discussion section goes on to suggest the implications both for the future of governance of partnership and for further research in this area.
Balancing professional and team boundaries in mental health services: pursuing the holy grail in Somerset.
The overcoming of professional boundaries to collaboration in patient care has become one of the goals of mental health service policy in England over the past 25 years, predominantly through the creation of community mental health teams. However, research has shown that these boundaries have been slow to come down, and some commentators have pointed to the benefits of appropriate boundaries. This paper introduces a theoretical framework, which seeks to categorise boundary activity in organisations and then examines the boundary activity of professional groups and community teams during the integration of mental health and social care service provision in one locality in the southwest of England. The paper identifies the ways in which this integration impacted on boundary activity and draws out the messages for mental health policy and practice that emerge.
Policies, priorities, opportunities and barriers in mental health services: five years of the London managers' survey.
Since 1996, an annual survey of senior managers of mental health services in London has been undertaken in order to identify trends in their views of their task. This is the only longitudinal study in the current literature of the views of a group of health and social care managers in England. This paper first outlines the methods and the findings of the survey in 2000, drawing comparisons with data collected in 1998 and 1999 (and occasionally earlier). The discussion section draws out the central themes that emerge from the surveys: firstly, community mental health teams hold a central role in the mental health system; secondly, the development of trust between agencies is a complex challenge; thirdly, it appears that social care managers may be more committed to implementation of national policy than their health colleagues; fourthly, personal and organizational instability is a fact of life; and finally, the relationship between the promulgation of national policy and its adoption into local practice is not straightforward. The conclusion reflects on the potential implications of these findings for the future development of mental health services in England.
Provider arrangements for mental health services in 'The New NHS'
Mental health services in England, in common with many other European countries, have been the subject of sustained government attention during the 1990s. Since the election of the Labour administration in Britain in May 1997, mental health services have been discussed in most Department of Health documents on health and social care policy, and mental health services in England have a new national strategy. At the same time, the local provision of mental health services within NHS Trusts has been undergoing organisational change. This paper sets out the policy context and evidence base for the reorganisation of provider arrangements for mental health services. In addition, the results of a documentary analysis of unpublished reviews of provider arrangements in 10 localities are presented. The review identified three major themes: firstly, the reconfiguration of NHS Trusts is based around Specialist Mental Health Trusts and Community and Mental Health Trusts; secondly, the joint provision of services and/or the integration of services between health and social services is starting to appear and; thirdly, the delegation of responsibility to localities based on Primary Care Group/Social Services boundaries is being discussed. The paper discerns a number of trends and points to the need for further research, in particular into the relationship between organisational arrangements and effective service delivery.