Advertisement

GeoJournal

, Volume 67, Issue 1, pp 27–40 | Cite as

“Functional localities: an integrated spatial approach towards health care locality definition”

  • Niamh K. ShorttEmail author
  • Adrian J. Moore
Original Paper

Abstract

This paper demonstrates a spatial approach towards the definition of localities for health care planning. Recent international decentralisation of health care provision, and more specifically devolution within the United Kingdom, emphasises the need to develop a geographical focus in the delimitation of local structures for health care planning. Geographers, but most especially those applying Geographical Information Science (GIS) techniques, have made enormous contributions in this field and more generally in research related to health services. This paper considers some of these previous approaches and moves on in the light of new technologies, and more importantly the availability of appropriate data, to create localities that reflect dynamic spaces of social interaction, administration and policy. The paper’s focus is placed on the importance of flow data that reflects␣the spatial interaction between services and the population. This data, divided into three sub-groups of administration, education and health, allows us to identify the population’s allegiance to place and ultimately create spatially bounded functional localities that reflect this. Whilst the approach is largely technology driven, it also incorporates the expertise of local health care professionals thus recognising the importance of collaboration and multi-sectoral engagement. Although this combined approach impacted upon the way in which the final localities were defined, crucially it enabled us to incorporate features of both rigorous spatial analysis and a wealth of local knowledge.

Keywords

Locality Health care planning GIS Health geography Spatial interaction 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Notes

Acknowledgements

The authors are extremely grateful to Professor Mike Coombes of CURDS at the University of Newcastle upon Tyne and Colin Wymer who both assisted with the ERA analysis.

References

  1. Balogh, R. (1996). Exploring the role of localities in Health commissioning: A review of the literature. Social Policy and Administration, 30, 99–113CrossRefGoogle Scholar
  2. Bradford, M. (1991). School-performance indicators, the local residential environment, and parental choice. Environment and Planning A, 23, 319–332CrossRefGoogle Scholar
  3. Brown, L. A., & Holmes, J. (1971). The delimitation of functional regions, nodal regions and hierarchies by functional distance approaches. Journal of Regional Science, 11, 57–72CrossRefGoogle Scholar
  4. Bullen, N., Moon, G. & Jones, K. (1993). The definition of geographical communities for health planning: Final report. Chichester, Health Information Research Service, University of Portsmouth.Google Scholar
  5. Butler, T., & Roland, M. (1998). How will primary care groups work? British Medical Journal, 316, 214–214Google Scholar
  6. Campari, I. (1996). Uncertain boundaries in urban space. In P. A. Burrough, & A. U. Frank (Eds.), Geographic objects with indeterminate boundaries (pp. 57–70). London: Taylor and FrancisGoogle Scholar
  7. Chisholm, J. (1998). Primary care and the NHS white papers. British Medical Journal, 316, 1687–1688Google Scholar
  8. Clark, G. L. (1982). Instrumental reason and policy analysis. In D. T. Herbert, & R. J. Johnston (Eds.), Geography and the urban environment (pp. 41–61). London: John Wiley & Sons, Ltd.Google Scholar
  9. Clarke, G. P., & Langley, R. (1996). A review of the potential of GIS and spatial modelling for planning in the new education market. Environment and Planning C, 14, 301–323CrossRefGoogle Scholar
  10. Commission on Medicare. (2001). Caring for medicare: Sustaining a quality system. Canada: SaskatchewanGoogle Scholar
  11. Cooke, P. (1986). The changing urban and regional system in the United-Kingdom. Regional Studies, 20, 243–251CrossRefGoogle Scholar
  12. Coombes, M. (2000). Defining locality boundaries with synthetic data. Environment and Planning A, 32, 1499–1518CrossRefGoogle Scholar
  13. Coombes, M., & Openshaw, S. (2001). Contrasting approaches to identifying ‘Localities’ for research and public administration. In A. Frank, J. Faper, & J. P. Cheylan (Eds.), Life and motion of socio-economic units (pp. 301–315). London: Taylor & FrancisGoogle Scholar
  14. Court, M. & Phillips, D. R. (1985). Grassrooting. The Health Services 29th OctoberGoogle Scholar
  15. Craig, N., McGregor, S., Drummond, N., Fischbacher, M., & Iliffe, S. (2002). Factors affecting the shift towards a ‘primary care-led’ NHS: A qualitative study. British Journal of General Practice, 52, 895–900Google Scholar
  16. Day, T. (1990). Getting closer to the consumer? Locality planning in the Exeter health district. Bristol: University of BristolGoogle Scholar
  17. Department of Health. (1997). The new NHS: Modern, dependable. London: HMSOGoogle Scholar
  18. Department of Health. (2006). Our health, our care, our say: A new direction for community services White Paper. London: HMSOGoogle Scholar
  19. Duncan S., & Savage M. (1991). New perspectives on the locality debate. Environment and Planning A, 23, 155–164Google Scholar
  20. Dunford H., & Hughes J. (1988). Pimlico Patch Committee: An experiment in locality planning. London: Primary Health Care Group, King’s Fund CentreGoogle Scholar
  21. Erickson, G. M., & Finkler, S. A. (1985). Determinants of market share for a hospital’s services. Medical Care, 23, 1003–1018CrossRefGoogle Scholar
  22. Ferguson, S., & Irvine, B. (2003). Hungary’s health care system. London: Civitas-The Institute for the Study of Civil SocietyGoogle Scholar
  23. Fincher, R. (1989). The social-relations of localities-spatial divisions of labor and the local state. Environment and Planning A, 21, 674–677Google Scholar
  24. Gibson, A. J., & Asthana S. (2000). Estimating the socioeconomic characteristics of school populations with the aid of pupil postcodes and small area census data: An appraisal. Environment and Planning A, 32, 1267–1285CrossRefGoogle Scholar
  25. Government of Ireland (2001). Primary care a new direction: Quality and fairness a health system for you. The Stationery Office, DublinGoogle Scholar
  26. Griffith, J. R., Restuccia, J. D., Tedeschi, P. J., Wilson, P. A., & Zuckerman, H. S. (1981). Measuring community hospital services in Michigan. Health Services Research, 16, 135–160Google Scholar
  27. Hillery, G. A. (1995). Definitions of community: Areas of agreement. Rural Sociology, 20, 111–124Google Scholar
  28. Iliffe, S., & Munro, J. (2000). New labour and Britain’s National Health Service: An overview of current reforms. International Journal of Health Services, 30, 309–334CrossRefGoogle Scholar
  29. Kearns, R. A., & Joseph, A. (1993). Space in its place: Developing the link in medical geography. Social Science & Medicine, 37, 711–717CrossRefGoogle Scholar
  30. King, M., & Court, M. (1984). A sense of scale. Health and Social Service Journal, 21, 734–735 JuneGoogle Scholar
  31. Kivell, P. T., Turton, B. J., & Dawson, B. R. P. (1990). Neighbourhoods for health service administration. Social Science and Medicine, 30, 701–711CrossRefGoogle Scholar
  32. Kvamme, O., Olesen, F., & Samuelsson, M. (2001). Improving the interface between primary and secondary care: A statement from the European Working Party on Quality in Family Practice (EQuiP). Quality Health Care, 10, 33–39CrossRefGoogle Scholar
  33. Mitchell, B. (1988). A guide to Irish parish registers. Baltimore: Genealogical Publishing CoGoogle Scholar
  34. Naish, J., Macarlean, D., Sharples, P., Curtis, S., Gilham, V., Gregory, I., Ball, C., & Eldridge, S. (1998). Partners in information management: multi sectoral information in a primary care group area. London: Queen Mary and Westfield, East London & City Health Authority & The Wolfson Institute for Preventative MedicineGoogle Scholar
  35. New Zealand Ministry of Health (2001). The primary health care strategy. WellingtonGoogle Scholar
  36. Norheim, L. (1999). Community development for health—A Resource Guide for Health Workers. Lancaster: Lancaster University Public Health and Health Professional Development UnitGoogle Scholar
  37. Odoi, A., Wray, R., Emo, M., Birch, S., Hutchison, B., Eyles, J. & Abernathy, T. (2005). Inequalities in neighbourhood socioeconomic characteristics: potential evidence-base for neighbourhood health planning. International Journal of Health Geographics 4Google Scholar
  38. Openshaw S., & Alvanides S. (2001). Designing zoning systems for the representation of socio-economic data. In A. Frank, J. Raper & J. P. Cheylan (Eds.), Life and motion of socio-economic units. London: Taylor & FrancisGoogle Scholar
  39. Shortt, N. K. (2002). Defining regions for locality health care planning: A multidimensional approach. Unpublished Ph.D. Thesis. School of Biological and Environmental Studies. Coleraine, University of UlsterGoogle Scholar
  40. Shortt, N. K., Moore, A. J., Coombes, M., & Wymer, C. (2005). Defining regions for locality health care planning: A multidimensional approach. Social Science & Medicine, 60, 2715–2727CrossRefGoogle Scholar
  41. Taket, A. R., & Curtis, S. E. (1989). Locality planning for health care: A case study in East London. Area, 21(4):357–364Google Scholar
  42. Victorian Government. (2001). Primary care strategy-primary care partnerships. Victoria: Australia Department of Human ServicesGoogle Scholar
  43. WHSSB. (1998). Summary of responses to fit for the future. Derry: Western Health and Social Services Board (WHSSB)Google Scholar
  44. World Health Organisation (1991). Sundsvall statement on supportive environments for health. 3rd International Conference on Health Promotion, Sundsvall, SwedenGoogle Scholar

Copyright information

© Springer Science + Business Media B.V. 2006

Authors and Affiliations

  1. 1.Institute of GeographyUniversity of EdinburghEdinburghUK

Personalised recommendations