Health and Social Care

Textbooks, monographs and policy-focused books on our Health and Social Care list push forward the boundaries of teaching, theory, policy and practice. The list covers areas including global health, health inequalities and research into policy and practice. 

Key series include Transforming Care which provides a crucial platform for scholars researching early childhood care, care for adults with disabilities and long-term care for frail older people, and the Sociology of Health Professions, offering high-quality, original work in the sociology of health professions with an innovative focus on their likely future direction. Our leading journal in the area is the International Journal of Care and Caring.

Health and Social Care

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Although the European Commission has promoted the use of co-creation methodology for social services, this innovative practice has not yet been uniformly introduced in Europe. The SoCaTel platform was released with open access to promote and implement a digital co-creation platform involving all stakeholders, especially older adults and their carers, in long-term care. Using an innovative methodology applied in four European sites (Spain, Finland, Ireland and Hungary), in this article, we investigate the acceptance of this technology among older adults, its effectivity as a virtual support tool in the context of COVID-19 and its potential for developing digital repertoires.

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This article seeks to advance our understanding of the care experiences of people living with the effects of disability, ageing and other social locations during the COVID-19 pandemic. Drawing on key informant interviews (n = 8) and results from an anonymous online survey (n = 36), this article provides evidence of how people with disabilities and older adults in Ontario, Canada, experienced disruptions in different types of care in their multiple caring relationships. The results describe why they were not able to access the care that they needed during a period when activities began to resume and how their caring relationships had been disrupted. The impact of disruption on people with disabilities, older adults and others in their care relationships was exacerbated by barriers rooted in ableism, ageism and other forms of exclusion. This study demonstrates the importance of addressing unmet care needs by moving beyond the dichotomy of ‘carer’ and ‘cared for’.

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The UK’s adult social care system faces severe challenges, including funding shortages, unmet needs and an overburdened workforce. Resultantly, there is a push for high-quality evidence in service enhancement and resource allocation. Using evidence to improve services is essential, but questions arise about best practices for identifying ‘what works’, integrating evidence into everyday practice and addressing resource constraints. Findings from a 2021 UK survey and consultative forums with stakeholders across adult social care underscore concerns about implementing evidence-based practices and highlight the need for increased collaboration to expand the evidence base. These findings shed light on stakeholders’ perspectives regarding factors shaping adult social care practices, opportunities for evidence to play a greater role, definitions of valid evidence and priorities for change. Improved communication and coordination within the sector are crucial to enhance evidence-based decision making, focus limited resources on proven strategies and shape a more effective, evidence-informed adult social care system.

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This chapter summarises Chapters 3–6 under the categories of the proposed three aspects of planning – two of which have been present, in various guises, since the start of the book – what/who matters (central to Archer’s model of reflexivity and planning, and richly discussed by care-leavers in this study), and a sense of personal time and planning (initially via some care-leavers’ scepticism about future-oriented planning), and the third, shared deliberation and shared planning strongly ‘present’ in the secondary analyses in Chapters 3–6. These three aspects (of planning) might each be viewed as strengths, in contrast to the view that ‘lack’ of future-oriented planning might be regarded as a vulnerability. The chapter, read together with Chapter 8, can provide a ‘live iteration’ in which qualitative data are summarised from Chapters 3–6 and, in Chapter 8, the work of Michael Bratman is discussed, whose work interplays in a deeply fascinating way with the voices of the young people in Chapters 3–6. His idea of the ‘remarkable trio of capacities’ for planning is a major source of the idea of the three-aspects model of planning for this book, in interplay with Archer’s work on reflexivity in social context, and re-imagined via young people’s sense of personal time.

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Chapter 2 sets out the argument for Transitional Safeguarding. Putting it bluntly, the current safeguarding system does not work for many young people and represents poor use of public resources. Binary adults’ and children’s safeguarding legislation, policy, and practice frameworks create gaps for young people to fall into; this binary fuels other binaries such as the categorisation of young people as either vulnerable or culpable. Transitional Safeguarding seeks to redress these binaries and span such boundaries. The chapter outlines the six key principles that underpin Transitional Safeguarding: being evidence-informed; ecological; contextual; developmental and transitional; relational; and equalities-oriented. These address the current challenges in safeguarding young adults, exemplifying the ‘both/and’ ethos of putting Transitional Safeguarding into practice, leadership, and policy development.

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The conclusion draws together the key discussion points outlined in the book, including the core elements of system transformation in this area. We identify important components at micro and macro levels. At a micro level, the experiences of young people are key – unless they are placed at the centre of this work, then their needs will not be fully understood or addressed. At a macro level, various systems and structures govern and influence this work and we have explored some of these for children and adult safeguarding that contribute to (but are not solely responsible for) gaps in safeguarding practices with young people. We end with an outline of core components for leading change moving forward.

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Chapter 4 provides an overview and commentary about ‘emerging adulthood’ as a developmental stage. There are key theoretical frameworks and concepts that offer useful insights into understanding young people’s development, and therefore can influence how we articulate and further develop Transitional Safeguarding. However, these frameworks have some limitations and there are important critiques to be aware of, for example, the theory of ‘emerging adulthood’ is situated in a particular economic, social, and historical context which is not universal and may not stand the test of time. It is more helpful to move beyond age-stage developmental theories and instead engage with the complexity and heterogeneity of young people’s lives and identities. Life Course Theory seeks to do this in part, although there may also be limitations about the applicability of this theory outside of westernised environments. The need for theoretical frameworks to reflect diverse contexts chimes with Transitional Safeguarding’s attention to the principle of equality, equity, diversity and inclusion, the impact of trauma on development links with the relational principle, and the developmental imperative for young people to be afforded choice and voice, which is central to the participative principle.

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Care-leavers interviewed in our studies expressed strong emotions. When participants articulated what and who matters, this was usually done with deep feeling. When forward planning was discussed, some participants powerfully rejected the idea of planning ahead. Moreover, the research interview’s focus on internal conversations often triggered discussions about very strong, often profound, accounts of emotions linked to birth parents and siblings, foster parents and foster siblings, peers and friends, and sometimes services and professionals. In this chapter, following philosopher Martha Nussbaum’s work, emotions are framed as ‘suffused with intelligence and discernment’. Furthermore, the chapter ‘grapple[s] with the messy material of grief and love, anger and fear’, and stretches our senses of time by reminding us that healing usually takes time, and that young people in transition from care may have much experience of the details of emotions, time, and planning. Building also on work by philosopher Matthew Ratcliffe on emotional intentionality, emphasis is placed in this chapter on the circumstances of being in care and leaving care (see Chapter 1), which can involve multiple emotion ruptures during childhood and adolescence, and then the complex process of transition (from out-of-home care) itself, and emerging adulthood as an opportunity to make sense of, revise, reframe, and form new and renewed relationships, and plan – in the broadest and most flexible sense.

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