Supporting ‘Needs-Led’ Services: Implications for Planning and Management Systems (A case study in mental handicap services)

Abstract

Many of the principles of the Community Care White Paper (DoH, 1989) bear a striking resemblance to the Welsh mental handicap strategy launched six years earlier (Welsh Office, 1983). This paper considers the lessons to be learnt from the Welsh strategy for the development of needs-led services as promulgated by the White Paper. Similarities and differences between the two policy initiatives are first identified before considering the conceptual basis of needs-led services. Attention is drawn to two interdependent dimensions of needs-led services, user participation and management delegation, as a means of depicting three underlying models, each with different value stances. By drawing from a case study of one area in Wales, an attempt is made to test the expectations for needs-led services in terms of local planning and management requirements of the three models against the experiences of those charged with putting them into practice. Implications for the White Paper are explored in connection with user involvement strategies and assessment and care management processes.

Co‐Production and Self‐Care: New Approaches to Managing Community Care Services for Older People1

“…Planners and managers, used to the old traditions of needs analysis have often found it hard to incorporate user views in any meaningful sense. McGrath and Grant (1992) give a detailed analysis of the difficulties taking the case of the All Wales Strategy, but Cormie (1992) and Barnes (1993) show that user input can be managed effectively and can have beneficial outcomes. (ii) Assessment is a key stage in service delivery.…”

The Roles and Tasks of Care Management Practitioners in Wales — Revisited

“…Challis pointed out that the essence of the assessment process involves engaging a person, forming a relationship, giving advice and … a range of human relationship skills including counselling.' (Lewis et al, 1997 p12) This argument has been reflected elsewhere in the literature on people with mental health problems (Huxley, 1993) and with learning disabilities (McGrath & Grant, 1992;Hatfield, 1993). In addition,…”

“…(Lewis et al, 1997 p12) This argument has been reflected elsewhere in the literature on people with mental health problems (Huxley, 1993) and with learning disabilities (McGrath & Grant, 1992;Hatfield, 1993). In addition,…”

Stress and job satisfaction among social workers, community nurses and community psychiatric nurses: implications for the care management model

“…A degree of emotional support for users and carers, and practical support for providers, was additionally construed as part of the care manager's role (Social Services Inspectorate 1991a). However, most commentators take this to be a small part of the role and express concerns about the rigid separation of assessment and care planning from direct service provision (Fisher 1991, Challis 1992, Hatfield 1993, Huxley 1993, McGrath & Grant 1992. The distinction between 'new managerial' and professional roles therefore lies at the very heart of the endeavour, raising major issues about the professional identities, competencies and aspirations of the practitioners involved.…”