Category / Sociology & Social Policy

Fieldwork preparation in Nepal

If you have a number of research projects running in the same location it pays to combine some of the preparation.  Thus as part of five different studies and one PhD project, I’m currently in Kathmandu.  The projects are (1) the THET-funded intervention in Nawalparasi; (2) the CEL-funded qualitative research led by Dr. Catherine Angell on CPD (Continuous Professional Development); (3) the FHSS-funded project on transgender which is led by Dr. Pramod Regmi; (4) the FHSS-funded project with Pourakhi which supports Nepali women returning home after having been abroad as migrant workers;  and (5) the Green Tara Trust funded project on improving maternal health care in Dhading and Nawalparasi, and the FHSS PhD project is that of Mrs. Preeti Mahato.  Two of the project and the PhD topcic are closely related as all three cover maternity care in one for or another in Nawalparasi.  The planning meetings we are having in Nepal involve planning training sessions and workshops, resource allocation and research preparation.DSCN0026

Fortunately, it is not all work.  Today I enjoyed Kheer (Achar and Chana) for lunch in the Green Tara flat in Kathmandu a lovely rice pudding with slightly sour green vegetables and chick peas (see photo).  The actual meal is traditionally health tomorrow but as this is the weekend the staff brought it one day forward so that I could join in too.

Finally, I like to thank colleagues who gave me mobile phones and a camera.  One of the mobile phones is already in use by one of the Nepali charity workers in Kathmandu. I bought a new battery and memory card for camera in the UK and it is working fine, the photo with this blog has been taken with the donated camera!

 

Prof. Edwin van Teijlingen (writing from Nepal).

Centre for Midwifery, Maternal & Perinatal Health Research

 

New Harding and Pritchard paper in international health policy journal

InternationalMapAndrew Harding and Colin Pritchard have recently had a paper published in the International Journal of Health Policy and Management.

The paper, titled ‘UK and Twenty Comparable Countries GDP-Expenditure on-Health 1980 2013: The Historic and Continued Low Priority of UK Health Related Expenditure, uses GDPEH data to outline the low proportional commitment that the UK makes to healthcare expenditure. It is well established in the health and social policy world that the UK prioritises less of its wealth to health than almost any comparable country. However, the authors use an innovative and novel means of exploring proportional differences in commitment.

The key finding is that since 1980, in order to meet the mean average European health spend, the UK would have needed to have made an additional commitment of one-fifth. For the final period, between 2010-2013 the authors show that the UK has prioritised 12% less in proportional terms (as a % of GDP) than the European average.

The paper ends with the following quote, “Echoing others who have recently contributed to discussion in this area, if other comparable countries can make a larger proportional commitment and deem it affordable, in light of aforementioned challenges, why cannot the United Kingdom prioritise accordingly?”

New HSS PhD paper!

SPSHSS PhD student Andrew Harding and fellow authors  Jonathan Parker, Sarah Hean and Ann Hemingway have recently had a paper accepted for publication in Social Policy & Society, the sister publication to the Journal of Social Policy and run by the Social Policy Association.

A critical yet under-researched area, the paper presents a comprehensive literature review that critiques current research on the outcome/impact of information and advice on welfare. A realist evaluation approach is then proposed as being capable to address critical weaknesses in existing research.

Among other areas that are covered, the paper provides an overview of the importance of information and advice in the context of the marketisation of UK welfare provision and a new ‘efficacy framework’ is developed which can be used to assess the scope of research.

A final draft post-refereeing version of the paper will be uploaded to BRIAN in due course.

Announcement BU Humanisation Conference 2016

BU Humanisation Conference     21st June 2016

Venue: Room EB708, Executive Business Centre, 89 Holdenhurst Road, BH8 8EB

 

Please find the Programme for the Humanisation conference on the 21st June 2016 attached.

Please feel free to pass the information on to others internal and external to the university (academic and practice) who you feel may be interested

The conference is being run at no cost and so you need to make your own arrangements for lunch.  Let Dr. Caroline Ellis-Hill  ( cehill@bournemouth.ac.uk ) know by the 15th June if you wish to attend .

If you only want to attend for part of the day, please state which part of the day you’d like to attend.

 

9.30 Registration  
10.00 Dr Caroline Ellis-Hill Welcome
10.10 Anne Quinney Humanisation of the BU Generic Student Assessment Criteria.
10.30 Dr Sean Beer Perceptions of the authenticity of food: a study of residents in Dorset (UK)
10.50 Prof Ann Hemingway Innovative routes to Wellbeing: Equine Assisted interventions
11.10 Coffee  
11.30 Jane Fry Sharing human concerns: utilising an embodied interpretative approach to convey findings from a descriptive phenomenological study
11.50 Dr Carole Pound Humanising care: translating theory into practice in stroke care
12.10 Rutherford and Dr. Emer Forde The Rutherford Introspective Photography: Promoting self-reflection and wellbeing of GP trainees through photography.
12.30 Free time   Please see information about local venues for lunch
2.00 Dr Vanessa Heaslip How phenomenology enables insight into the Human lives of Gypsy Roma Travellers’
2.20 Mevalyn Cross Experiencing the Humanisation Framework together
2.40 Dr Jan Mosja Chaplaincy at the bedside. Learning from Buddhist chaplains and their contributions to the humanisation of health care.
3.00 Sally Lee Humanising and the Care Act well-being principle
3.20 Dr Mary Grant and Dr Catherine Lamont Robinson HeART of Stroke: feasibility study of an Art & Health intervention following a stroke
3.40 Thanks, Tea and Close  

 

New paper BU PhD student Sheetal Sharma

Plos ONE Sheetal 2016Congratulations to FHSS PhD student Sheetal Sharma on her latest paper [1].  The paper ‘Measuring What Works: An impact evaluation of women’s groups on maternal health uptake in rural Nepal’ appeared this week in the journal PLOS One.  Sheetal’s innovative mixed-methods approach was applied to a long-running maternity intervention in rural Nepal.  The paper concludes that community-based health promotion in Sheetal’s study had a greater affect on the uptake of antenatal care and less so on delivery care. Other factors not easily resolved through health promotion interventions may influence these outcomes, such as costs or geographical constraints. The evaluation has implications for policy and practice in public health, especially maternal health promotion.

Reference:

  1. Sharma, S., van Teijlingen, E., Belizán, J.M., Hundley, V., Simkhada, P., Sicuri, E. (2016) Measuring What Works: An impact evaluation of women’s groups on maternal health uptake in rural Nepal, PLOS One 11(5): e0155144 http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0155144

Lessons from Southern Health – leadership to support a culture of voice across complex integrated systems

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Dr Lee-Ann Fenge

Over the past few years there have been a number of reports which have highlighted concerns about failures of care and patient safety within a range of NHS settings raising serious concerns about the leadership of such organisations. Most recently The Care Quality Commission has identified “serious concerns” about the safety of mental health and learning disability patients at Southern Health NHS Trust. The concerns highlight the failures of leaders to deliver, monitor, assure, and safeguard a culture of safety, quality, and compassionate care and services.

This inspection took place following the publication of an independent review (the Mazars report  that described a number of concerns about the way the Trust reported and investigated deaths, particularly of people using its mental health and learning disabilities services, and a lack of leadership, concerning the reporting and investigation of unexpected deaths of mental health and learning disability service users.

So what leadership challenges are there in turning this situation around? Undoubtedly there have already been improvements in the care offered within the Trust, and the commitment of staff to provide high quality care is beyond doubt. However, the problems result from on-going senior leadership failures within the organisation. Leadership is the most influential factor in shaping organisational culture (Faculty for Medical Leadership and Management, 2015), and is essential to ensure high quality, safe and compassionate healthcare. A key failing identified in Southern Healthcare concerns a lack of robust governance arrangements to investigate incidents, resulting in a lost opportunity to learn from these incidents.

This highlights the importance of senior leadership in establishing and maintaining a culture which is open, responsive and able to learn. Such a culture includes a climate in which communication is valued as a two process which values critical upward communication. This requires a culture of ‘voice’ in which concerns raised by patients, carers and staff are listened to and responded to appropriately. This was sadly lacking at Southern Health and action was not taken to address known risks to the safety of patients, including a lack of response to previous concerns highlighted by the CQC in January 2014, October 2014 and August 2015.

The Trust also failed to respond appropriately to staff concerns about their abilities to discharge certain roles and duties. This perhaps illustrates the failure of senior managers to create a culture of ‘psychological safety’ for staff in which to identify, respond and learn from these problems. Psychological safety has been shown to be a crucial element in organizational efforts to detect and prevent problems (Edmondson et al. 2016). A culture which provides psychological safety for staff embraces ‘challenge’ as a pivotal learning mechanism, and this is supported by the work of McSherry and Pearce (2016) who suggest that safe, quality care requires leaders who can challenge and be challenged.

It is important to learn from the failings of Southern Health. Increasingly NHS leaders need to be able to respond to growing complexity across integrated systems of care. They need the ability to support a system of communication which values the ‘voice’ of all stakeholders to create innovative solutions to 21st century challenges. This requires system leadership that works in partnership across organisations ‘to construct the services that are needed’ (HSJ, 2015:4). It also requires a commitment to create a shared vision of care which values the voice and presence of patients, carers and staff as key stakeholders.

References

McSherry, R.and Pearce, P. (2016) ‘What are the effective ways to translate clinical leadership into healthcare quality improvement?’ Journal of Healthcare Leadership; 2016 (8): 11-17