A Service Model For Delivering Care Closer to Home.

Upton Surgery (Worcestershire) has developed a flexible and responsive service model that facilitates multi-agency support for adult patients with complex care needs experiencing an acute health crisis. The purpose of this service is to provide appropriate interventions that avoid unnecessary hospital admissions or, alternatively, provide support to facilitate early discharge from secondary care. Key aspects of this service are the collaborative and proactive identification of patients at risk, rapid creation and deployment of a reactive multi-agency team and follow-up of patients with an appropriate long-term care plan. A small team of dedicated staff (the Complex Care Team) are pivotal to coordinating and delivering this service. Key skills are sophisticated leadership and project management skills, and these have been used sensitively to challenge some traditional roles and boundaries in the interests of providing effective, holistic care for the patient. This is a practical example of early implementation of the principles underlying the Department of Health’s (DH) recent Best Practice Guidance, ‘Delivering Care Closer to Home’ (DH, July 2008) and may provide useful learning points for other general practice surgeries considering implementing similar models. This integrated case management approach has had enthusiastic endorsement from patients and carers. In addition to the enhanced quality of care and experience for the patient, this approach has delivered value for money. Secondary care costs have been reduced by preventing admissions and also by reducing excess bed-days. The savings achieved have justified the ongoing commitment to the service and the staff employed in the Complex Care Team. The success of this service model has been endorsed recently by the ‘Customer Care’ award by ‘Management in Practice’. The Surgery was also awarded the ‘Practice of the Year’ award for this and a number of other customer-focussed projects.

Receptivity to Self-Service Technology (SST): A Research Overview and the Way Forward

In a digital era characterised by the need for efficiency and value, self-service technology rises as a delivery interface offered by public and private sector service providers. With the assumption of a win-win situation for both the provider and customers who can ‘do it themselves’ online/offsite and offline/onsite, stereotypes arise concerning antecedents for positive receptivity and impediments in adopting SSTs. The present paper offers a literature-based discussion of some of the existing and emerging perspectives in this domain; it delivers a contextual review of studies conducted, highlights controversial viewpoints that need to be reconsidered, and suggests future research themes that can make use of the emergent digital sources in data collection and analysis. The purpose is to spark future research on the extent to which SST is a champion for different service types, and to systematically study the customer profile to be targeted for its optimal use in value co-creation.