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    Developing and testing a case-management intervention to support the return to work of health care workers with common mental health disorders

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    Parsons et al 2022.pdf
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    Author
    Griffiths, Amanda
    Keyword
    Mental health
    Return to work
    Health personnel
    Occupational health
    Date
    2022
    
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    DOI
    10.1093/pubmed/fdac055
    Publisher's URL
    https://academic.oup.com/jpubhealth/advance-article/doi/10.1093/pubmed/fdac055/6594717
    Abstract
    BACKGROUNDTo assess the feasibility and acceptability of conducting a trial of the clinical effectiveness and cost-effectiveness of a new case-management intervention to facilitate the return to work of health care workers, on sick leave, having a common mental disorder (CMD).METHODSA mixed methods feasibility study.RESULTSSystematic review examined 40 articles and 2 guidelines. Forty-nine National Health Service Occupational Health (OH) providers completed a usual care survey. We trained six OH nurses as case managers and established six recruitment sites. Forty-two out of 1938 staff on sick leave with a CMD were screened for eligibility, and 24 participants were recruited. Out of them, 94% were female. Eleven participants received the intervention and 13 received usual care. Engagement with most intervention components was excellent. Return-to-work self-efficacy improved more in the intervention group than in the usual care group. Qualitative feedback showed the intervention was acceptable.CONCLUSIONSThe intervention was acceptable, feasible and low cost to deliver, but it was not considered feasible to recommend a large-scale effectiveness trial unless an effective method could be devised to improve the early OH referral of staff sick with CMD. Alternatively, the intervention could be trialled as a new stand-alone OH intervention initiated at the time of usual OH referral.
    Citation
    Parsons, V., Juszczyk, D., Gilworth, G., Ntani, G., Henderson, M., Smedley, J., McCrone, P., Hatch, S. L., Shannon, R., Coggon, D., et al. (2022). Developing and testing a case-management intervention to support the return to work of health care workers with common mental health disorders. Journal of Public Health, DOI: 10.1093/pubmed/fdac055
    Type
    Article
    URI
    http://hdl.handle.net/20.500.12904/15720
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      Optimal healthcare delivery to care homes in the UK: A realist evaluation of what supports effective working to improve healthcare outcomes

      Dening, Tom; Schneider, Justine (2018)
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    • Thumbnail

      Optimal healthcare delivery to care homes in the UK: A realist evaluation of what supports effective working to improve healthcare outcomes

      Dening, Tom; Schneider, Justine (2018)
      Introduction: care home residents have high healthcare needs not fully met by prevailing healthcare models. This study explored how healthcare configuration influences resource use. Methods: a realist evaluation using qualitative and quantitative data from case studies of three UK health and social care economies selected for differing patterns of healthcare delivery to care homes. Four homes per area (12 in total) were recruited. A total of 239 residents were followed for 12 months to record resource-use. Overall, 181 participants completed 116 interviews and 13 focus groups including residents, relatives, care home staff, community nurses, allied health professionals and General Practitioners. Results: context-mechanism-outcome configurations were identified explaining what supported effective working between healthcare services and care home staff: (i) investment in care home-specific work that legitimises and values work with care homes; (ii) relational working which over time builds trust between practitioners; (iii) care which ‘wraps around’ care homes; and (iv) access to specialist care for older people with dementia. Resource use was similar between sites despite differing approaches to healthcare. There was greater utilisation of GP resource where this was specifically commissioned but no difference in costs between sites. Conclusion: activities generating opportunities and an interest in healthcare and care home staff working together are integral to optimal healthcare provision in care homes. Outcomes are likely to be better where: focus and activities legitimise ongoing contact between healthcare staff and care homes at an institutional level; link with a wider system of healthcare; and provide access to dementia-specific expertise.
    • Thumbnail

      Complex care needs and devolution in Greater Manchester: A pilot study to explore social care innovation in newly integrated service arrangements for older people

      Hughes, Jane; Challis, David (2020)
      Objective: The aim of this study was to describe emergent approaches to integrated care for older people with complex care needs and investigate the viability of measuring integrated care. Methods: A case study approach was used. Sites were recruited following discussion with senior staff in health and social care agencies. Service arrangements were categorised using a framework developed by the researchers. To investigate joint working within the sites, the development model for integrated care was adapted and administered to the manager of each service. Data were collected in 2018. Results: Six case study sites were recruited illustrating adult social care services partnerships in services for older people with home care providers, mental health and community nursing services. Most were established in 2018. Service arrangements were characterised by joint assessment and informal face-to-face discussions between staff. The development of an infrastructure to promote partnership working was evident between adult social care and each of the other services and most developed with home care providers. There was little evidence of a sequential approach to the development of integrated working practices. Conclusion: Components of partnerships promoting integrated care have been highlighted and understanding of the complexity of measuring integrated care enhanced. Means of information sharing and work force development require further consideration. What is known about the topic?: The devolution of health and social care arrangements in Greater Manchester has aroused considerable interest in much wider arenas. Necessarily much of the focus in available material has been upon strategic development, analysis of broader trends and mechanisms and a concern with changes in the healthcare system. What does this paper add?: The findings from this study will enable emerging approaches to be described and codified, and permit the specific social care contribution to the new arrangements to be discerned. The findings are relevant beyond the immediate context of Greater Manchester to wider integrated care. The evidence can be used by commissioners and services, providing a sound basis for further work as service systems develop. What are the implications for practitioners?: This research is important because it is one of the first pieces of work to examine the new integrated care arrangements in Greater Manchester. By providing guidance to promote evidence-based practice, this study contributes to service development in Greater Manchester and the achievement of the broad national service objectives of improving user and carer experiences and ensuring value for money. © 2020 AHHA.
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