The Impact of Partnership Working in the Health and Social Care Sector - Research Paper Example

Introduction Traditionally, organisations used to operate individually without consulting or engaging with each other on matters of mutual interest. Competition between companies is crucial and each organisation would rather act alone but research has shown that though competition is key to organisational success, working in partnership especially in sectors that are interrelated is crucial (Balloch & Taylor, 2001; Glasby & Dickinson, 2008). This is especially so in the health and social care sectors where all the actors need to work collaboratively to provide high quality services to end users or risk failure. Most of the activities in this sector are interrelated and as such working individually may bring about challenges and inefficiencies in costs and use of resources especially at this time when the government is facing budget pressures. Partnership working is essential in this sector for effectively delivery but what is the meaning of partnership working? There are very many definitions of partnership working and as many advantages and barriers as there are definitions. This is according to Glaby and Littlechild (2006). They define partnership working as “the search to connect healthcare system with other human service systems to improve outcomes” (p. 7). The success of partnership argues Lymbery (2006) relies on good systems of inter-professional collaboration and this is not easy given the great differences in power and culture between different occupations and competitive nature of professions. Given the numerous challenges posed by partnership working, one would pose to wonder why it is still so crucial for different agencies to work together. This paper will evaluate the impact of negative and positive outcomes of partnership working in the health and social care sector. To achieve this, the paper will be divided into numerous sections. First, the meaning of partnership working as well as inter-professional practice will be discussed so as to understand the issue at hand. Secondly, a brief history of health and social care will be given to show how the field have developed over time and embraced partnership working. Thirdly, the factors that enhance the success of partnership working will be discussed followed by barriers or challenges to effective utilisation of partnerships. Finally, a short summary of issues discussed and recommendations partnership working will be given. Working in Partnership The concept of partnership seems so easy to understand as it applies to several areas of business and our daily lives. It is not a surprise to hear friends calling each other partners, besides; the name applies to a business owned by two individuals and also to marriage relationships. However, what does it mean to work in partnership? Does it mean to combine capital and human resources or a organisation can act individually and also with others? According to Glasby and Littlechild (2006) partnership working has as many definitions as there are sociologists and depends on the context. One definition by Sullivan and Sketcher is based on the emphasis placed on such issues as shared responsibilities, negotiation by people from different agencies working together, and the intention of delivering benefits (Glasby & Littlechild 2006, cited in Sullivan & Sketcher, 2002). For the audit commission, performance working means having a shared vision, objectives, actions, resources and risks. It also entails giving users a seamless services and the recognition by all players of their interdependence (p. 6). Out of all these definitions Glasby and Littlechild (2006: 7) came up with one definition: partnership working is “search to connect health care system (acute, primary, medical) with other human service systems (long-term care, educational, vocational and housing services) to improve outcomes (clinical, satisfaction, efficiency).” The aim of collaboration among the various agencies is to ensure smooth and effective service delivery by effective use of resources and information. It would not make sense for the agencies to duplicate resources in provision of similar services to similar clients; they require each others help. For example, effectively service delivery requires collaboration between care givers, transport and housing services. Furthermore, the various agencies can collaborate in designing effective social policies to help the industry work well (Abendsten et al. 2011; Ball, Forbes, Parris & Forsyth, 2010). It also ensures integration of functions and budgets as well as increasing accountability. Partnership working cannot be effective without collaboration by the different professionals in the field. This brings about the concept of inter-professional working. This refers to “how two or more people from different professions communicate and cooperate to achieve a common goal” (Glasby & Littlechild, 2006: 7). The health and social care sector is involved in provision of services by different professionals such as practioners, social workers, nurses, and doctors and they need to work together for the same to work despite the competitive nature of the professions (Glasby & Dickinson, 2008; lymbery, 2006; Pullen-Sansfacon & Ward, 2012). History of Health and Social Care The UK has a universal welfare system whereby all individuals are entitled to benefits. The health and social care sector is part of the welfare system apart from education, housing and other essential services. The National Health Service has the responsibility for the health of the population while the care sector is entrusted with ensuring the vulnerable groups such as children, old people and the disabled are well taken care of through provision of social benefits (Daly, 2011).This system emanated from the Poor Law Act which made the sick to be eligible for support. Health and social care were treated as different fields as stipulated by the National Health Service Act 1946 and National Assistance Act 1948: health sector dealt with the sick people in need of health while social care dealt with social needs and the service was and is still is provided in care homes though in contemporary society, some people prefer and allowed to be taken care of in their homes (Alcock, 2008; Glasby & Littlechild, 2006). The poor laws gave priority to male individuals in a patriarchal society but in modern times where discrimination is prohibited all are included in the government policies. Traditionally, health services were offered by professional bureaucrats but as time progressed the government saw the need to incorporate the private sector in provision of services to enhance efficiency (Alcock, 2008). Glasby and Littlechild (2006) in their study indicate that marketisation emerged in the 19th and 20th centuries and saw the care being provided by public sector, private sector and professionals. Every person in Britain is supposed to register with a general practitioner for provision of healthcare services especially assessments although some still attend government hospitals. In the past, the local authorities had the role and responsibility of providing many types of care but now they concentrate on health needs such as dealing with community nursing, managing hospitals and public health functions (Ball et al. 2010). There was no integration of services as is apparent today ad this resulted in a lot of inefficiencies especially in resource utilisation. For example, there were shortages in residential homes and the local authorities were overworked. The people were also placed in institutions according to balance of power between local health and social care workers rather than according to needs assessment due to over reluctance by the different agencies. It was not until 1976 when joint working efforts emerged in form of joint care planning teams and joint financial programmes (Glasby & Dickinson, 2008). Glasby and Littlechild (2006) assert that formal arrangement for collaboration began in 1990s through community care reforms. This led to improvement of services which had deteriorated over time in terms of overcrowded homes and inhumane conditions. Outcomes of Partnership Working Partnership working has had its positive and negative outcomes and these are mostly influenced by national, regional and local policies. Partnership working is based on the idea of shared vision, joint working, partnership and interagency collaboration. Some of the agencies involved in health and social care are health sector, social care, housing and transport and they must work together for efficiency. It assumed that these agencies have common interests which are interdependent and thus one cannot function without the other (Ball et al. 2010; Stevenson, 2013). This prompts the need to work together instead of competing with each other. According to the audit commission, the practice of partnership working is based on several principles: the services are user oriented; all players should recognise they are interdependent and that an action by one agency has an impact on others. Its like the parts of a body, they must work together in order to function properly and if one part is not working properly then the body is unable to function. Another principle is the removal of boundaries for the user such that services are seamless (Lymbery, 2006). The agencies must negotiate and be committed to working with each other for the outcomes to be realised. Moreover, they should be committed to a common goal otherwise the whole idea of partnership working is useless. The partnership also based on integration, coordination, communication and collaboration principles. In their study Gasby and Littlechild (2006:8) assert that “partnership working depends on actions at different levels and can acquire different types of joint working.” The strategic level deals with sharing information about resource use. Policies are made at national level on how to share resources to achieve the desired outcome. For example, the National Health Service (NHS) is the body that gives guidance on health issues. Government spending is also budgeted at national level thus these agencies must contribute to ensure enough allocation of resources (Appleby, 2013). The operational management level is involved with policy formulation such as the formulation of national service framework for older people requiring implementation of single assessment process that covers health and social care needs (Abendsten, 2011; Glasby and Dickinson, 2008). On the individual level, the policies formulated are put into operation; for example, through joint training, information sharing systems and the availability of single point of access. So what benefits do agencies gain from working in partnership? There are many benefits that result from partnership working. As stated earlier, these agencies are parts of a system and as such if one part is missing or malfunctioning the other parts are affected as well. In this case, partnership working ensures that the different agencies are working together towards a common goal instead of working in a fragmented manner leading to inefficiency. For example, duplication of resources is eliminated thus reducing costs (Dickinson, 2008).Another benefit is that they can share information that is crucial in improving service delivery to users who are the most important. These agencies collect data from users such as patients and the different organs can share that information to improve health or formulate policies essential for all agencies. Partnership working involves sharing a common vision, objectives and plans and this helps to identify any gaps in provision of services thus are able to address any unmet needs (Balloch & Taylor, 2001). They also provide seamless service to users due to breakdown of boundaries. Users can access a variety of services at one point without having to shop around. For example, if their needs are assessed by a general practitioner they can then get services from government or private hospitals or get care services without having to be assessed again. There is also clarity of roles and responsibilities. Working in partnership enables the agencies to define what role each will be performing as opposed to where the user is tossed around different agencies not knowing where their needs can be addressed. Furthermore, due to clarity of roles they are more accountable to their actions. When roles are fragmented it is not easy to discern who to hold accountable in case of any problems. Though partnership working has been successful, it is faced with many challenges. The first challenged results from inter-professional working which is necessitated by joint working. Each organisation has its own culture to which individuals are accustomed and it is not easy to change culture. When professionals move across different organisations, they have to adapt to culture of that organisation and this may present an enormous challenge. For example, if a professional has to work in a private and also a public hospital to provide healthcare he/she may be hindered by the working culture. This is because the way of doing things in private and public sector is different. There is also lack of understanding each others role, culture, processes and language (Gasby &Littlechild, 2006). If the agencies do not understand each other’s role then conflicts may arise or a good relationship may not be established. Appleby (2013) asserts that some aspects of partnership working are taken up more than others. He gives an example of the mental health services which have been neglected and thus suffers shortage of approved specialists who carry out assessments. Lack of involvement by some sectors may also be a barrier to partnership. All agencies must be committed to a common purpose for the outcomes to be achieved and cannot work if some are left behind. For example, if other health, social care and transport providers collaborate to assist those with disabilities but the housing service sector is left behind the outcome will not be desirable. They may be committed to providing good housing care but if housing services do not do something about its designs then the goal cannot be achieved. There is also conflict of priorities between various agencies such as the national priorities for NHS and local priorities for local government. Partnership impacts a lot on professionalism and reduces the spirit of competition and autonomy and this may lead to low morale and high turnover. Furthermore, professionals have varied ideologies, values and interests which may be conflicting. For effectiveness to be achieved, the agencies must have a shared vision and purpose and be committed to achieving it. The roles for each agency must also be clear to avoid confusion and appropriate incentives and rewards be given to get agencies engagement to collective goals (Glasby & Dickinson, 2008). All agencies must be accountable for their actions and the agreed pool of resources utilised wisely. Good leadership cannot be overemphasized in achieving success. Conclusion The paper discussed the impact of partnership working in the health and social care sector. It started by explaining what working in partnership means as well as the concept of inter-professional working. Working in partnership entails coming together of various agencies with a common vision and purpose to improve the outcomes of the sector. This requires collaboration by professionals from various fields in order to achieve the common goal. The paper then gave a brief history of the sector followed by the success factors as well as barriers to effective partnership. Lastly it recommended ways of enhancing collaboration. The realisation that the agencies are interdependent and that the action of one agent has an impact on the others is the building block of partnership working. References Abendsten, M., Hughes, J., Clarkson, P., Sutcliffe, C., Challis, D. 2011. The pursuit of integration in the assessment of older people with health and social care needs. British Journal of Social Work, 41(3): 467-485. Alcock, P. 2008. Social policy in Britain. 3rd ed. Basingstoke: Palgrave Macmillan. Appleby, J. 2013. Health and social care will need half of government spending unless changes are made: King’s fund. Integrated Care Network. Available at: http://www.integratedcarenetwork.org Ball, R., Forbes, T., Parris, M and Forsyth, L. 2010. The evaluation of partnership working in the delivery of health and social care. Public Policy and Administration, 25 (4): 387-407. Balloch, S ad Taylor, M (eds). 2001. Partnership working: policy and practice. Bristol: Policy Press. Daly, M. 2011. Welfare. 3rd ed. Cambridge: Polity Press. Dickinson, H. 2008. Evaluating outcomes in health and social care. Bristol: Policy Press. Glasby, J and Dickinson, H. 2008. Partnership working in health and social care. Bristol: Policy Press. Glasby, J and Littlechild, R. 2006. The health and social care divide: the experiences of older people. Bristol: Policy Press. Lymberly, M. 2006. United we stand: partnership working in health and social care and the role of social work in services for older people. The British Journal of Social Work, 36(7): 1119-1134. Pullen-Sansfacon, A. and Ward, D. 2012. Making interprofessional working work: introducing a group work perspective. The British Journal of Social Work, 2012. Stevenson, N. 2013. Partnerships in health and social care. NHS Confederation. Available at: http://www.nhsconfedorg/Training/PrimaryCareTrust/OurWorkProgramme/pages/partnership [Accessed Jan 31, 2013] Read More