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Editorial

Editorial This is the time of year when a journal editor inevitably reflects on the year ahead and this year it marks the mid-way point of our transformation of Managing Community Care into a ‘hybrid’ journal. When we started, our main objective was to guarantee the topicality and relevance of articles for people in the field responsible for making sense of the community care reforms of a decade ago. In the last year we have been building a more substantial focus on research, introducing peer-reviewing of certain articles. We are confident that, by the end of this year, we will have a sound balance in this journal between these two goals. We also believe that this journal, in its own small way, has played a part in establishing the idea of evidence-based community care in this country – not just conceptually, but practically. We all know that we are now at the start of another huge revolution in community care, springing from government policy. This seems to be substituting the phrase ‘health and social care’ for community care, signalling the need to bring down the barriers between these two key fields, but also, less helpfully, excluding other interests like housing, life-long learning and leisure, which have clawed their way gradually into community care planning. This new revolution will be a core focus in the coming year in MCC, but we also shall be scrupulously attentive to the place and experiences of service users. It is therefore very pleasing to be able to publish in this issue two articles in our Research in Practice section which are at the cutting edge of these changes, and both of which document user experience. Many people believe that the Government’s sub-plot in its rhetoric about health and social care is to eliminate local authority social services departments. The article by Nick Le Mesurier and Stuart Cumella brings some evidence of the benefits to service users of providing access to social care services through primary health care rather than through ‘area offices’. This could be an inspiration to directors of social services brave enough to refashion their established service delivery methods along the lines described; others may feel defensive, but the article should at least be seen as a warning of how office systems can overpower user needs. Similarly, the update on the research into the integrated Somerset mental health service by Pauline Gulliver and colleagues suggests that user experiences are not guaranteed to improve because of a partnership approach. These articles indirectly raise the question of what should count as evidence. Although Le Mesurier and Cumella’s research design used a robust methodology (experimental group and a control), it was one small study in one locality. Despite the authors’ plea for more research, their uncomfortable message for social services directors is potentially dismissable on these grounds. However, there is plenty of evidence from the world of medicine that there can be a huge built-in resistance to any research which challenges the efficacy of established treatments, and that this can persist over decades until more and more studies confirm that the evidence should not be ignored. It will be interesting to observe how such issues come to be played out. In community care, the politicomanagerial levers are much more powerful than the research evidence levers. Current ministers will not wait for incontrovertible research evidence to be built up. In fact, they are already promoting change for a mixture of reasons – for example, financial, anecdotal, philosophical, managerial, party political. No doubt sometimes this is based on evidence. Although this is the very stuff of social policy, it will always leave a risk of policy flying in the face of robust and helpful evidence. Peter Thistlethwaite Editor Managing Community Care Volume 9 • Issue 1 • February 2001 © Pavilion Publishing (Brighton) Ltd http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Integrated Care Pier Professional

Editorial

Thistlethwaite, Peter
Journal of Integrated Care , Volume 9 (1) – Feb 1, 2001
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Publisher
Pier Professional
Copyright
Copyright © 2001 by Pier Professional Limited
ISSN
1476-9018
eISSN
2042-8685
Publisher site
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Abstract

This is the time of year when a journal editor inevitably reflects on the year ahead and this year it marks the mid-way point of our transformation of Managing Community Care into a ‘hybrid’ journal. When we started, our main objective was to guarantee the topicality and relevance of articles for people in the field responsible for making sense of the community care reforms of a decade ago. In the last year we have been building a more substantial focus on research, introducing peer-reviewing of certain articles. We are confident that, by the end of this year, we will have a sound balance in this journal between these two goals. We also believe that this journal, in its own small way, has played a part in establishing the idea of evidence-based community care in this country – not just conceptually, but practically. We all know that we are now at the start of another huge revolution in community care, springing from government policy. This seems to be substituting the phrase ‘health and social care’ for community care, signalling the need to bring down the barriers between these two key fields, but also, less helpfully, excluding other interests like housing, life-long learning and leisure, which have clawed their way gradually into community care planning. This new revolution will be a core focus in the coming year in MCC, but we also shall be scrupulously attentive to the place and experiences of service users. It is therefore very pleasing to be able to publish in this issue two articles in our Research in Practice section which are at the cutting edge of these changes, and both of which document user experience. Many people believe that the Government’s sub-plot in its rhetoric about health and social care is to eliminate local authority social services departments. The article by Nick Le Mesurier and Stuart Cumella brings some evidence of the benefits to service users of providing access to social care services through primary health care rather than through ‘area offices’. This could be an inspiration to directors of social services brave enough to refashion their established service delivery methods along the lines described; others may feel defensive, but the article should at least be seen as a warning of how office systems can overpower user needs. Similarly, the update on the research into the integrated Somerset mental health service by Pauline Gulliver and colleagues suggests that user experiences are not guaranteed to improve because of a partnership approach. These articles indirectly raise the question of what should count as evidence. Although Le Mesurier and Cumella’s research design used a robust methodology (experimental group and a control), it was one small study in one locality. Despite the authors’ plea for more research, their uncomfortable message for social services directors is potentially dismissable on these grounds. However, there is plenty of evidence from the world of medicine that there can be a huge built-in resistance to any research which challenges the efficacy of established treatments, and that this can persist over decades until more and more studies confirm that the evidence should not be ignored. It will be interesting to observe how such issues come to be played out. In community care, the politicomanagerial levers are much more powerful than the research evidence levers. Current ministers will not wait for incontrovertible research evidence to be built up. In fact, they are already promoting change for a mixture of reasons – for example, financial, anecdotal, philosophical, managerial, party political. No doubt sometimes this is based on evidence. Although this is the very stuff of social policy, it will always leave a risk of policy flying in the face of robust and helpful evidence. Peter Thistlethwaite Editor Managing Community Care Volume 9 • Issue 1 • February 2001 © Pavilion Publishing (Brighton) Ltd

Journal

Journal of Integrated Care – Pier Professional

Published: Feb 1, 2001

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