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Integration For Mental Health

Integration For Mental Health. Phil Confue Director Mental Health & Learning Disabilities. Integration. Background Trust re-configuration Unitary Authority Health Action Zone. The Process. Integration. Why Joint Working Peoples Experience Imperatives from central government

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Integration For Mental Health

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  1. Integration For Mental Health Phil Confue Director Mental Health & Learning Disabilities

  2. Integration Background • Trust re-configuration • Unitary Authority • Health Action Zone

  3. The Process

  4. Integration Why Joint Working • Peoples Experience • Imperatives from central government • Local Conditions

  5. Integration Options • No Change • Joint Commissioning • Joint Provision • Joint Commissioning and Provision

  6. Integration Commissioning Board • Membership • Chair • Conduct • Executive

  7. Integration Structure of Services

  8. Integration Timescales • Consultation May - Aug 2000 • Shadow Nov 2000 • Live April 2001

  9. Section 31 Partnership Pooled Budgets Joint Commissioning Joint Provisions

  10. Section 31 Partnership Organisational Accountability Audit Trail Not Delegate Responsibilities

  11. The Real Challenge

  12. Understand the Environment

  13. What Do People Want • Social Network • Money In their pocket • A Job • Good Housing

  14. What Do we give them • Assertive outreach • Crisis Resolution • Atypical Neuroleptics

  15. Influence Control

  16. Decision Making • Star ratings • LDP Targets • Annual Accountability Agreement • Break Even

  17. Defying the Policy • Performance Management • The “Killer Targets” • Understand the policy • Use the agenda of others

  18. The Paradigm • Values • Delivering high quality mental health care • Beliefs • Free at the point of delivery • Needs lead • Assumptions • Professionals know how to deliver care effectively

  19. Stories • What core belief do stories reflect • How pervasive are these beliefs (through levels) • Who are the heroes and villains • What norms do the mavericks deviate from • Do stories relate to: • Strengths and weaknesses • Successes or failures • Conformity or mavericks

  20. Routines & Rituals • What behaviour do routines encourage • What are the key rituals • What core beliefs do these reflect • What do training programmes emphasise • How easy are ritual/routines to change

  21. Symbols • What language and jargon is used • How internal or accessible is it • What aspects of strategy are highlighted in publicity • What status symbols are there • Are there particular symbols which denote the organisation

  22. Organisational structure • How mechanistic/organic are the structures • How flat/hierarchical are the structures • How formal/informal are structures • Do structures encourage collaboration or competition • What type of power structures do they support

  23. Control Systems • What is mostly closely monitored/controlled • Is emphasis on reward or punishment • Are controls related to history or current strategy • Are there many or few controls

  24. Power Structures • What are the core beliefs of the leadership • How strongly are these beliefs held (idealist or pragmatist) • How is power distributed in the organisation • Where are the main blockages to change

  25. Cultural Web Symbols Stories Power Structures Paradigm Rituals And routines Organisational structure Control systems

  26. Analysis • What is the dominant culture • How easy is this to change • Are there linking threads through the separate elements

  27. Relationships Goals

  28. “Problems will never be solved within the culture in which they were created” Albert Einstein

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