Commissioning Systems

Discovering Health offer consultancy support to commissioners who want to design or re-design their health and social care systems. This could be whole systems or specific areas such as drugs and alcohol. Mark Gilman was involved in performance managing the orthodox drug and alcohol treatment systems that were established in every upper tier (n152) local authority in England. From 2005 to 2015, Mark Gilman led on a series of national and international collaborations to design ‘Recovery Oriented Integrated Systems’ (ROIS) of health and social care. These are sometimes also referred to as ‘Recovery Oriented Systems of Care’ (ROSC). Mark Gilman has presented widely on system change and is able to show how these changes can be made whilst making the necessary cost savings in a time of austerity and public service reform.

Provider Organisations

Discovering Health is able to offer consultancy services to providers of health and social care who wish to improve their ability to produce real world social outcomes as opposed to inputs and outputs. The drug treatment sector provides a good case study. Drug treatment attracted significant investment over a ten year period from 2000 to 2010. Before the recession this had reached almost £1 billion. The success of this investment was measured in system outputs. Firstly, there was a measure of the number of people who entered treatment and how quickly they got into treatment (Access). Then there was a measure of how many of them stayed in treatment for a minimum of 90 days (Retention). The current proxy measure of recovery is the number of people leaving treatment and not returning within six months of leaving (Successful Completions). These process measures of inputs and outputs are being replaced with measures of real world social outcomes that make sense to local authorities. These include employment, training, education, volunteering and ability to care for children and maintain a housing tenancy. Discovering Health can assist providers to reshape their organisations so that they are able to produce real world outcomes in their clients.

6 thoughts on “Services

  1. Congratulations on this refreshing approach, focusing on the real outcomes that reflect peoples quality of life and are the only true measure of recovery. The current obsession with measuring successful completions, whilst an improvement on previous proxy measures is a poor overall indicator of the quality of treatment. One only needs to listen to service users to understand the deep dissatisfaction that still exists with treatment services. Service users and people from across the recovery community are asking for precisely what Mark advocates for – job, homes and friends.

    Jon Royle, Chief Executive The Bridge Project and Chair of Trustees, Faces and Voices of Recovery UK (Home of the UK Recovery Walk)

    1. It sounds to me like the cnurert situation in most math departments is likely to select for women who don’t mind or even prefer to be in the minority – the women who aren’t happy to have so few women in the department would presumably be that much more likely to leave to do other things. And it seems from the comments people made at the panel that events like this can help to keep those women from leaving for reasons that have nothing to do with their abilities in math, and to attract other women who might otherwise be wary of entering such a male-dominated field. That seems to me to be a good enough reason to have events like this, to begin with.But more than that, to me, this event more than proved its usefulness with that first question that was asked, about how being pregnant might affect a woman’s career. Can you imagine such a question being asked at a panel where all or most of the participants were men? Even if there was a woman brave enough to ask such a question, would a panel of men even know what to say? And yet it’s clearly an important question that many women struggle with. (As I can tell even from the comments to this entry alone.) Isn’t it good to have a place where women can discuss such issues and give advice to each other and discuss their experiences, without each woman having to feel like she has to reinvent the wheel alone, stuck as she is as the only woman in a faculty of men, at what has to already be a difficult time in her life?There are clearly questions about what it’s like to be a woman in mathematics that men can’t answer. Is it really so bad to provide a place where such questions can be discussed?

  2. Hello Mark. I am pleased to see that you have set up independently. It is an exciting place to be…..sometimes! I would be happy to collaborate if any of your clients have issues with CQC as this is my specialism. Best wishes. David Finney

  3. almost exactly the same thigns you just said, only you put it better than I did. (My arguments against affirmative action are in point #2, if you are curious about it.) So it’s a bit unexpected for me to suddenly find myself on the opposite side of this same argument. But I’ve thought about this a lot since then, and I guess I’ve come to realize that thigns are not as simple as I used to believe.Девочки ли, мальчики были на первых ролях в классе или кружке — никто никогда не обращал на это ни малейшего внимания, ни в отрицательном смысле, ни в положительном. Совпадение ли, что девочек на первых ролях было при этом очень много?That sounds wonderful! So where did all these girls who were great at mathematics in school disappear to? Why are so many fewer women than men going into pure math, when there were so many girls in leading roles in math in school? I have a friend who is a math teacher in a private high school, who says the same thing – that a lot of his strongest students are girls, and not boys. So where do they all go? Why do they not go on to math, or physics, or computer science?More than half the students in the very math-intensive biostatistics classes that I take are women, and they are certainly not weaker than the men. So why are so many more women going into applied math than pure math?I have seen women graduate students say that they left mathematics because they didn’t feel welcome in the all-male department – they were looked down on, disrespected, didn’t feel like anybody was willing to listen to any problems they might be having that were different from the men’s problems. It’s easy to just dismiss those women as people who just couldn’t cut it, but when those same women then go on to do fine in other math-related fields, I feel like that’s a sign that there might be some kind of problem that should be addressed.The thing is, women *are* different from men. They might have different problems that the men in the majority might not have. If we insist that people not pay attention to our gender at all – if we pretend that women are just like men – then this is giving the people in the majority carte blanche not to have to worry about those problems. (Want a room where you can use a breast pump during the day without being disturbed? Well, now you are just being unreasonable! None of the *other* people in the department have this problem, so you must be imagining it! etc, etc.) And I think that this approach can be very harmful, and can result in the department losing people that might otherwise have been a great asset to the department.Affirmative action is almost certainly not the best way to solve this problem, but I feel like this *is* a large problem that should be addressed, and not just ignored and swept under the carpet. And it seems to me that a meeting specifically set up in such a way that women speakers can talk about the work that they do, with a panel that includes talking about issues women might face working in mostly-male math departments, could go a long way in making it clear that women *are* welcome in math, that people *do* care about their problems. And such a meeting could even help in beginning to figure out how to *solve* these problems.I’m sorry, I’m shutting up now. Sorry this comment is so long!

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