Integration of Health and Social Care Scotland and Interprofessional Education and Training - Coursework Example

School: IPE ESSAY Lecturer: IPE ESSAY Introduction This paper examines two major strategies ly Integration of Health and Social Care Scotland and Interprofessional education and training. Several health commentators have acknowledged the place of decentralisation in achieving effective and efficient healthcare system (Bell, 2010). In terms of efficiency, having a decentralised system has been said to open up the opportunity to ensure that there is greater accessibility, especially with indigenous communities and their people (DH, 2000). This is because with a decentralised system, most issues that have to do with bureaucracies in the transfer of health resources and personnel are broken down to local levels where it becomes easier to reach the people on the ground. In most cases of decentralised healthcare system, because health service is closer to the health users, it is possible to do more within very limited time period and thus promoting efficiency. Effectiveness is also achieved because service providers are offered the opportunity of spending more committed time with the few people they have to handle at a time, as compared to the need to handle so many people at a time in a centralised process (Harker, 2012). It was based on such spirit of decentralisation and the need to achieve an effective and efficient health service that the legislations were passed in 1946, 1947 and 1948 to bring about the National Health Service (NHS) in U.K. (Harker, 2012). Since the NHS came into existence, it has recognised four major health systems namely National Health Service (England), Health and Social Care in Northern Ireland (HSCNI), HNS Scotland, and NHS Wales, which work independently as part of a decentralised system. The decentralised system has however been criticised very lately as having major lapses when it comes to the strengthening of inter-professional working within the current UK health and social services. This paper therefore seeks to justify two major recent strategies that may be employed as part of efforts in developing strengthened inter-professional working within the current UK health and social services. The strategies are Integration of Health and Social Care Scotland and Interprofessional education and training. The outcomes of these strategies are largely based on team interviews conducted as primary source of data and literature review as part of secondary source of data. Integration of Health and Social Care Scotland Justification of Strategy As the name implies, the integration of health and social care strategy is a programme that is designed to bring together the work and activities of health care professionals and social care professionals (Lawrence, 2005). Based on the primary data collection which was conducted through the use of an interview, it was revealed by the respondents with whom there was an interaction that the integration of health and social care strategy is an important and timely intervention that will come to ensure that the gap that existed between health care professional and social care workers is bridged. Through the review of literature, the integration of health and social care programme was noted to be a policy that has been started in Scotland with the hope of extending it to other parts of the UK (Bell, 2010). The policy came as a proposal that was published by the Scottish Government to integrate adult health and social care (HAD, 2003). This means that the emphasis shall be between adult health and social care. This strategy will be justified based on the relationship between adult health conditions and social health problems such as the relationship between mental health and substance abuse. Appraisal of Strategy There are a number of critical appraisals that can be performed on the integration of health and social care policy. This appraisal will be done with reference to the Government’s response to the strategy as published by The Scottish Government (2013). The first issue considered in the response paper is the case for change, where the question of whom to legislate for is asked. In response to this question, Evashwick and Meadors (2013) noted that the adult population of UK and some children are faced with health risks that have direct bearing on their social lifestyle. With this in mind, the ordinary UK citizen who is faced with a combination of health and social needs must be the targtet for who the legislation is made for. There is also the question of what to legislate for, which is a very important aspect of the policy. This is where the issue of strategy come in. This is because with an integrated legislation of this nature, it is important to ensure that the independence of the two major services are kept, as well as the need to introduce an all new paradigm to integration (Gröne and Garcia-Barbero, 2002). With this noted, the need for the integration for be made in a hierarchical manner whereby service users whose health problems are identified to have some levels of social care issues will be made to receive collaborated services from both an independent adult health service provider and a professional social care giver is recommended. Impact of Strategy The impact of the integration health and social care policy can be noted to be enormous. For example, it is expected that because service users will go through a hierarchical care plan that takes them through the hands of more than one professional, it will be possible to guarantee quality and effectiveness. This is because chances that there will be lapses with all the professionals are highly unlikely. This will be in contrast with a situation where the service user has to use only one service provider. It is also hoped that there will be a kind of internal checks and balance among the professionals and thereby guaranteeing high output of work by the professionals to be involved in the integration programme. At least with knowledge that another colleague might depend on their outcomes to function effectively, it is expected that there will be a lot of internal efforts put up by the service providers. Last but not least, it is expected that this integration programme will achieve an all-round wellness for service providers at a much affordable cost. This is because service users will not have to two the integration services as separate services, each of which they must foot the bills. Examples from Contact From the various interactions with colleagues, there were two major issues that were raised about the integration of health and social care programme. The first issue had to do with the need to make the programme function on the principle of right-based. The second issue had to do with the need to make the programme function on the principle of needs-based. As there were differences in opinion, the ideas were subjected to the review of literature. Through this, it was found that the right to health and social care is already enshrined in the law books of the land (Gröne and Garcia-Barbero, 2002). There was however nothing specific about having an integration of these two services. On the part of needs-based, it was realised that it is not all people whose health needs have direct bearing with social care (Kodner and Spreeuwenberg, 2002). For this reason, using needs-based will make it possible to identify the best group of people who are really in need of the integration programme so that it can be applied on them. Interprofessional education and training Justification of Strategy Inter-professional education and training is identified as another important strategy that can be adopted into the wider NHS in UK to ensure massive integration between various healthcare services. Writing on the interprofessional education and training programme, Roethel (2012) explained it to be an educational programme that involves two or more professions in health and social care to learn together as means of cultivating collaborative practice. The essence of this programme can be said to be the need to providing massive client-based healthcare (Mackintosh, Adams, Singer-Chang and Hruby, 2011). Even though interprofessional education and training is an ongoing programme, the justification for using it as a major strategy is that it will equip future professionals with integration skills right at the training stages of their education. This way, it can be assured that this integration will become a permanent part of them by the time it is due for the to put them to practice as discussed earlier. Appraisal of Strategy In terms of appraising the strategy, its strengths and weaknesses will both be acknowledged. In terms of strength, it can be said that the fact that the programme targets inter-professional integration at the educational level stage is a great advantage. This is because it will give students the opportunity of appreciating the essence of integration before they go to the field. This way, once the need for integration and interprofessional practice comes up, they will not have any difficulty adjusting to it. What is more, because the strategy will be introduced at the learning stage, most respondents who were interacted with indicated that they will take it very seriously, knowing it will form part of their academic success. The strategy has however been criticised for not being an end in itself because there is the likelihood that if it is not used in conjunction with other strategies, there will be no legislation binding the professionals to continue with the integration after their education (Twichell, 2011). Impact of Strategy Because the client or patient is the focus of the interprofessional education and training programme, using it as a strategy to achieve integration among the various health services will ensure that output of care to patients become customised and based on the needs of patients as explored earlier. This way, patients can be assured that they will be receiving the best of care that has them and their interest in mind, rather than the interest of the service providers. What is more, there can be the assurance of contingency services resulting from this. This is because where a patient is brought to another professional under emergency situation, there can be some level of knowledge on what to do; at least as first aid before there will be transfer to the main professional in charge. Again, the outcome of this strategy will ensure that service providers will be highly knowledgeable, having learnt something little about a lot of other professions within the health sector. Examples from Contact There are personal examples from contacts that were had with colleagues. The first of this had to do with the practicality of transfer of knowledge through the interprofessional education and learning programme. This is because several services were provided and covered by the team, including home assessments, hospital assessments to facility discharge, package of care, arrangement of care home admission, adult protection, and senior staff work in supervisory roles. In terms of team dynamics that were achieved, for which it is hoped that there will be transfer and application in the professional field of practice, mention can be made of skills such as interpersonal relations, working under pressure, and working under very minimal supervision. The team was very emphatic on the fact that there could be both positive and negative outcomes but the positive outcomes could overshadow the negative ones like possible conflict between roles. Conclusion This essay has so far acknowledged the role and importance of a decentralised healthcare system, the basis of which the NHS came into being in the UK. But even as a the NHS has been praised for having some solutions to most of the health needs that plagued the common citizen of the UK, it has also been realised that the NHS cannot be a conclusive solution to the problems that face the country’s health sector. As way of killing two birds with one stone, it is possible to maintain the NHS’s decentralised system of healthcare and at the same time introduced a more integrated approach to health service delivery. From the two key strategies and policies which are the inter-professional education and training, and integration of health and social care which have been discussed into detail, it will be concluded that efforts must be put in place to ensure that these two strategies become an embedded component of the NHS. This way, not only will UK’s health system become decentralised but also highly integrated. Once this is achieved, there can be efficiency and effectiveness within the various systems or services coming together to form the NHS before transferring the generalised benefits to the larger UK population. It is said that there will be internal efficiency and effectiveness with the UK healthcare system if integration is achieved because health professionals within various services will have the opportunity to do cross professional and cross-sectional learning from among themselves before applying this on the service user. Because there will be room created for inter-professional learning, it will also be possible to achieve some levels of contingency stand-ins for some professional when other professionals cannot genuinely be available to render their services. Finally, implementing these two strategies to bring about an integrated health system will ensure that independent checks and balance among the various health services is improved. References Bell, D. (2010). "The impact of devolution - Long-term care provision in the UK". Joseph Rowntree Foundation. DH (2000) The NHS Plan: A plan for investment. A plan for reform London: The Stationery Office Evashwick C and Meadors A (2013). "Defining integrated delivery systems". AHSR FHSR Annu Meet Abstr Book. 11: 31–2. Gröne, O & Garcia-Barbero, M (2002): Trends in Integrated Care – Reflections on Conceptual Issues. World Health Organization, Copenhagen. Harker, R. (2012). "NHS funding and expenditure SN/SG/724". House of Commons Library: London HDA (2003) The Working Partnership. London: Health Development Agency Kodner, DL & Spreeuwenberg, C (2002): Integrated care: meaning, logic, applications, and implications – a discussion paper. International Journal of Integrated Care, Vol. 2, 14. Lawrence, D. (2005). Building a Better Delivery System: A New Engineering/Health Care Partnership — Bridging the Quality Chasm. National Academy of Sciences: Washington, DC. Mackintosh, S. E., Adams, C. E., Singer-Chang, G. And Hruby, R. (2011). "Osteopathic Approach to Implementing and Promoting Interprofessional Education". Journal of the American Osteopathic Association (JAOA) 111 (4): 206–212. Roethel K. (2012). "Medical Schools Push Teamwork". US News & World Report. The Scottish Government (2013). Integration of Adult Health and Social Care in Scotland. [online] Available from http://www.scotland.gov.uk/Resource/0041/00414332.pdf [6th April, 2014] Twichell T. (2011). "Medical School Expands Interprofessional Education". University of Colorado-Denver. World Health Organization, 2010. Framework for action on interprofessional education and collaborative practice. Geneva: WHO Press. Read More