dc.contributor.author | Sheaff, Rod | |
dc.contributor.author | Windle, Karen | |
dc.contributor.author | Wistow, Gerald | |
dc.contributor.author | Ashby, Sue | |
dc.contributor.author | Beech, Roger | |
dc.contributor.author | Dickinson, Angela | |
dc.contributor.author | Henderson, Catherine | |
dc.contributor.author | Knapp, Martin | |
dc.date.accessioned | 2014-05-08T15:00:13Z | |
dc.date.available | 2014-05-08T15:00:13Z | |
dc.date.issued | 2014-04 | |
dc.identifier.citation | Sheaff , R , Windle , K , Wistow , G , Ashby , S , Beech , R , Dickinson , A , Henderson , C & Knapp , M 2014 , ' Reducing emergency bed-days for older people? Network governance lessons from the 'Improving the Future for Older People' programme ' , Social Science and Medicine , vol. 106 , pp. 59-66 . https://doi.org/10.1016/j.socscimed.2014.01.033 | |
dc.identifier.issn | 0277-9536 | |
dc.identifier.other | ORCID: /0000-0001-7681-2732/work/62749248 | |
dc.identifier.uri | http://hdl.handle.net/2299/13517 | |
dc.description | This document is the Accepted Manuscript version, and is made available under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way. | |
dc.description.abstract | In 2007, the UK government set performance targets and public service agreements to control the escalation of emergency bed-days. Some years earlier, nine English local authorities had each created local networks with their health and third sector partners to tackle this increase. These networks formed the 'Improving the Future for Older People' initiative (IFOP), one strand of the national 'Innovation Forum' programme, set up in 2003. The nine sites set themselves one headline target to be achieved jointly over three years; a 20 per cent reduction in the number of emergency bed-days used by people aged 75 and over. Three ancillary targets were also monitored: emergency admissions, delayed discharges and project sustainability. Collectively the sites exceeded their headline target.Using a realistic evaluation approach, we explored which aspects of network governance appeared to have contributed to these emergency bed-day reductions. We found no simple link between network governance type and outcomes. The governance features associated with an effective IFOP network appeared to suggest that the selection and implementation of a small number of evidence-based services was central to networks' effectiveness. Each service needed to be coordinated by a network-based strategic group and hierarchically implemented at operational level by the responsible network member. Having a network-based implementation group with a 'joined-at-the-top' governance structure also appeared to promote network effectiveness. External factors, including NHS incentives, health reorganisations and financial targets similarly contributed to differences in performance.Targets and financial incentives could focus action but undermine horizontal networking. Local networks should specify which interventions network structures are intended to deliver. Effective projects are those likely to be evidence based, unique to the network and difficult to implement through vertical structures alone. | en |
dc.format.extent | 8 | |
dc.format.extent | 351691 | |
dc.language.iso | eng | |
dc.relation.ispartof | Social Science and Medicine | |
dc.subject | older people | |
dc.subject | emergency bed days | |
dc.subject | hospital services | |
dc.subject | governance incentives | |
dc.title | Reducing emergency bed-days for older people? : Network governance lessons from the 'Improving the Future for Older People' programme | en |
dc.contributor.institution | School of Health and Social Work | |
dc.contributor.institution | Nursing, Midwifery and Social Work | |
dc.contributor.institution | Centre for Research in Public Health and Community Care | |
dc.contributor.institution | Communities, Young People and Family Lives | |
dc.contributor.institution | Centre for Applied Clinical, Health and Care Research (CACHE) | |
dc.description.status | Peer reviewed | |
rioxxterms.versionofrecord | 10.1016/j.socscimed.2014.01.033 | |
rioxxterms.type | Journal Article/Review | |
herts.preservation.rarelyaccessed | true | |