Will the real Mrs Smith please stand up? A critical examination of the role of vignettes in integrated service development and delivery

Ray, Mo, George, Thomas, Toze, Michael and Clayton, Owen (2020) Will the real Mrs Smith please stand up? A critical examination of the role of vignettes in integrated service development and delivery. Journal of Integrated Care . ISSN 1476-9018

Full content URL: https://doi.org/10.1108/JICA-05-2020-0031

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Will the real Mrs Smith please stand up? A critical examination of the role of vignettes in integrated service development and delivery
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Abstract

Purpose
To explore the use of fictitious vignettes representing older people and the extent to which they serve as an effective resource in developing service provision and transforming health and social care.
Design/ Methodology/ Approach Based on a critical review of contemporary research and academic discourse in health and social care integration, gerontological health and social care and critical and social gerontology.
Findings Fictitious vignettes or case studies of older adults, such as ‘Mrs Smith’, may be a useful means to promote communication with and between health and social care colleagues about current services and transforming or reorganising service provision. However, we argue that while there may be a role for vignettes, care should be taken in their use. The potential to ‘homogenise’ older people into the ‘typical’ patient personified by Mrs Smith may do very little to challenge age based stereotypes and assumptions. Moreover, vignettes cannot match the potential value and importance of older men and women directly participating in the evaluation and development of services.

Originality
This article offers a critical perspective on the use of vignettes.

Practical Implications
This article argues that changing the way services are organised and delivered must be underpinned by critical reflection of the assumptions which underpin attitudes towards old age, including our tendency to define older people by chronological age and to homogenise ‘the elderly’ into a single group. The value of participatory methods which meaningfully involve older citizens in both evaluating and planning services could contribute significantly to innovation in service development and person centred approaches to health and care.

Social Implications
This paper highlights the critical importance of challenging age based stereotypes and ageist policy and practice. Recognising old age as being characterised by diversity and difference challenges our tendency to see old age, especially advanced old age, as an inevitable problem.

Key words Integrated care, service provision, person-centred care, vignettes, older adults, age based discrimination, ageism, participation.

Keywords:vignette, old age representation, ageism, health and social care integration, participatory methods
Subjects:L Social studies > L340 Disability in Society
Divisions:College of Social Science > School of Health & Social Care
ID Code:41401
Deposited On:27 Jul 2020 15:57

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