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首页> 外文期刊>Journal of health services research & policy >Improving community support for older people's needs through commissioning third sector services: a qualitative study
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Improving community support for older people's needs through commissioning third sector services: a qualitative study

机译：通过调试第三部门服务改善社区对老年人需求的支持：定性研究

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Aim This exploratory study of commissioning third sector services for older people aimed to explore whether service data was fed back to commissioners and whether this could improve intelligence about the population and hence inform future commissioning decisions. Background Third sector services are provided through charities and non-profit community organizations, and over recent years services have developed that assess and advise people for self-management or provide wellbeing support in the community. Third sector services have an opportunity to reach vulnerable populations and to provide intelligence about them. Some third sector services are state funded (commissioned) in the United Kingdom. While evidence is available about the commissioning of statutory health and social care, as well as private providers, there is limited evidence about how third sector health services are funded. Methods Participants were recruited from commissioner organizations and third sector organizations, both with an interest in supporting the independence, self-management and wellbeing of older people. Organizations were recruited from five purposively selected sites within one region of England (East Midlands). Semi-structured interviews explored the relationships between commissioners and providers and the nature of funding arrangements, including co-production. Interviews also explored collection of data within the service and how data were fed back to commissioners. Focus groups were held with older people with the potential to benefit from wellbeing services. Results Commissioning arrangements were varied, sometimes complex, and often involved co-production with the third sector. Commissioners valued third sector organizations for their engagement with the local community, value for money, outreach services and ability to provide information about the community. Assessing the needs and outcomes of individuals was integral to delivery of support and advice to older people. Diverse approaches were used to assess an individual's needs and outcomes, although there were concerns that some assessment questionnaires may be too complex for this vulnerable group. Assessment and outcomes data were also used to monitor the service contract and there was potential for the data to be summarized to inform commissioning strategies, but commissioners did not report using assessment data in this way, in practice. While the policy context encouraged partnerships with third sector organizations and their involvement in decision making, the relationship with third sector organizations was not valued within contract arrangements, and may have been made more difficult by the tendering process and the lack of analysis of service data. Conclusion This exploratory study has demonstrated a diversity of commissioning arrangements for third sector services across one region of England. Most commissioners invited co-production; that is, the commissioners sought input from the third sector while specifying details of the service. Service data, including assessments of needs and outcomes, were reported to commissioners, however commissioners did not appear to use this to full advantage to inform future commissioning decisions. This may indicate a need to improve measurement of needs and outcomes in order to improve the credibility of the commissioning process.
机译：旨在对老年人调试第三部门服务的探索性研究旨在探索服务数据是否被送回专员以及这是否可以改善对人口的智力，并为未来的调试决定提供信息。背景技术第三部门通过慈善机构和非营利性社区组织提供，近年来，服务已经制定了评估和建议人们进行自我管理或在社区中提供福祉支持。第三个部门服务有机会达到弱势群体，并为他们提供情报。一些第三个部门服务是英国资助的国家资助（委托）。虽然有关法定卫生和社会关怀的调试，以及私人提供商的证据，但有限的证据证明了第三个部门卫生服务资金。方法招聘参与者从专员组织和第三部门组织招募，这都是为了支持老年人的独立，自我管理和福祉而兴趣。组织是从英格兰（东米德兰兹）的一个地区的五个有动的选定地点。半结构化访谈探讨了专员和提供者之间的关系以及融资安排的性质，包括共同生产。访谈还探讨了服务中的数据集合以及数据如何回到专员。焦点小组与老年人举行，潜力受到福利服务的潜力。结果调试安排有所不同，有时复杂，经常与第三部门合作。专员有价值的第三部门组织与当地社区进行参与，资金价值，外展服务和提供有关社区信息的能力。评估个人的需求和结果与向老年人提供支持和建议是一体的。各种方法被用来评估个人的需求和结果，尽管有担心某些评估问卷对于这一弱势群体可能过于复杂。评估和结果数据也用于监测服务合同，并概述数据通知调试策略，但委员在实践中没有以这种方式使用评估数据。虽然政策背景鼓励与第三部门组织的伙伴关系及其参与决策，但与第三部门组织的关系在合同安排中没有重视，并且可能在招标进程和缺乏对服务数据分析的情况下变得更加困难。结论这项探索性研究表明，在英格兰一个地区的第三部门服务的调试安排的多样性。大多数专员邀请合作;也就是说，专员在指定服务的详细信息时从第三个扇区寻求输入。委员会向专员报告了服务数据，包括评估需求和结果，但委员们没有似乎无法充分利用通知未来调试决定。这可能表明需要改善需求和结果的测量，以提高调试过程的可信度。

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