Decentring Health And Care Networks

Networks have become a prominent template for public service governance. Often seen as an alternative to hierarchies and contracts, networks cross institutionalized organizational or sectoral boundaries to promote collaboration and the sharing of resources when addressing complex problems. Nowhere is this more the case than in the field of health services modernization and improvement. Comprising unique empirical contributions, drawn primarily from the experience of the UK National Health Service (NHS), this edited collection develops a ‘decentred’ analysis of health and care networks. Contributors look beyond particular structures or patterns of governance and focus instead on the interpretation of the meaningful practices of policy actors as they encounter and enact policy instruments and structures. The approach offers a distinct form of analysis that deepens and enriches more traditional public policy accounts of network governance. It recognizes the influence of local history, highlights the influence of dominant economic, technical and corporate narratives, and acknowledges the continued influence of biomedical knowledge and professional expertise. Offering practical insight for current and future service leaders about the challenges of implementing, managing and working within networks, this book draws out key messages for practitioners and researchers alike.

Taking a ‘decentred’ approach to the analysis of health policy means being attentive to the historical contingencies and circumstances within which reforms are located, the influence of dominant or elite narratives in the shaping of policy, the local traditions and customary practices through which policies are mobilised, and the way local actors contest, negotiate and co-construct policy. This book offers a unique analysis of the changing landscape of healthcare reform in Britain, as an example of decentralized reforms across the developed world. The collection is framed by the recognition that healthcare reform has resulted in variegated and decentralized forms of governance. The chapters look at distinct aspects of reform within the British NHS to bring to light the influence of local histories, traditions, coalitions, and values, in the remaking of a national healthcare system. Each chapter focuses on a different aspects of reform, and in others developing cross-national and comparative analysis. However, each offers a unique contribution and analysis of contemporary theories of healthcare governance. This book will be of key interest to scholars, students and practitioners in healthcare, health and social policy, political science, and public management and governance.

EPDF and EPUB available Open Access under CC-BY-NC-ND licence. Groups most severely affected by COVID-19 have tended to be those marginalised before the pandemic and are now largely being ignored in developing responses to it. This two-volume set of Rapid Responses explores the urgent need to put co-production and participatory approaches at the heart of responses to the pandemic and demonstrates how policymakers, health and social care practitioners, patients, service users, carers and public contributors can make this happen. The first volume investigates how, at the outset of the pandemic, the limits of existing structures severely undermined the potential of co-production. It also gives voice to a diversity of marginalised communities to illustrate how they have been affected and to demonstrate why co-produced responses are so important both now during this pandemic and in the future.

EPDF and EPUB available Open Access under CC-BY-NC-ND licence. Groups most severely affected by COVID-19 have tended to be those marginalised before the pandemic and are now being largely ignored in developing responses to it. This two-volume set of Rapid Responses explores the urgent need to put co-production and participatory approaches at the heart of responses to the pandemic and demonstrates how policymakers, health and social care practitioners, patients, service users, carers and public contributors can make this happen. The second volume focuses on methods and means of co-producing during a pandemic. It explores a variety of case studies from across the global North and South and addresses the practical considerations of co-producing knowledge both now - at a distance - and in the future when the pandemic is over.

Healthcare managers, professionals and service users operate in an increasingly complex environment in terms of policy, regulation and governance arrangements. The policy process is becoming pluralised as competing narratives are drawn upon to influence practice. A wide range of contradictory and inconsistent policies are on offer to healthcare stakeholders, which ultimately results in a broad spectrum of responses, adaptations and improvisations throughout the process of policy implementation. The impact on managerial and professional practice is significant: Whilst some voices are suppressed or ignored, the complex nature of contemporary policy contexts can also help local actors exercise their agency and advance their agenda. This edited volume investigates how contemporary policy trends are influencing healthcare systems, organisations and professions and explores the various ways in which policy implementation could be enacted, resisted and reinvented by healthcare managers and professionals on the ground. It sheds light on the complex web of connections that exist between policy development (Part I), its translation into practice (Part II), and the activities of organisational leaders who are trying their best to make sense of – and succeed in – challenging policy contexts (Part III).

Many healthcare improvement approaches originated in manufacturing, where end users are framed as consumers. But in healthcare, greater recognition of the complexity of relationships between patients, staff, and services (beyond a provider-consumer exchange) is generating new insights and approaches to healthcare improvement informed directly by patient and staff experience. Co-production sees patients as active contributors to their own health and explores how interactions with staff and services can best be supported. Co-design is a related but distinct creative process, where patients and staff work in partnership to improve services or develop interventions. Both approaches are promoted for their technocratic benefits (better experiences, more effective and safer services) and democratic rationales (enabling inclusivity and equity), but the evidence base remains limited. This Element explores the origins of co-production and co-design, the development of approaches in healthcare, and associated challenges; in reviewing the evidence, it highlights the implications for practice and research. This title is also available as Open Access on Cambridge Core.

This book presents a critical examination of the development of user involvement within research, and investigates the issues currently preventing a productive integration of Mad knowledges within research and practice. Drawing on social, linguistic and critical theories, it proposes the conditions needed to address the development of Mad epistemologies. The author’s unique approach deliberately highlights her own positionality and draws on decades of experience as a service recipient, survivor, activist and researcher to illustrate the structural and symbolic barriers faced. Employing concepts including epistemic injustice, individualization, normalization and structural violence, it suggests a radically new way of articulating ‘what’s the matter with us?’ In doing so, the book itself goes some way towards enacting the radical challenge to academic and epistemic hierarchies which, it is argued, will be required to further advance mad knowledges and user-led research. Crucially, it demonstrates how this approach can be both methodologically and conceptually rigorous. This novel work holds important insights for students and scholars across the humanities and social sciences; particularly those working in the areas of critical psychology, disability studies, Mad studies, feminist studies, critical race theory, and Queer theory.