Biomedical subjects

David Towell

Publications and source records attributed to David Towell.

4 recordsLinked to original sources

PubMed2004

Why do we keep on meeting like this? The board as ritual in health and social care.

Despite their prevalence and longevity in many forms of social organization, most research on formal meetings suggests that they do not fulfil the instrumental purposes (e.g. setting strategy) that their constitutions propose. A three-year study of the Joint Commissioning Board for mental health in Somerset, UK, revealed that it was no exception. However, many of the participants on the Board suggested that it fulfilled important purposes that drew attention to its role as ritual. This paper examines the role of the Board in the light of the literature on ritual--in particular the work of the neo-Durkheimian tradition flowing from the work of Douglas--and locates the importance of the meeting in the formation of social solidarity. This theoretical perspective illuminates issues around classification and language which explain the disempowerment felt by some members of the Board. Finally, this paper identifies the challenges in engaging a broader range of stakeholders (including users and carers) in these rituals.

Ceremonial Behavior↗

PubMed2002

Joint commissioning. Going halves.

Joint commissioning and provision of mental health services in Somerset failed to produce significant benefits to users over its first two years. Users considered access to services deteriorated and concerns remain that there is no alternative to hospital admission in crises. Users and carers were included as non-voting members of the commissioning board, but users felt less involved in care planning than previously. The combined health and social care trust does not seem to have delivered anything which has not been achieved elsewhere without the transfer of social care staff to a new employer.

Continuity of Patient Care↗

PubMed2002

Governance of partnership between health and social services: the experience in Somerset.

As one part of a larger study of the integration of mental health and social care, the present paper explores the role of the Joint Commissioning Board in the governance arrangements for health and social partnership in Somerset, UK. A short review of the literature on joint planning and joint commissioning revealed that such partnership has proved problematic, and that the role of non-executive directors and councillors is usually overlooked. Furthermore, the research on corporate boards suggests that their performance does not match the prescriptions made for them. Following a description of the methodology of the study, the present paper reports the findings of the activity of the Joint Commissioning Board from three data sources: (1) observation of meetings; (2) analysis of documentation; and (3) participant interviews. All three sources support the view, put forward in the Discussion section, that the Board does not play a proactive role in the setting and monitoring of policy and priorities. Nonetheless, it is argued, the Board plays a central and constructive role in the governance of partnership: as the symbol of interagency partnership; as the vehicle for sustaining commitment to mental health; and as the method of bringing additional elements of public accountability to the commissioning and providing of health and social care. Locating this ritual function of the Board within the broader sociological literature, the Discussion section goes on to suggest the implications both for the future of governance of partnership and for further research in this area.

Community Mental Health Services↗

PubMed2002

Balancing professional and team boundaries in mental health services: pursuing the holy grail in Somerset.

The overcoming of professional boundaries to collaboration in patient care has become one of the goals of mental health service policy in England over the past 25 years, predominantly through the creation of community mental health teams. However, research has shown that these boundaries have been slow to come down, and some commentators have pointed to the benefits of appropriate boundaries. This paper introduces a theoretical framework, which seeks to categorise boundary activity in organisations and then examines the boundary activity of professional groups and community teams during the integration of mental health and social care service provision in one locality in the southwest of England. The paper identifies the ways in which this integration impacted on boundary activity and draws out the messages for mental health policy and practice that emerge.

Adaptation, Psychological↗