Abigail Burgess

Experiences of service user and carer participation in health care education

The agenda of involving service users and their carers more meaningfully in the development, delivery and evaluation of professional education in health is gaining in importance. The paper reports on a symposium which presented three diverse initiatives, established within a school of nursing and midwifery in the United Kingdom. These represent different approaches and attempts to engage service users and in some instances carers more fully in professional education aimed at developing mental health practitioners. Each is presented as achieving movement on a continuum of participation from service users as passive recipients to service users as collaborators and co-researchers. The paper concludes with a discussion of the lessons to be learnt which will hopefully stimulate service user involvement on a wider basis.

The introduction of integrated out-of-hours arrangements in England: a discrete choice experiment of public preferences for alternative models of care

Objective  To establish which generic attributes of general practice out‐of‐hours health services are important to the public.

Effect of introduction of integrated out of hours care in England: observational study

Abstract Objectives To quantify service integration achieved in the national exemplar programme for single call access to out of hours care through NHS Direct, and its effect on the wider health system. Design Observational before and after study of demand, activity, and trends in the use of other health services. Participants 34 general practice cooperatives with NHS Direct partners (exemplars): four were case exemplars; 10 control cooperatives. Setting England. Main outcome measures Extent of integration; changes in demand, activity, and trends in emergency ambulance transports; attendances at emergency departments, minor injuries units, and NHS walk-in centres; and emergency admissions to hospital in the first year. Results Of 31 distinct exemplars, 21 (68%) integrated all out of hours call management. Nine (29%) achieved single call access for all patients. In the only case exemplar where direct comparison was possible, a higher proportion of telephone calls were handled by cooperative nurses before integration than by NHS Direct afterwards (2622/6687 (39%) v 2092/7086 (30%): P < 0.0001). Other case exemplars did not achieve 30%. A small but significant downturn in overall demand for care seen in two case exemplars was also seen in the control cooperatives. The number of emergency ambulance transports increased in three of the four case exemplars after integration, reaching statistical significance in two (5%, −0.02% to 10%, P = 0.06; 6%, 1% to 12%, P = 0.02; 7%, 3% to 12%, P = 0.001). This was always accompanied by a significant reduction in the number of calls to the integrated service. Conclusion Most exemplars achieved integration of call management but not single call access for patients. Most patients made at least two telephone calls to contact NHS Direct, and then waited for a nurse to call back. Evidence for transfer of demand from case exemplars to 999 ambulance services may be amenable to change, but NHS Direct may not have sufficient capacity to support national implementation of the programme.

Integrated Service User‐Led Teaching In Higher Education: Experiences And Learning Points

Printed in Great Britain by Newnorth, Bedford Copyright for all published material in this journal is held by Pavilion Journals (Brighton) Limited unless specifically stated otherwise. Authors and illustrators may use their own material elsewhere after publication without permission but Pavilion asks that this note be included in any such use: ‘First published in The Mental Health Review, Volume 11 Issue 4 • December 2006.’ Subscribers may photocopy pages within this journal for their own use without prior permission subject to both of the following conditions: that the page is reproduced in its entirety including the copyright acknowledgments; that the copies are used solely within the organisation that purchased the original journal. Permission is required and a reasonable fee may be charged for commercial use of articles by a third party. Please apply to Pavilion Journals (Brighton) Limited for permission. Editorial . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

A research guide to CCG management

Recent and forthcoming studies relevant to the main performance requirements of clinical commissioning groups are highlighted. These are derived from the strategic commissioning approach to applied health management subjects adopted in National Institute for Health Research programmes. Their mid-term perspective helps to ensure sound empirical findings of utility over time across organisational and policy changes. A practical guide is offered to identifying sound evidence and transferable learning, with some exemplar illustrations from the past NIHR portfolio. This portfolio bears witness to the benefits of a ‘needs led science added’ approach, particularly for health managers seeking a fit between research findings and their particular contexts.