| Titre : | Halfway there ? Policy, politics and outcomes in community care. : Bilan des reformes des soins communautaires au Royaume Uni. (1996) |
| Auteurs : | M. HENWOOD ; J. ROBINSON ; G. WISTOW |
| Type de document : | Article |
| Dans : | Social policy & administration (vol. 30, n° 1, 1996/01-03) |
| Pagination : | 39-53 |
| Langues: | Anglais |
| Mots-clés : | Soins communautaires ; Marché ; Royaume Uni ; Bilan ; Evaluation ; Réforme ; Qualité |
| Résumé : | The community care reforms which followed the 1989 White paper "Caring for people" were apparently focused on adressing the needs of people requiring long-term care, and on achieving improved outcomes and better quality of life. The agenda set out by the White Paper was for community care in the next decade and beyond. Halfway through this decade, we question the extent to which the objectives of promoting choice and independence for users and carers have been achieved. The paper draws particularly on a programme of monoitoring conducted jointly by the Nuffield Institute for Health and the King's Fund, based on national and local focus groups meeting over a two-year period. It proposes a framework for evaluation which consists of four components : the definition of desired outcomes ; specification of service systems necessary to deliver such outcomes ; promotion of access to services ; and the development of supporting operational policies and resource allocation mechanisms. This framework offers a substantiial step beyond much of the monitoring of the community care reforms which has taken place to date. This has assessed progress largely in terms of the establishment of new systems and processes. We conclude that such changes were essential building blocks fo delivering better-quality community care services, and in the short term it may have been legitimate to view their establishment as proxies for progress towards delivering user-centred services.... (.). |
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