Collaboration: “easy to say, difficult to do”

2015 ◽  
Vol 23 (4) ◽  
pp. 232-249
Author(s):  
Christopher Edmunds ◽  
Kerry KilBride
Keyword(s):  
Public Sector ◽  
Social Care ◽  
Health Board ◽  
Senior Managers ◽  
Content Type ◽  
Complex Needs ◽  
Care Services ◽  
Health And Social Care ◽  
Service Areas ◽  
Increasing Demand

Purpose The purpose of this paper is to recount 12 months of a pioneering collaboration between the Aneurin Bevan University Health Board, five local authorities and nine registered social landlords in South East Wales. It will aim to share the understanding that has emerged, demonstrating how a large number of agencies, many of which have different purposes or which have traditionally been in competition with each other, have been able to work collaboratively, to meet the interests of some very vulnerable people. Design/methodology/approach This reflective approach draws on the views of a large number of staff from each of the three constituent public sector service areas and their experience of collaborative working using action research principles. The study will use people’s own words to highlight real experiences, but analysed against similar collaborative activity elsewhere reflected in the literature. As there has been no established pathway for the collaboration to follow, we have adopted a Plan-Do-Study-Act cycle to capture the evolving “In One Place” (IOP) process. Findings This paper highlights the inherent systemic barriers that have to be identified and overcome if the authors are to move from wishful thinking to pragmatic realism, both within and between organisations. The sense of public sector agencies being able to work together, simply because it makes good sense, is challenged and the paper identifies both cultural and professional factors that made a difference in this collaboration, which could be harnessed elsewhere. Originality/value From the outset, a key driver for the IOP has been to align health, social care and housing processes by bringing together practitioners and senior managers to identify need and to plan and deliver services locally, offering a real benefit to individuals with complex needs. This is set within the context of increasing demand on public services, financial austerity and the history of “housing” being on the margins of discussion when considering the integration of health and social care services. The authors are able to demonstrate the benefit of housing being at the centre of such discussions.

scholarly journals Social care legislation as an act of integration

2016 ◽  
Vol 24 (3) ◽  
pp. 139-149
Author(s):  
Natalie Davies ◽  
Wulf Livingston ◽  
Emyr Owen ◽  
Peter Huxley
Keyword(s):  
Social Services ◽  
Online Survey ◽  
Social Care ◽  
Well Being ◽  
Health Board ◽  
Senior Managers ◽  
Content Type ◽  
Face To Face ◽  
North Wales ◽  
Health And Social Care

Purpose – The purpose of this paper is to investigate health and social care integration in North Wales in a short window of time between the assent of the Social Services and Well-being (Wales) Act 2014 and its implementation in 2016. Design/methodology/approach – The findings are based on the experiences of health and social care professionals from six Local Authorities and one Regional Health Board working in a management role with strategic responsibility, gathered from an online survey (n=43), semi-structured face-to-face interviews (n=14) and supplemented with reflective interviews with regional coordinators responsible for facilitating cross-organisational working (n=2). Findings – Senior managers are devoting considerable energy to understanding the implications of the new legislation, ensuring that their organisations will be ready and able to successfully implement it. This work is perceived to be commensurate with wider agendas to transform and integrate working practices and services, influenced by a range of financial, environmental, organisational, social and policy factors. Originality/value – This research has direct implications for stakeholders in North Wales, having already been used to shape conversations about integration in the region, and furthermore builds upon existing knowledge in the academic and professional field of integration, with additional limited wider implications for policy and research.

Pursuing collaborative advantage in Swedish care for older people: stakeholders' views on trust

2020 ◽  
Vol 28 (3) ◽  
pp. 231-241
Author(s):  
Inger Kjellberg ◽  
Stefan Szücs
Keyword(s):  
Older People ◽  
Social Care ◽  
Content Type ◽  
Complex Needs ◽  
Collaborative Advantage ◽  
Care Services ◽  
Health And Social Care ◽  
Swedish Experience ◽  
Coordination And Collaboration ◽  
Care For Older People

PurposeThe purpose of this paper is to explore stakeholder views on the policy of integrated health and social care for older people with complex needs in Sweden and the issue of trust in implementing the policy.Design/methodology/approachThe study used a qualitative interview design and interviews with nine strategically selected stakeholders. A thematic analysis focused on trust, as defined in the theory of collaborative advantage, was used.FindingsThis study of health and social care exposed a lack of trust on political, strategic and inter-professional levels. Two opposing lines of argument were identified in the interviews. One advocated a single government authority for health and social care. The other was in accordance with recently implemented national policies, which entailed more collaboration between local government authorities, obliging them to make joint local agreements. The Swedish experience is discussed in an international context, examining the need for collaboration in integrated care services for older people.Research limitations/implicationsAlthough the findings are important for the current adjustment in health and social care for older people, the number of interviewees are limited. Future studies will include more regions and longitudinal studies.Originality/valueSweden is currently undergoing an extensive adjustment in line with recent national government policy which involves more primary health care and a corresponding reduction in the number of hospital beds. The restructuring of the care system for older people with complex needs is a paradox, as it simultaneously increases the need for centralisation while also increasing coordination and collaboration on a local basis.

Challenging times: building a health, housing and social care local workforce strategy

2018 ◽  
Vol 21 (3/4) ◽  
pp. 108-122
Author(s):  
Patricia Dearnaley ◽  
Joanne E. Smith
Keyword(s):  
Service Delivery ◽  
Older People ◽  
Health Care Services ◽  
Social Care ◽  
Workforce Planning ◽  
Care Needs ◽  
Fiscal Impact ◽  
Content Type ◽  
Care Services ◽  
Health And Social Care

Purpose The purpose of this paper is to stimulate a wider debate around the coordination of workforce planning in non-statutory services (in this case, specialist housing for older people or those with long-term health and social care needs, such as learning disabilities). The authors argue that current NHS reforms do not go far enough in that they fail to include specialist housing and its workforce in integration, and by doing so, will be unable to optimise the potential efficiencies and streamlining of service delivery to this group. Design/methodology/approach The paper used exploratory study using existing research and data, enhanced by documentary analysis from industry bodies, regulators and policy think tanks. Findings That to achieve the greatest operational and fiscal impact upon the health care services, priority must be given to improving the efficiency and coordination of services to older people and those requiring nursing homes or registered care across the public and third sectors through the integration of service delivery and workforce planning. Research limitations/implications Whilst generalisable and achievable, the model proposed within the paper cannot be fully tested theoretically and requires further testing the in real health and social care market to evidence its practicality, improved quality of care and financial benefits. Originality/value The paper highlights some potential limitations to the current NHS reforms: by integrating non-statutory services, planned efficiency savings may be optimised and service delivery improved.

Collaborating across health and social care: joint funding an adult protection Coordinator post in Caerphilly, UK

2015 ◽  
Vol 17 (2) ◽  
pp. 139-147
Author(s):  
Andrea Giordano ◽  
Alison Neville
Keyword(s):  
Social Services ◽  
Social Care ◽  
Service Improvement ◽  
Health Board ◽  
Content Type ◽  
Health And Social Care ◽  
Abuse And Neglect ◽  
Vulnerable Adults ◽  
Adult Protection

Purpose – The purpose of the paper is to improve the consistency and quality of the response to vulnerable adults who experience abuse and neglect within NHS, independent healthcare and social care settings is noted by practitioners, agencies and patients. Health and social care policy frameworks promote principles of service improvement and consistency, along with a focus on outcomes and resource effectiveness and interagency collaboration. The Protection of Vulnerable Adults (POVA) coordinator role carries the responsibility of coordinating a response to individual referrals of abuse and neglect as described as part of the Designated Lead Manager role in the Wales Interim POVA Policy and Procedures for the POVA from abuse (Wales Adult Protection Coordinators Group, 2013). Design/methodology/approach – This paper will explore the benefits realised through a registered nurse being seconded from the Aneurin Bevan University Health Board into a newly created joint adult protection Health Coordinator post within the Caerphilly County Borough Council social services department POVA team. Findings – This is the first example of such partnership working in adult protection in Wales and has provided a number of benefits in relation to: providing adult protection advice; coordinating the response to referrals of vulnerable adult abuse and neglect within health and social care settings; carrying out or buddying others to complete adult protection investigations; facilitating the two day non-criminal POVA investigation training course and, awareness raising within the local Health Board. The development of a student nurse placement in the social services POVA team cements the multiagency collaborative approach that this development sought to achieve. Originality/value – The need to improve the consistency and quality of the response to vulnerable adults who experience abuse and neglect within NHS, independent healthcare and social care settings is noted by practitioners, agencies and patients.

Time for some home truths – exploring the relationship between GPs and social workers

2014 ◽  
Vol 22 (2) ◽  
pp. 51-61 ◽  
Author(s):  
Catherine Mangan ◽  
Robin Miller ◽  
Jeremy Cooper
Keyword(s):  
Social Workers ◽  
Social Care ◽  
Response Rate ◽  
Poor Quality ◽  
Content Type ◽  
Care Services ◽  
Health And Social Care ◽  
The Impact ◽  
The Relationship

Purpose – The purpose of this paper is to explore the relationship between general practitioners (GPs) and social care professionals by reflecting on a project (the Home Truths project) which sought to improve joint working between general practice and social care though an action-research process. Design/methodology/approach – iMPOWER's Home Truths project involved gathering local data regarding joint working in local areas and using this data as a catalyst for change. The Institute of Local Government Studies and the Health Services Management Centre at the University of Birmingham were asked to act as a critical friend to the project. This involved supporting the design of the data collection, offering advice on the process and to carrying out a short evaluation of the impact of the first wave. The paper reflects on the collected data from the sites and information from the impact evaluation. Findings – The paper highlights the poor quality of the relationship between GPs and social workers. Findings that illustrate this include GPs’ poor knowledge of social care services; a perception that social care services were of poor quality and rating the quality of their relationships with social workers as poor. However GPs felt that knowing more about social care could help prevent their patients going into residential care earlier than necessary and wanted to work more closely with social care to exploit the benefits and opportunities. The interventions that have been put in place to try and improve relationships focus on the day-to-day working lives of the professionals rather than attempting to introduce new initiatives. Research limitations/implications – The response rate from GPs in the areas was low (average response rate was 10 per cent in each area) and it may be that only those GPs who are interested in working with social care responded. The initiatives that have been developed appear to be reasonable responses to the issues identified. However, a lack of discrete outcomes through which to measure improvement will make it difficult to demonstrate the impact of the interventions. Originality/value – This paper underlines that despite many years of policy makers promoting better integration, the relationship between the key gate-keepers within the health and social care systems is still poor. The findings from the Home Truths surveys and action plans has gone some way to address the gap identified in the evidence base about the relationships between GPs and social workers.

scholarly journals Health and social care access for adults with learning disabilities across the UK during the COVID-19 pandemic in 2020

2021 ◽  
Vol 26 (3) ◽  
pp. 174-179
Author(s):  
Samantha Flynn ◽  
Chris Hatton
Keyword(s):  
Learning Disabilities ◽  
Northern Ireland ◽  
Social Care ◽  
Family Carers ◽  
Content Type ◽  
Care Services ◽  
Health And Social Care ◽  
Adults With Learning Disabilities ◽  
The Uk ◽  
The Impact

Purpose This paper aims to present data about access to health and social care services during the COVID-19 pandemic for adults with learning disabilities across England, Northern Ireland, Scotland and Wales. Design/methodology/approach Data were collected directly from 621 adults with learning disabilities and through separate proxy reports by family carers and paid support staff of another 378 adults with learning disabilities. The data were collected between December 2020 and February 2021 and concerned the use of health and social care services since the start of the first COVID-19 national lockdown in March 2020. Findings Access to and use of health and social care services significantly reduced for adults with learning disabilities across the UK during the COVID-19 pandemic between March 2020 and February 2021, with many people not receiving any services at all during that period. Similar patterns were seen across England, Northern Ireland, Scotland and Wales. However, data suggest some variations between countries for some services. Practical implications Future pandemic planning must ensure that access to these essential services is not completely lost for adults with learning disabilities and their family carers, as it was in some cases during the COVID-19 pandemic in 2020. Originality/value This is the largest study about the impact of the COVID-19 pandemic on health and social care services for adults with learning disabilities in the UK. The authors primarily collected data directly from adults with learning disabilities, and worked with partner organisations of people with learning disabilities throughout the study.

From the service user association's perspective

2020 ◽  
Vol 28 (2) ◽  
pp. 53-63
Author(s):  
Charlotte Klinga ◽  
Johan Hansson ◽  
Henna Hasson ◽  
Magna Andreen Sachs ◽  
Carolina Wannheden
Keyword(s):  
Mental Health ◽  
Service User ◽  
Social Care ◽  
Service Users ◽  
Content Type ◽  
Care Services ◽  
Care And Support ◽  
Health And Social Care ◽  
The Individual ◽  
Integrated Mental Health

PurposeThe aim of this study was to identify key components of integrated mental health and social care services that contribute to value for service users in Sweden.Design/methodology/approachAn explorative research study design was used, based on data from four group interviews conducted in June and August 2017 with service user representatives.FindingsThe analysis resulted in eight subcategories reflecting components that were reported to contribute to value for service users. These subcategories were grouped into three main categories: (1) professionals who see and support the whole person, (2) organizational commitment to holistic care and (3) support for equal opportunities and active participation in society.Research limitations/implicationsThe findings are primarily transferable to integrated mental health and social care services, as they emphasize key components that contribute to value for service users in these specific settings.Practical implicationsThe complexity of integrated mental health and social care services requires coordination across the individual and organizational levels as well as ongoing dialogue and partnerships between service users, service user associations and health and social care organizations. In this integration, it is important that service users and service user associations not only are invited but also keen to participate in the design of care and support efforts.Originality/valueService User Associations (SUAs) can act as a bridge between county and municipal services through their participation in the development of local activities; at the regional and national levels, SUAs can help achieve more equitable integrated services. It is important that SUAs are not only invited but encouraged to actively participate in the design of such care and support efforts.

Co-production in integrated health and social care programmes: a pragmatic model

2018 ◽  
Vol 26 (1) ◽  
pp. 87-96 ◽  
Author(s):  
Axel Kaehne ◽  
Andrea Beacham ◽  
Julie Feather
Keyword(s):  
Social Care ◽  
Good Practice ◽  
Essential Elements ◽  
Discussion Paper ◽  
Content Type ◽  
Academic Knowledge ◽  
Care Services ◽  
Current Thinking ◽  
Health And Social Care ◽  
Integrated Health

Purpose The purpose of this paper is to outline the current thinking on co-production in health and social care, examine the challenges in implementing genuine co-production and argue for a pragmatic version of co-production that may assist programme managers in deciding which type of co-production is most suitable for which programme. Design/methodology/approach A discussion paper based on the professional and academic knowledge and insights of the authors. A focus group interview schedule was used to guide discussions between authors. Findings The authors argue for a pragmatic approach to co-production within integrated care programmes. The authors set out the basic parameters of such an approach containing procedural rather than substantive standards for co-production activities leaving sufficient room for specific manifestations of the practice in particular contexts. Practical implications The authors put forward a pragmatic model of co-production that defines the essential elements of a process for ensuring services are designed to meet with the needs of patients yet allowing the process itself to be adapted to different circumstances. Originality/value The paper summarises the discussion on co-production in relation to integration programmes. It formulates a pragmatic model of co-production that may assist programme managers in establishing good practice co-production frameworks when designing or implementing integrated health and social care services.

A response to “A preventable death? A family’s perspective on an adult safeguarding review regarding an adult with traumatic brain injury”

2017 ◽  
Vol 19 (1) ◽  
pp. 4-9 ◽  
Author(s):  
Pete Morgan
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Support Services ◽  
Brain Injuries ◽  
Social Care ◽  
Discharge Planning ◽  
Community Support ◽  
Content Type ◽  
Care Services ◽  
Health And Social Care

Purpose To reflect on the particular case from a professional’s perspective to provide, in conjunction with the original article, a more holistic overview of some of its implications for safeguarding practice and, by definition, for the provision of health and social care support services to individuals with a traumatic brain injury and their families. The paper aims to discuss these issues. Design/methodology/approach A response to an already published article. Findings That a lack of “professional curiosity” on the part of practitioners across a range of professions and agencies led to a failure to initiate safeguarding processes and procedures appropriately, resulting in avoidable damage to the subject of the article, the author’s partner and their families. Practical implications There is a need for a greater awareness and understanding of the implications of traumatic brain injuries across health and social care services: that hospital discharge planning and community support services need to be more flexible in identifying and meeting the needs of patients with traumatic brain injury, that there is no substitute for “professional curiosity” in ensuring that assessments are holistic, and that services are appropriate and multi-agency working is effective. Originality/value This is a response to an existing publication.

scholarly journals Barriers and facilitators to accessing health and social care services for people living in homeless hostels: a qualitative study of the experiences of hostel staff and residents in UK hostels

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e053185
Author(s):  
Megan Armstrong ◽  
Caroline Shulman ◽  
Briony Hudson ◽  
Patrick Stone ◽  
Nigel Hewett
Keyword(s):  
Social Care ◽  
Barriers And Facilitators ◽  
Complex Needs ◽  
Care Access ◽  
Care Services ◽  
Health And Social Care ◽  
Service Barriers ◽  
The Uk ◽  
The Impact ◽  
Care Support

IntroductionThe number of people living in homeless hostels in the UK has steadily increased over the past decade. Despite people experiencing homelessness often having considerable health problems and a range of complex needs frequently in association with addictions, the experiences of hostel staff and residents especially in relation to accessing health and social care support have seldom been explored. The aim of this paper is to identify the barriers and facilitators to accessing health and social care services for people living in homeless hostels.DesignExploratory qualitative baseline data were collected as part of an intervention to facilitate palliative care in-reach into hostels.Setting/participantsInterviews were conducted with 33 participants; 18 homeless hostel managers/support staff and 15 people experiencing homelessness, from six homeless hostels in London and Kent.ResultsThree themes were identified (1) internal and external service barriers to health and social care access due to stigma, lack of communication and information sharing from services and assumptions around capacity and the role of the hostel, (2) the impact of lack of health and social care support on hostel staff leading to burnout, staff going beyond their job role and continuous support given to residents, (3) potential facilitators to health and social care access such in-reach and support from those who understand this population and hostel staff training.DiscussionResidents have multiple complex needs yet both hostel staff and residents face stigma and barriers accessing support from external services. Positive relationships were described between hostel residents and staff, which can be an essential step in engaging with other services. People experiencing homelessness urgently need better access to person-centred, trauma-informed support ideally via in-reach from people who understand the needs of the population.

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