-high mortality, often oversimplifying, without really doing justice to the very significant progress that has also been made. The Ndhiwa Project: Toward a Simplified Model of Care Elba Rahmouni: What were the major phases of the project? Léon Salumu: During the first two years [2014 and 2015], MSF expended significant resources in the villages in testing and awareness-raising campaigns conducted outside of the health centres, whose capacities we also
have relevance and applicability to health services (Arksey and O’Malley, 2005). We know that people who use mental health services, carers and professionals have different views about effective care, with professionals often prioritising a clinical model of care, and service users emphasising a social model of care (Rose, 2003). Similarly, they may also have different research priorities. Service users want research that makes a noticeable difference to their care experiences, both personally and generally (Beresford, 2005). More importantly, they want research
the room to catch a new person and then pirouette around another. Each needed to be minutely connected with other leaders to ensure that all remained safe, at the same time as watching closely for her or his particular partner and partners they would soon be assisting. The exercise built a particular (not of course completely unproblematic – of which, more later) model of care. First, there was an intimate connection to the direct partner as the person quietly led him or her around the space. Second, as the touch became slighter, there was the experience of the
engagement or involvement became recognised NHS functions, reflected in job titles. There was growing acknowledgement of the fact that people were living longer and that increasing numbers had to manage long-term conditions, which required a different approach to traditional “patch and mend” medicine. Interest correspondingly grew in models of care for long-term conditions, such as the Wagner Chronic Care Model (Wagner, 2001 ). The Department of Health launched the Expert Patient Programme (Tidy, 2015 ). Patient experience was recognised as a key dimension of care
between people – as a set of such transitive actions and reactions. Basic actor training can improve the performance of such actions. In the process, actors can learn to attend more closely to the responses of other people. This ‘attentiveness’ is a key element of Tronto’s model of care ethics, which posits it as a primary necessity in the delivery of care ( 2013 : 34). The cultivation of conscious attentiveness can help carers to recognise and clarify their intentions (both conscious and subconscious) and the consequences of their actions within the caring relationship
and training opportunities, supporting their transition into education, employment and desistance with a model of care that reflects the organisation’s investment in support structures for them. However, it is important to recognise that Clean Break is, first and foremost, a theatre company. It has made a critical intervention in the lives of women who have been failed by the state but it cannot and must not take the place of it. Lucy Perman ( 2018 ) reflected on this tension: Recently care hasn’t been a particularly positive term. It’s linked with social work
of a prospective community hospital closure in rural Scotland, two lead campaigners assumed an institutionally versed approach to their advocacy, leveraging legal, policy, and local politics instruments at different levels of the system. The insertion of experiential knowledge of the hospital and its model of care was less prominent in their strategising. Their wrangling with the local council, regional NHS, and Members of Parliament was in some respects strongly ‘institutional’, making reference to higher authorities
chart the political career of new models of care, moving with specialists and advocates in turns between clinic and surgery, and national and international policy fora. In so doing, this work builds on a small number of historical studies that situate tools of clinical management in a context of professional politics and concerns over quality. 29 Whilst positioning the promotion of technologies for professional management in terms of cultural and political anxieties about professional accountability, it suggests that specialists and elite medical bodies were not
’, and doctors even considered the application of similar models of care to different problems. 123 Discussing group practices, for instance, Hart proposed that ‘the expected number of patients may justify concentration in regular mini-clinics for hypertension, diabetes, chronic obstructive airways disease, epilepsy, [and] rheumatic diseases’. Common approaches were possible, Hart suggested, because management of all these conditions had become centred on ‘monitoring … a set of variables, support by ancillary staff with at least some special training, the use of
). People with long-term conditions account for a very high proportion of all health service usage. Yet those services often struggle to provide what is needed. The NHS is typically organised to deliver single episodes of care along single disease pathways. Or, as the NHS Five Year Forward View (NHS, 2014 ) put it: sometimes the health service has been prone to operating a “factory” model of care and repair. Chronic illness and multi-morbidity require different approaches. Medicines and treatments matter, but so do other factors: a collaborative approach from the