|dc.description.abstract||Healthcare worldwide faces severe quality and cost issues, and the search for sustainability in healthcare establishes a grand challenge. Public interest is growing in a systemic re-conceptualizing of healthcare, from primarily a consumerist problem of individual need for treatment to a need for communities themselves to become more effective in systemic prevention, coping and caring. In community led approaches, scarce resources are moved away from ever-increasing consumerist services to empower, develop and enable communities to plan their own health and community improvements in mutually interdependent patterns of care often seen as ‘co-production’. This approach is exemplified by the innovative NUKA system of community led healthcare which originated in Alaska and which was trialled in Scotland in 2012, where it did not achieve similar acclaim as in the United States. In the Scottish NUKA trial opposition from professionals meant the trial was ended early. Our research found that omitting to account for the strong professional identity of GPs and other practice staff was instrumental in the failure of the trial. Beyond deficiencies inadequately considering professional identities, the trial also failed to engage the community and its patients as owners and architects of the system. We argue that the root cause of these problems, was a more general critical systemic failure to manage participatory boundaries and associated identities. Community Operational Research practitioners have developed relevant theories, methodologies and methods to address issues of participation and identity, so could make a significant contribution to opening up new solutions for community led healthcare.||en_UK|
|dc.relation||Walsh M, Kittler M & Mahal D (2017) Towards a New Paradigm of Healthcare: Addressing Challenges to Professional Identities through Community Operational Research (Forthcoming/Available Online), European Journal of Operational Research.||-|
|dc.rights||This item has been embargoed for a period. During the embargo please use the Request a Copy feature at the foot of the Repository record to request a copy directly from the author. You can only request a copy if you wish to use this work for your own research or private study.||-|
|dc.subject||OR in health services||en_UK|
|dc.subject||Community Operational Research||en_UK|
|dc.title||Towards a New Paradigm of Healthcare: Addressing Challenges to Professional Identities through Community Operational Research (Forthcoming/Available Online)||en_UK|
|dc.rights.embargoreason||Publisher requires embargo of 24 months after formal publication.||-|
|dc.citation.jtitle||European Journal of Operational Research||-|
|dc.type.status||Post-print (author final draft post-refereeing)||-|
|dc.contributor.affiliation||People Centred Healthcare Management||-|
|dc.contributor.affiliation||Management Work and Organisation||-|
|dc.contributor.affiliation||HS Health - Stirling||-|
|Appears in Collections:||Management, Work and Organisation Journal Articles|
|Walsh Kittler Mahal Towards a new paradigm for healthcare COR EJORS 2017.pdf||728.36 kB||Adobe PDF||Under Embargo until 4/6/2019 Request a copy|
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