module specification

This module examines the changes in the financing, commissioning, management and provision of community care since the NHS and Community Act of 1990, particularly in terms of care co-ordination, targeting resources, matching provision to need,  involving service users, and ensuring high quality of care.

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This module aims to enable students to examine the application of theory, policy and research to a practice setting in the context of community care. It will draw on the views and expertise of those attending the course, all of whom would be expected to have some experience of, or interest in, the changes taking place in health and welfare.

It will provide students an opportunity to:

• Understand and analyse community care policy in the light of current social, economic and political debates about the changing role of public services.

• Relate changes taking place in community care policy and implementation to wider strategic issues in health and welfare, and evaluate how far they incorporate the user agenda.

• Further their professional development and expertise through a module which inter-relates theory and practice in a multi-disciplinary context.

• Explore some of the key dilemmas faced in implementing a quasi-market approach to the delivery of public services.  Community care will be used as a case study to contextualise the issues facing practitioners and managers in a rapidly changing public sector.

Major changes in the financing, commissioning, management and provision of community care were introduced as a result of the NHS and Community Act of 1990.  This module begins by examining current developments in the context of the ever changing environment (roles, expectations, demography, social structures, and approaches to public sector management, for example). The major focus, however, is to examine policy and assess progress in implementing and managing the three core aims of the Act, and a fourth policy objective that was a less central aim in 1990, but is core to the more recent Modernising agenda in social services, i.e. ensuring quality care. In other words, our focus is on: the strengthening of care co-ordination; improving the targeting of resources, ensuring provision more closely matches need; a greater involvement of the service user in determining how those needs are best met; and ensuring services deliver a high quality of care. The implications of current policy and practice for informal carers, is a crucial consideration, and there will be some examination of comparative arrangements in other European societies.

A framework for analysis and evaluation will be built up through lectures, case studies, and discussions. The usual format will be that a 55 minute lecture will be followed, after a coffee break, by a seminar or workshop. In three or four of the sessions, seminar time will be devoted to presentations by students of their outline plans for their essays. Students choosing the same essay title can thus learn from each other, from comments by tutors, and the discussion generated, about the appropriateness and adequacy of their work to date. They will also gain contrasting information and views on the same issue in different local authority areas or between client groups. Students may obtain further guidance on their essay plans during session week 13, when tutors are available for 20 minute bookable 1-to1 sessions.

Students are recommended to read one or 2 of the listed papers for each week as a minimum. To assist selection, at least one reference is marked with an asterisk as particularly central. Additional electronic material and lecture notes will be made available via WebCT.

By the end of the module students should be able to:

1. Analyse the rationale for particular aspects of community care policy development.

2. Evaluate the implementation of policy for particular interest groups, highlighting any issues of equity.

Assignment to be handed in WEEK 14 :

A 4,000 word essay focussing on a current issue in the development of community care services by the public sector. It should include a case study of a particular care group, or social/health care agency. Students may choose one from about 4 given titles. Examples include:

1. Meeting needs equitably and appropriately - issues for commissioners.

2. Outline and evaluate the current mechanisms for co-ordinating care.

3. What roles do the service user and their close relatives and/or friends play in community care arrangements today? 

4. Describe and analyse one or more of the current approaches to ensuring quality of provision in community care.

In addition each student will be required to take part in presenting a seminar paper and/or a poster based on the assessment in weeks 6-12, from which to gain feedback on their ideas and reading to date.

Bytheway, B., Bacigalupo, V., Bornat, J., Johnson, J. & Spurr, S. (2002) Understanding care, welfare and community.: a reader . London: Routledge
Challis, L. & Henwood, M (1994) Equity in community care. British Medical Journal 308 1496-9
DoH. (2000) National Service Framework for Older People. London: DoH
Heywood, F., Oldman, C. & Means, R. (2002) Housing and home in later life. Open Univ Press
Komaromy, C. (2001, ed) Dilemmas in UK Health Care Buckingham: Open University Press
Malin N. (1994) Implementing Community Care. OUP
Martin, V & Henderson, E (2001) Managing in Health and Social Care. Routledge, chapters 10 and 11, and http://www.carestandards.org.uk/
Means and Smith, (1998) Community Care: Policy and Practice. Macmillan.
Newton et al (1996) Care Management: Is it working? London: Sainsbury Centre for Mental Health 
Richards, M. (2001) Long-term care for older people: law and financial planning. Jordans
Victor, C.R. (1997) Community Care and Older People. Stanley Thornes
Williams, F., Popay, J. & Oakley, A.  eds (1999)  Welfare research: a critical review. London: UCL Press chaps 1 & 2