第三部门组织在英格兰的NHS和地方当局中受委托的方式的后果:一种混合方法研究
Rod Sheaff1, Angela Ellis Paine2, Mark Exworthy3
1Peninsula School of Medicine and Dentistry, University of Plymouth, ITTC Building, Davy Road, Plymouth Science Park, Plymouth, UK.
在英格兰,志愿,社区和社会企业的委托通过两种模式运作:商品化和协作. 两者都有挑战,但协作调试,特别是COVID-19后,显示出更好的整合和结果的潜力.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生政策 公共卫生政策
- 组织研究 组织研究
背景情况:
- 志愿者,社区和社会企业 (VCSEs) 对英国的医疗保健和护理系统至关重要.
- 对于国家卫生服务 (NHS) 和地方当局如何委托VCSEs,其输出,影响环境和委托变化等方面的理解有限.
研究的目的:
- 阐明VCSEs的调试过程.
- 确定委员会委员和VCSEs的后果,障碍和必要的吸收能力.
主要方法:
- 采用了观察性,混合方法的现实主义分析.
- 包括探索性范围,支出分析和6个英国卫生经济体 (2019-23) 的比较案例研究 (2019-23).
- 追踪器的活动包括社会处方,学习障碍支持和终身护理.
主要成果:
- 确定了两个并行调试模式:商品化 (基于采购) 和协作 (基于关系).
- 围绕采购法规的解决方案是常见的;模式的平衡因地区和环境而异.
- 随着COVID-19的流行,调试转向了更具协作性的方法. 风险医疗企业并不总是得到充分资助,而综合护理系统的形成影响了当地网络.
结论:
- 相互矛盾的委托模式和解决方案突显了采购法规中的紧张关系.
- 将VCSE投入使用的成本低于全部成本是不可持续的.
- 发展吸收能力需要加强专员的管理/沟通技巧和VCSEs的结果证明.
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