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The allied health professions have gained legitimacy through the pursuit of research evidence and the standardisation of practice. Yet there remains very little analysis or understanding of these professions. Adopting theory from the sociology of health professions, this book explores the sociological, economic, political and philosophical pressures that have shaped the professions. Drawing on case studies and examples from occupations including optometrists, occupational therapists and physiotherapists to emerging vocations, including pedorthists and allied health assistants, the book offers an innovative comparison of allied health professions in Australia and Britain. By telling the story of their past, the book prepares the allied health professions for a new and different future.

This book is an account of an ethnographic study designed to learn more about how families handle everyday life in the context of dementia, with the idea that if what families were already doing was better understood, their own efforts could be better supported. By following, and learning from, family arrangements for care, the question of what makes care for a family member living with dementia possible or impossible, easier or more difficult, is foregrounded. This question is also traced beyond the specific site of home to consider the ways that health and social care services and policy orientations are organized to support and/or hinder family arrangements. The book contributes to theorizing the intersections between what often seem unrelated: the formal care policies that articulate strategies to ‘manage’ populations of older people living with a diagnosis of dementia, the care practices of those at the frontlines who are responding to what often seem like overwhelming needs, and the care practices of families working to make everyday life liveable. The methodological approach and theoretical lens taken locates this work in a growing field of care practices research that is informed by the relational logic of material semiotics. This lens shifts the reader’s gaze from the isolated caregiver-care recipient dyad, and draws attention to the practical arrangements of bodies, objects, discourses, spaces and relations that constitute everyday living for persons living with dementia and their carers.

This book offers a unique multi-disciplinary perspective on tackling health inequalities in a rich country, examining the New Labour policy agenda for tackling health inequalities and its inherent challenges. The book presents an overview of progress since the publication of the seminal and ambitious 1998 Acheson Inquiry into health inequalities, and the theoretical and methodological issues underpinning health inequalities. The chapters consider the determinants of inequality — for example, early childhood experience and ethnicity — the factors that mediate the relationship between determinants and health — nutrition, housing and health behaviour — and the sectoral policy interventions in user involvement, local area partnership working and social work. This book offers a combination of broad analysis of progress from differing perspectives.

Involving citizens in policy-decision-making processes – deliberative democracy – has been a central goal of the Labour government since it came to power in 1997. But what happens when members of the public are drawn into unfamiliar debate, with unfamiliar others, in the unfamiliar world of policy making at national level? This book sets out to understand the contribution that citizens can realistically be expected to make. Drawing on the lessons from an ethnographic study of a public-involvement initiative in the health service – the Citizens Council of the National Institute for Clinical Excellence (NICE) – it explores the practical realities behind the much-quoted faith in ‘deliberation’ that underpins so many models of public involvement and presents the analysis of 64 hours of video and audiotape capturing a warts-and-all picture of deliberation in action. The book sets deliberative participatory initiatives within a broad inter-disciplinary context and challenges politicians, policy makers, and academics to develop more realistic approaches to democratic innovation.

Adult social care was the first major social policy domain in England to be transferred from the state to the market. There is now a forty-year period to look back at to consider the thinking behind the strategy, the impacts on commissioners and providers of care, on the care workforce and on those who use care and support services. In this book, Bob Hudson meticulously charts these shifts. He examines the shift from philanthropic endeavour to state planning and provision, through to the marketisation of services and support. He challenges the dominant market paradigm, explores alternative models for a post-Covid future and locates the debate within the wider literature on political thinking and policy change.

This book brings together selected research on commissioning healthcare in the English NHS carried out by national policy research unit in commissioning and the healthcare system (PRUComm) between 2011 and 2018. PRUComm is funded by the English Department of Health’s Policy Research Programme. The bookexplores the changes to commissioning in the English NHS quasi market introduced by the Health and Social Care Act 2012 (HSCA 2012). It focuses on threemain areas: first, the development and operation of the newly formed commissioning bodies named Clinical Commissioning Groups (CCGs) which were supposed to increase clinical engagement; secondly, technical aspects of commissioning being the use of competition and cooperation by CCGs to commission care in the HSCA 2012 regulatory context encouraging competition,and the allocation of financial risk through contracts between commissioners and providers of care (including new forms of contract such as alliances); and thirdly the reorganisation of the commissioning of public health services.The research demonstrates that the HSCA 2012 has had the effect of fragmenting commissioning responsibilities and in the process impaired good governance and strong accountability of commissioners. It shows how the use of market mechanisms has declined despite the pro competition regulatory regime of the HSCA 2012, and that more cooperative processes are used at local level to reconfigure health services. It concludes that strategic planning and monitoring of services will always be essential for the English NHS, whether the term ‘commissioning’ is used to describe these activities or not in the future.

Improving health in populations in which it is poor is a complex process. This book argues that the traditional government approach of exhorting individuals to live healthier lifestyles is not enough – action to promote public health needs to take place not just through public agencies, but also by engaging community assets and resources in their broadest sense. The book reports lessons from the experience of planning, establishing, and delivering such action by the five-year Sustainable Health Action Research Programme (SHARP) in Wales. It critically examines the experience of SHARP in relation to current literature on policy; community health and health inequalities; and action research. The authors make clear how this regional development has produced opportunities for developing general concepts and theory about community-based policy developments which are relevant across national boundaries and show that complex and sustained community action, and effective local partnership, are fundamental components of the mix of factors required to address health inequalities successfully. The book concludes by indicating the connections between SHARP and earlier traditions of community-based action, and by arguing that we need to be bolder in our approaches to community-based health improvement and more flexible in our understanding of the ways in which knowledge informs developments in health policy.

This book compares the health systems of 11 countries to find out what the most successful, in terms of health outcomes, health equity and other measures, having in common. It considers patterns of social determinants, health funding and health expenditure, as well as the ‘first wave’ COVID-19 response of a wider sample 25 countries. Making use of Qualitative Comparative Analysis, it combines detailed studies of its eleven countries with robust, comparative analysis of them.

This book engages with the realities of life for people living with dementia at home and within their neighbourhoods while giving voices to the lived experiences of people with dementia across the globe, including Australia, Canada, Sweden and the United Kingdom. Moreover, the voices highlight the urgent need for changes to ensure equal access and inclusion in neighbourhoods. Neighbourhoods, then, become places of connection for people with dementia to wider communities and opportunities. The book also addresses the fundamental social aspects of the environment such as place attachment, belonging and connectivity. In an effort to help practitioners and researchers, the critical and evidence-based collection reveals the potential and challenges of dementia care shifting to a neighbourhood setting. Thus, the neighbourhood-centred perspective provides an innovative guide for policy and practice and calls for a new place-based culture of care and support in the neighbourhood.

Recently, there has been a surge of interest in addressing ethnic health inequalities. However, there are misconceptions about Black and Minority Ethnic (BME) groups that focus on them as being hard to reach and difficult to engage in health services and research. This term is used routinely across all sectors of society. However, what is apparent is that they are “not hard to reach”, but rather health services and research “are not reaching” them, by assuming that health and health practices are experienced equally and services are effective for all. This publication illustrates how this term plays a debilitating role in problematising BME people. It is argued that we need to shift away from the using this term because it contributes to exclusionary practices and has implications for escalating inequalities in health and healthcare access for BME groups. The chapters in this book explore some of the exclusionary practices that occur in health research and practice and provides guidance for practitioners and researchers on how to avoid misconceptions about BME groups. Chapter 1, outlines understandings of key concepts and misconceptions about terms such as race and ethnicity. Chapter 2, explores the relationship between race, ethnicity and health and examines why ethnic health inequalities are occurring. Chapter 3, focuses on how we can improve research in this field to advance inclusionary practice. In the remaining chapters, principles of good practice and how to implement them by means of real research examples from the field are presented.

Does health promotion have a lasting and positive effect on people? With mounting pressure to reduce costs to the NHS and increasing scepticism of the so-called nanny state, health promotion initiatives are increasingly being criticised as costly and ineffective, with many arguing that health inequalities can only be reduced through radical political and economic change. This book examines the methods used to evaluate the value of health promotion projects and determines whether attempts to change people's lifestyles have proved successful. Taking into account the practical and ethical issues involved in deciding the appropriate approach to take in efforts to reduce health inequalities, the book assesses what might be the best path forward for health promotion.

Drawing on in-depth case studies across England, this book argues that governance and population health are inextricably linked. Using original research, it shows how these links can be illustrated at a local level through commissioning practice related to health and wellbeing. Exploring the impact of governance on decision-making, Governance, commissioning and public health analyses how principles, such as social justice, and governance arrangements, including standards and targets, influence local strategies and priorities for public health investment. In developing 'public health governance' as a critical concept, the study demonstrates the complexity of the governance landscape for public health and the leadership qualities required to negotiate it. This book is essential reading for students, academics, practitioners and policy-makers with an interest in governance and decision-making for public health.

This book critically explores the urban governance of healthy lifestyles and the contemporary problematisations of the obesity, sedentarism and alcohol ‘epidemics’. To do so, it uses US and UK case studies to shed light on the complex socio-spatial dynamics of responsibilities for health and argues for an engagement with the construct of ‘sensible’ behaviour at a time of its rising political salience.

Health care systems across the world are in a state of permanent revolution as they struggle to cope with multiple pressures arising from changing demography, new technologies and limited resources. Focusing on the British NHS, this book looks at how it has coped with such pressures over its 60-year history and considers what the future holds. It explores the complexity of health policy and health services, offering a critical perspective on their development. The book offers a reassessment of successive reforms of the NHS and their cyclical nature.

The National Health Service (NHS) is undergoing a period of significant reform, with the reintroduction of the internal market, a focus on patient choice and the controversial introduction of ‘foundation hospitals’ — all central to New Labour's strategy for changing healthcare in the UK. This book contends that attempts to reform the NHS can only be understood by reference to both the wider social and political contexts, and to the organisational and ideational legacies present within the NHS itself. It aims to take students beyond a basic understanding of the historical development of health policy in the UK, to one that demonstrates an appreciation of the interactions between health policy, organisation and society. The book acts as a bridge between conventional textbooks on the NHS and contemporary health policy research, provides an account of the development of policy and organisational change not found elsewhere and provides recommendations for how the NHS can be better organised in the future.

It is vital for healthcare leaders to have a clear sense of which leadership ideas and practices are rooted in sound theory and convincing evidence, and which are more speculative. This book provides a coherent set of six lenses through which to scrutinise the leadership literature relevant to healthcare — leadership concepts, characteristics, contexts, challenges, capabilities and consequences. It offers a view of leadership beyond the traditional focus on the individual, and argues instead that leadership has to be understood and developed as a complex set of practices by many people within specific organisational and inter-organisational contexts and cultures.

Biosensors and biosensing practices collect and share living data, data concerning changes in body states. Health biosensing emerges where devices, health experience, scientific and medical knowledges and online platforms meet around bodies. This book contrasts forms of health biosensing in significant life events ranging from conception to ageing. It explores practicalities, histories and promises of fertility and hormonal biosensing, stress biosensing, DNA genotyping platforms, and old-age biosensing. While the biosensing industries promote promise-horizons of the ‘soon’, ethnographic stories of failure and disappointment abound. ‘Living data’ may be about health for many people, but still happens mostly outside biomedicine or clinical practice. Yet biosensing has the potential to change human bodies and lives in barely imagined ways. This book argues for thinking about biosensing platforms and bodies together to understand that potential and to recognise harms and limitations.

As many social inequalities widen, this is a crucial survey of local authorities' evolving role in health, social care, and wellbeing. The book reviews structural changes in provision and procurement, and explores social determinants of health including intergenerational needs and housing. The book begins with an overview of the relationship between health and housing, regional disparities and responses across England, Wales, and Scotland in the provision of health and social care, and local authority commissioning. It considers how the Municipal Corporations Act (1835) led to the establishment of elected town councils. In the mid- to late 20th century, municipalisation gave way to centralised government, which subverted the autonomy of local authorities. Currently, social care is provided and funded by local authorities and private funders. The main objective of social care is to help people to live well and happily, and live as long as they can. This person-centred approach is in contrast to the systems that have been developed to support the health care needs of people. In 2020, poverty still remains a key driver of poor health and wellbeing. With detailed assessments of regional disparities and case studies of effective strategies and interventions from local authorities, the book addresses complex issues (Wicked Issues), considers where responsibility for wellbeing lies and points the way to future policy-making. The Centre for Partnering (CfP), a network of universities working with the private and third sectors, is a key outcome of this innovative review.

This book critically examines the topics of medical fitness to practice tribunals and revalidation and how we as a society ensure doctors remain competent in their chosen speciality, through a critical socio-legal lens that draws on the disciplinary fields of medical sociology, criminology and law.

This book is a crucial contribution to debates about the rapid modernisation of health care systems and the dynamics of changing modes of governance and citizenship. Structured around the role of the professions as mediators between state and citizens, and set against a background of tighter resources and growing demands for citizenship rights, the book offers a much-needed comparative analysis, using the German health care system as a case study. The German system, with its strongly self-regulatory medical profession, exemplifies both the capacity of professionalism to re-make itself, and the role of the state in response, highlighting the benefits and dangers of medical self-regulation, while demonstrating the potential for change beyond marketisation and managerialism. The book critically reviews dominant models of provider control and user participation, and empirically investigates different sets of dynamics in health care, including tensions between global reform models and nation-specific conditions; inter-professional dynamics and changing gender arrangements; the role of the service-user as a new stakeholder in health care; and the rise of a new professionalism shaped by social inclusion. This book provides new approaches and a wealth of new empirical data.