Jane Bentley

Interprofessional care co-ordinators: the benefits and tensions associated with a new role in UK acute health care

While more flexible models of service delivery are being introduced in UK health and social care, little is known about the impact of new roles, particularly support worker roles, on the work of existing practitioners. This action research study aimed to explore the impact of one such new role, that of interprofessional care co-ordinators (IPCCs). The general (internal) medical service of a UK hospital uses IPCCs to provide support to the interprofessional team and, in doing so, promote efficiency of acute bed use. Using a range of methods, mainly qualitative, this action research study sought to explore the characteristics and impact of the role on interprofessional team working. While the roles flexibility, autonomy and informality contributed to success in meeting its intended objectives, these characteristics also caused some tensions with interprofessional colleagues. These benefits and tensions mirror wider issues associated with the current modernisation agenda in UK health care.

Patient Advice and Liaison Services: strengthening the voices of individual service users in health-care organizations

Objective  To explore the roles of Patient Advice and Liaison Services (PALS) in their interactions with service users.

Research ethics and complex studies

The operation of research ethics committees in England now follows standard procedures. However, the new ethical review process favours research where research questions and protocols can be clearly specified in advance of the study. While this may not be problematic for those conducting clinical trials, it can prove more difficult for qualitative researchers seeking to study complex and changing environments, such as the health service. Here, the changing nature of the services being investigated and the emphasis placed on involving users and carers in the research process, makes it hard to predict methods in advance of the study. This paper argues for greater flexibility within the ethical review process better to respond to the needs not only of this type of research, but also to other research and development activities, such as audit and practice development. It highlights the need for trust, ongoing dialogue, approval of frameworks and codes of practice.

Quality criteria for patient advice and liaison services: what do patients and the public want?

Background  Every NHS trust and Primary Care Trust (PCT) in England now has a Patient Advice and Liaison Service (PALS) which provides an identifiable person to whom service users can turn if they have a problem or need information while using the NHS. This paper reports data from a 2‐year qualitative study of London PALS.

Horizontal or Vertical Support: Dilemmas for Patient Advice and Liaison Services in the NHS

Every hospital, mental health, primary care and specialist trust in the English National Health Service (NHS) should have a Patient Advice and Liaison Service (PALS), to provide information and support to NHS patients with questions or concerns. PALS should also act as a catalyst for service improvement. This article draws on findings from a qualitative study of London PALS. In particular, it focuses on data generated during observation of meetings of PALS staff in each of London’. five Strategic Health Authority (SHA) sectors, over a period of nearly two years. It describes two types of support received by PALS staff horizontal peer support (the sector meetings themselves; other informal and local PALS contacts; the National PALS Development Group) and vertical hierarchical support (the trusts where PALS are based; Strategic Health Authorities; the Department of Health (DoH)). PALS staff appreciated horizontal support more unequivocally than vertical. Both types of support (horizontal and vertical) reflect parallel government agendas. The Government intends the NHS to become a much flatter hierarchy, and in non-hierarchical structures, staff are expected to look to peers for support. However, a centralised performance management regime also requires staff to look upwards for guidance. As ‘boundary spanners’ working between services and service users, PALS staff are at risk of isolation, and need both types of support to be effective