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  • 1
    Electronic Resource
    Electronic Resource
    Priorities, “street level bureaucracy” and the community mental health team (1997)
    Oxford, UK : Blackwell Publishing Ltd
    Health & social care in the community 5 (1997), S. 0 
    Details
    ISSN: 1365-2524
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In the United Kingdom a combination of high profile incidents and reports personally critical of mental health policy in general and individual practitioners' actions in particular (Sheppard 1995) highlight the pressures which operate on mental health professionals in the community (Mechanic 1995a). These pressures are exacerbated by policy contradictions and resource limitations. Consequently community mental health practitioners (e.g. psychiatrists, community psychiatric nurses and social workers) can be sensitive to political and managerial agendas which may have a negative impact on their implementation of individual care programs (Marks et al. 1994). Using the concept of ‘street level bureaucracy’ (Lipsky 1980), this paper examines recent literature. It is argued that practitioners' reception and implementation of policy is influenced by the need to balance the tension between four elements: the political and policy imperatives, the agenda of local management, the professional and peer cultures in which practitioners operate and the balance of perceived personal advantage. It is further postulated that managers and policy makers may have a vested interest in not scrutinizing practitioners' implementation of policy too vigorously as a way of deflecting responsibility for its consequences. The ‘Care Programme Approach’ and recent legislative changes regarding community supervision (Department of Health 1995a) highlight the important and sometimes negative consequences for the service user that may result.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2524.1997.tb00130.x
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Health care rationing: nursing perspectives (1995)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of advanced nursing 22 (1995), S. 0 
    Details
    ISSN: 1365-2648
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Ideas currently postulated around the way health care should be delivered and costs controlled, often referred to as health care rationing, are increasingly coming to dominate the agenda of health care in the 1990s British nursing has yet to take a noticeably visible role in this debate, despite the fact that it poses a serious dilemma for a profession whose cultural ethos has been shaped by the concepts of universal access and comprehensiveness of care and is wedded to the idea of holism In the USA debate amongst nurses is further advanced and whilst this discourse may be of limited value to British nursing, owing to a differing historical and cultural attitude to health care, recent changes to the organizational values in the NHS are leading to similar issues arising already faced by American nurses This paper considers the broad parameters of the debate on health care rationing and examines how these parameters have been reflected within relevant North American and British nursing literature, pointing both to similar and differentiating factors between the two countries
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2648.1995.22040738.x
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
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