Designing and Governing Responsive Local Care Systems – Insights from a Scoping Review of Paramedics in Integrated Models of Care

Programs that fill gaps in fractured health and social services in response to local needs can provide insight on enacting integrated care. Grassroots programs and the changing roles of paramedics within them were analyzed to explore how the health workforce, organizations and governance could support integrated care. In this study, five concepts were identified for fostering integrated care in local systems: single point-of-entry care pathways; flexible and mobile workforce; geographically-based cross-cutting organizations; permissive regulation; and assessing system-level value.

Paediatric integrated care in the primary care setting: A scoping review of populations served, models used and outcomes measured

Paediatric integrated care (PIC), which involves primary care and behavioural health clinicians working together with patients and families, has been promoted as a best practice in the provision of care. In this context, behavioural health includes behavioural elements in the care of mental health and substance abuse conditions, chronic illness and physical symptoms associated with stress, and addressing health behaviours. Models of and contexts in which PIC has been applied vary, as do the outcomes and measures used to determine its value. Thus, this study seeks to better understand (1) what paediatric subpopulations are receiving integrated care, (2) which models ...

Global Competency and Outcomes Framework for Universal Health Coverage

The goal of this Global Competency and Outcomes Framework for UHC is to advance improvements in health and progress towards UHC through aligning health worker education approaches with population health needs and health system demands. More specifically, the primary objective of this document is to provide guidance for the specification of pre-service and in-service competency-based education outcomes for health workers, which in turn inform the development of relevant curricula, learning activities and assessment approaches. Its main target audience is health workforce educators, but it can be of relevance also for licensing and regulatory authorities and health service and facility managers ...

How do nurses support chronically ill clients’ participation and self-management in primary care? A cross-country qualitative study

In the context of the advancement of person-centered care models, the promotion of the participation of patients with chronic illness and complex care needs in the management of their care (self-management) is increasingly seen as a responsibility of primary care nurses. It is emphasized that nurses should consider the psychosocial dimensions of chronic illness and the client’s lifeworld. Little is known about how nurses shape this task in practice. The aim of this analysis is to examine how primary care nurses understand and shape the participation of patients with chronic illness and complex care needs regarding the promotion of ...

COVID-19 frontline primary health care professionals’ perspectives on health system preparedness and response to the pandemic in the Mahalapye Health District, Botswana

The World Health Organization issued interim guidelines on essential health system preparedness and response measures for the coronavirus disease 2019 (COVID-19) pandemic. The control of the pandemic requires healthcare system preparedness and response. This study aimed to evaluate frontline COVID-19 primary health care professionals’ (PHC-Ps) views on health system preparedness and response to the pandemic in the Mahalapye Health District (MHD). In March 2020, the Botswana Ministry of Health directed health districts to educate their health professionals about COVID-19. One hundred and seventy frontline PHC-Ps were trained in MHD; they evaluated the health system’s preparedness and response. More than ...

Meaningful use of a digital platform and structured telephone support to facilitate remote person-centred care - a mixed-method study on patient perspectives

Process evaluations are useful in clarifying results obtained from randomised controlled trials (RCTs). Traditionally, the degree of intervention usage in process evaluations is monitored by measuring dose or evaluating implementation fidelity. From a person-centred perspective, such evaluations should be supplemented with patients’ experiences of meaningful use, given that intervention use should be agreed upon between interested parties and tailored to each patient. This study aimed to elucidate patients’ experiences of a remote person-centred care (PCC) intervention by deepening the understanding of, if, how and for whom the intervention contributed to meaningful use.

Integrated care systems need to be different - but how exactly?

ICSs are intended to be a fundamental departure from previous NHS structures with a different type of leadership based on partnership, in which local partner organisations hold collective responsibility for resource use and outcomes. However, as ICSs take on statutory responsibilities for the first time later this year (assuming the Heath and Care Bill gains parliamentary approval) there is a risk of recreating established ways of working within the new structures. To live up to their promise, what are the things that should be ‘different’ about ICSs?

First, the concept of equal partnership between the NHS, local government, voluntary sector ...

Evaluation of the North West London Diabetes Foot Care Transformation Project: A Mixed-Methods Evaluation

Diabetes foot ulceration presents an enormous burden to those living with diabetes and to the local health systems and economies. There is an increasing interest in implementing integrated care models to enhance the quality of care for people living with diabetes and related complications and the value of co-production approaches to achieve sustainable change.

This paper aims to describe the evaluation methodology for the North West London Diabetes Foot Care Transformation project.

Development of a Blueprint for Integrated Care for Vulnerable Pregnant Women

There has been increasing awareness of perinatal health and organisation of maternal and child health care in the Netherlands as a result of poor perinatal outcomes. Vulnerable women have a higher risk of these poor perinatal outcomes and also have a higher chance of receiving less adequate care. Therefore, within a consortium, embracing 100 organisations among professionals, educators, researchers, and policymakers, a joint aim was defined to support maternal and child health care professionals and social care professionals in providing adequate, integrated care for vulnerable pregnant women.

An assertive, practical, and substantive agenda to catalyse meaningful change

The Lancet Global Health Commission on financing primary health care combines a shared vision with practical guidance on how to align health financing with overall reform strategies that place primary care service delivery at the core. The Commission reinforces key messages that WHO has put forward on health financing reforms to enable progress towards universal health coverage. It then extends these by application to primary care as a critical service delivery element for the progressive realisation of UHC.

WHO's guidance on health financing is crystallised into a framework for regular country assessment to inform policy dialogue. The alignment of ...