Effective Collaboration and the Ideal Scenario - Essay Example

Effective Collaboration and the Ideal Scenario Introduction This study intends to provide a deeper understanding on how collaboration of NHS and social services can be done effectively with the help and aid of each sector’s existing strengths and services. Effective collaboration, being the ideal scenario can only happen if adult learning disability as a social issue in which its care, management and monitoring can be delegated accordingly to the members of the immediate society. This paper also intends to provide an overview of different policy changes on the national level to furthermore support local implementation. Collaboration as means to provide the best care and policy implementation possible can become effective based on several factors. Collaboration also provides a more efficient, effective in the economy side of things. The economic problems of adults with learning disabilities are primarily concerned with basic production and consumption. Sometimes selection of, often preparation for, usually entrance upon, and almost surely progress in an occupation come during the adult years. The role of collaboration is not merely to care for the health of these individuals, but train them to become more productive, and enable them to become self sufficient. With rapid changes in the world of work, many adults find it necessary to learn new things or take a major leap in terms of their careers once or more during their working lives. Different agencies will have to discover new ties among government offices as well as partnerships with the private sector and NGOs to guarantee quality and accessibility of the benefits provided by the adult learning disability incentives by the government. Agencies will not only need to overcome traditional reluctance to work with each other to maximize benefits of scale in this case, but also will have to learn to actively participate in creating change within the agencies for the purpose of achieving harmony while in collaboration with other agencies. Collaboration among government entities, private enterprises and NGOs can assist policymakers in crafting meaningful reforms and can expedite the implementation of different policies that help advance adults with learning disabilities and some other disabled individuals. . Private sector experts, who deeply understand topics such disability, adult learning, adult care, mental health, can advise government policymakers. The private sector may have considerable expertise that can help meet the challenges of increasing efficiency, capacity, and consumer (that is, citizen) satisfaction. In this study different factors that affect collaboration between NHS and social services in particular will be examined. These are: The Collaborative Links between Agencies and Professionals in the Learning Disability Partnership Government Guidance, Legislation and Other Factors Influencing Organisational and Individual Collaboration within the Learning Disability Partnership The Structural Constraints, Problems and Solutions within the Learning Disability Partnership The Individual Constraints, Problems and Solutions within the Learning Disability Partnership Teams, Mechanisms and Skills for Collaborative Working within the Learning Disability Partnership The Limits of Collaboration; the Extent to Which Service Users are Involved in the Collaborative Process Analysis The Collaborative Links between Agencies and Professionals in the Learning Disability Partnership As shown in appendix 1, there are five main sectors that are qualified to be part of the multi-disciplinary team. These are: Health, Social Services, Public Services, Education, Voluntary and Private provisions. This goes to show that the role of managing learning disability encompasses different agencies because the process of learning is multi faceted and the human dimension of it which is “disability” demands a more specialized care and attention. Any educational or developmental plan designed to meet the needs of people with learning disabilities at a various developmental stages would have to maintain great flexibility. It would have to be adjustable to the demands of the times- the amount of learning required by changing economic, political, and social conditions. It would have to be adjustable to the changing needs of individuals through different life stages. The curriculum of elementary and secondary schools might change materially whereas the medical and health care of infants to senior citizens significantly vary. Inherent in lifelong learning should be provision for helping people accept, and even will come, cultural/societal change. Security should no longer reside in achieving a bachelor’s degree and depending upon the education represented therein to carry the holder through life, (at least for people with normal learning process), but the greater challenge is how to make the most out of individuals with learning disabilities, how to help them achieve their potential and become productive citizens of the country. . Security would exist in knowing that suitable educational opportunity is available at all times to assist with any necessary or desirable changes. As mentioned in appendix 1.5.11, “Transition from childhood to adulthood for people with a learning disability can be a difficult process for both the individual and their carers. The government vision within Valuing People (2001) suggests that people with a learning disability should have support and equality of opportunity to take part in education, training, or employment. Organisations such as the Connexions service and the Youth Enquiry Service (Youth Enquiry Service Online 2007) provide help and advice to disabled young people as they move into adult life. Such organisations work extensively with people with learning disabilities until they reach the age of 25, supporting them with advice, information, careers, counselling and advocacy services. They may come in contact with young mothers with learning difficulties, disabilities, and people who are deemed to be vulnerable”. Adult learning education under public auspices is concerned with extending democracy far into all human relationships. To achieve this purpose, it must be democratically organized and operated. It must identify itself with and serve all kinds of people such as farmers, miners, doctors, fishermen, teachers, clerical workers, lawyers, craftsmen- all occupational groups. It must be organized to serve men and women everywhere- in isolated rural areas, in suburban and other localities, in industrial centers, in residential suburbs, and in the slums and gold coasts of great cities. It must serve people of all races, ethnic groups, educational levels and religious faiths. Adult learning must provide people the capacity to think through, plan for and satisfy their personal and development needs, assisting them the material necessities of food, shelter, clothing and health as well as more intangible benefits such as security, adventure, comradeship, recognition and self government. It must try to make all people see that they can achieve these values primarily through cooperative group endeavor, as provided by the host society rather than competition and conflicts of interests among those people who might benefit in the course of collaboration. In helping to extend and reconstruct democracy, adult education cannot pretend to have the substantive answers ready to teach all. It does not and cannot have them. At best, in can only offer answers of the past, and new and better answers can be had only by those who work them out in the process of living and learning. Since answers to the problems are made, not found, the major responsibility of adult educators is to know how to go about making the answers and to become skilled in helping others make them. In a democracy, a community approach to adult education is necessary. A very high proportion of learning takes place in the family, in the neighborhood and in other peer groups. Interaction of personalities within such group shapes the individual and influences his character throughout life. The neighborhood, the community, and their component groups are of the highest importance in individual growth and development. Appendix 1.5.5 affirms the role of the community in fostering learning for adults who encounter difficulties: “In-house day services offer service to adults with a learning disability assessed as eligible for service under the fair access to care. A provision that offers a range of modernised community and centre based activities, promoting choice and inclusion in a person centred manner”. The community is likewise very important. The assumptions upon which the individual’s way of life is based require a maximum amount of participation by people in the solution of their problems. Group and neighborhood activities provide the base for social and political structure. Given that family structures are changing, collaboration becomes more meaningful since it provides a more progressive approach in addressing the said issues. Urbanization, fluctuations in size of families, the changing status of women, and other factors leave many adults for long periods without close family ties. Normal human companionship is important for mental health. Learning activities provide an opportunity to form and maintain personal friendships and often to develop specific skills and understandings in personal relationships. Since there is an increasing complexity of modern life multiplies the importance of relationships among groups, racial and cultural groups, religious groups, nations and clusters of nations operation on different philosophies an important objective of adult learning disability in recent decades has been to increase reciprocal understanding and appreciation among other people with different cultural and ethnic backgrounds. Government Guidance, Legislation and Other Factors Influencing Organisational and Individual Collaboration within the Learning Disability Partnership Fortunately, the national government enacted laws that will provide frameworks in potential collaboration. Laws, protection guidelines, implementing rules and regulations as products of new acts and bills provide not only the collaborators but the general public as well, of generally accepted principles in dealing with Adult Learning Disability. As illustrated in Appendix 2.1, there were just roughly three laws related to adult learning disability care prior to 1990. But as progress comes, more laws have been written in support of adult learning disability. Appendix 2.2 provides: Legislation How it affected collaborative working The National Health Service and Community Care Act (1990) It was aimed at allowing vulnerable people to live as independently as possible in their own homes or in a homely setting. It saw the closure of many long stay institutions. The Carers (Recognition and Services) Act 1995. It introduced the assessment of carer’s needs. The meant an extension of the services already on offer. The Disability Discrimination Act (1995) It aimed to end the discrimination which many disabled people face. This Act gave disabled people rights in the areas of employment, education, access to good, facilities and services, buying or renting land or property. The Community Care (Direct Payment) Act (1996) It meant that service users that met the criteria could receive funding for services direct. Arguably, this began to shift the balance of power from organisations to the ‘purchaser’. The Disability Rights Commission Act (1999) It produced a statutory duty to promote equality and to eliminate discrimination. It introduced an additional layer of collaboration by working with organisations to ensure best practice. The Health Act (1999) It introduced the development of Primary Care Trusts, that are part of the NHS responsible for the planning and securing of health services and improving the health of a local population. It made provision for payments between health service bodies and local authorities with respect to health and health-related functions. It also enabled Primary Care Trusts to regulate any professions concerned with the physical or mental health of individuals. The Care Standards Act (2000) It provided benchmarks for quality of care provided. It ensured service users received a certain level of care and thus increased the comparison of performance between agencies. No Secrets: Guidance on Developing and Implementing Multi-agency Policies and Procedures to Protect Vulnerable Adults from Abuse (2000) This paper highlighted the need of ‘joined up thinking’ so that people would not be ‘lost’ in between services. The new laws provide a more holistic approach in terms of policies in addressing this issue. The laws, which mostly fall under different government jurisdictions, call for the cooperation of other agencies to produce the best kind of care possible. These laws no longer look at adult learning disability on the “health care” side, but rather, provided a totally new definition, which is its social aspect. By doing so, collaboration becomes a necessity considering that such disability calls for the care of the immediate society. The Structural Constraints, Problems and Solutions within the Learning Disability Partnership One very important constraint during the course of our research is provided by Appendix 3.1Common Language and Communication Oliver’s definition of disability is based on principles of the social model, where society is viewed as the subject of change, and not the disabled individual; ‘ …impairment is the functional limitation within the individual caused by physical, mental or sensory impairment; disability is the loss or limitation of opportunities to take part in the normal life of the community on an equal level with others because of physical and social barriers.’ (Oliver 1998 BMJ;317; 1446- 1449) The definition contrasts to the definition provided by the Disability Discrimination Act 1995, which is founded on medical principles of disability. The Disability Discrimination Act 1995 uses medical principles when it defines a disabled person as someone who has a physical or mental impairment that has a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities. This definition has been criticised for ignoring the role that society plays in disabling an individual. Instead, it places greater emphasis on the medical condition of the individual and their inability to fit into society. Professionals too, within the partnership find themselves working with other disciplines who have not shared the same educational or training backgrounds. That is why it is very important to define the various leadership roles in Adult Learning Disabilities. Professionals and practitioners have different approaches in solving an issue or problem. Therefore, some basic principles must be understood and comprehended prior to any project implementation. Every team leader of adult education needs to know the size of the various population groups to be served. Statistics that give merely the total population of the community or the total adult population are not enough. Programs can be better tailored when the number of persons facing the various developmental tasks, their ages, and similar characteristics are known. Because conditions differ widely among communities, and agencies in collaboration, team leaders should, if possible, study the data reflecting local conditions. In doing so, bigger agencies may need to coordinate with local government units or other smaller community based agencies. Most of the essential information on larger communities and political subdivisions can be found in census reports and similar sources. For local conditions in small communities however county and state figures are usually more helpful than national summaries. It is also very important to keep a balance between approaches. Medical approach to a disability is good to a certain extent, this goes the same with the social aspect of it. The challenge is, how to harmonize both to produce a more favorable result for everybody. The Individual Constraints, Problems and Solutions within the Learning Disability Partnership There are different constraints and problems that can be encountered in a learning disability partnership. Appendix 4.2 of this study states that “The relationship between adults with learning disabilities and society can be viewed very differently by the health and social care professionals. Arguably, the health care professionals will apply or follow the medical model of disability, whereas the social care professional is more likely to apply or follow the social model of disability”. Another one is provided in Appendix 4.4 which talked about different configurations of teams and work settings. “On an individual level there is a lack of understanding of the roles of each professional within the partnership which can lead to unrealistic expectations and potential hostilities. Differences in professional ethos exist between members of partnership who roles appear to have some overlap. For example, health care managers co-ordinate care plans from the priority of health, while social care managers co-ordinate care plans from the social care perspective. Therefore, absence of shared philosophy will act as a barrier”. Teams, Mechanisms and Skills for Collaborative Working within the Learning Disability Partnership 5.2.1 There has been a series of initiatives designed by both central government and local authorities in order to stimulate joint working and to emphasise its role in effective service delivery. There is a growing realisation that meeting complex care needs requires a multi – agency approach where managers and professionals work together to plan and deliver services. This goes to show that as collaboration begins, so does conflicts. Multi agency becomes a requirement, because no agency is a master of all. He can specialize in one field, but definitely he does not have the capacity to know everything about it, thus the need for collaboration becomes more practical. Collaboration merits a continuous responsibility. The obligations one assumes do not decline with expiration of contract, and learning is required by the changing succession of civic problems and the evolving nature of our social, economic, and political world. In this field, probably more than in any other, group and individual needs can be served at the same time. As groups face issues and solve problems of collaboration, individual agencies will be growing in their tasks of taking civic responsibility and meeting social and civic obligations. Specific learning demanded includes refreshing oneself about the structure and operation of government in becoming acquainted with the major current problems. In addition, good collaboration requires the development of skills in detecting and evaluating propaganda; selecting areas for cooperation; participating in meetings that are related to the collaboration. . 5.3 What particular skills are needed for collaborative working? All Professionals working with adults with learning disabilities need to be aware that working in collaboration takes a lot of time and hard work. They must be dedicated in wanting to make it happen and need to accept and want to work with others. Collaboration requires time and favourable conditions for the team to develop. Thus, the antecedents of collaboration include individual readiness of all team members, understanding and acceptance of one’s own role and expertise; confidence in one’s own ability; recognition of the boundaries of one’s own discipline; effective group dynamics (communication skills, respect and trust.); an environment of team orientation; organisational values of participation; interdependence and a leader supportive of autonomy. (Thompson, 1998, p347). Professionals need to be able communicate and use appropriate language, negotiation, listening, empathy with partners, understanding and respecting difference to ensure effective collaborative work. The Limits of Collaboration; the Extent to Which Service Users are Involved in the Collaborative Process There is no such uniform and exact guide for setting up adult with learning programs for those with learning disabilities. The adult curriculum, less firmly established in experience, cannot be so standardized. Adults are not so likely as children to accept predetermined courses and curricula. In certain areas such as vocational education, outlines of content may be fairly well established, but even then adults will choose only those courses that meet their special needs although high school and college courses for adults are often modifications of similar courses for youth, in some areas, the curriculum is much more fluid, varying considerable among communities and even deferring from year to year within the same community. The voluntary nature of adult learning disability forces every carer to be his own field expert. Because adults do not have to go to school, programs must be based on needs and interests which they themselves feel or can be led to recognize. They will accept organized instruction, even arduous curricula provided they can thereby fulfill an ambition or satisfy a felt need. The adult carers first task is to identify those needs. 6.7 - Personal Values All workers must be self aware and understand the personal values they bring to a relationship which are based upon their life experiences and culture, which can enhance or limit collaboration. (Schulman, 2006). Meek (1998) concluded that service users do not centrally value workers according to their qualifications and knowledge, but rather according to their personal qualities and person centered skills such as listening, empathy and compassion. Parley (2001) discussed the increased likelihood of person centered outcomes when a person centered approach is adopted by the worker. 6.11 - Issues of power Often collaboration is limited due to the participants not being ‘equal’ due to the power assigned through status such as a medical consultant, a social worker possibly acting under a legal discourse, maybe engaged in child protection (Brayne and Carr, 2005). Schulman (2006) describes how a power imbalance can cause obstacles such as fear or envy which need to be addressed to work effectively. Hughs and Ferguson (2000) view power as something which works through institutions and agents. Furthermore, they argue that an encounter with a representative of the welfare state organisation may mean that a service user acts in ways they would not have otherwise. This may be due to the power held by workers, by nature of being the ‘gatekeepers’ to services. In Conclusion The needs of adults with learning disability cannot be identified once for all time. While some learning needs are basic and remain relatively stable for given age groups, others change greatly according to economic conditions, world tensions, the domestic situation and vicissitudes of our evolving civilization. These factors make program building for collaboration a continuous job. In a very real sense, it is never finished. Sound program collaboration building, then, requires the continuous identification and definition of adult’s educational needs, health needs, caring needs and interests. This can be done through the collaboration of different agencies. This work is the everlasting responsibility of the collaborators of adult learning disability. If they do it well, they will be on the road to developing a sound and thriving program. If they do it poorly, they are doomed to failure or at best, to mediocrity. In experienced collaborators, especially, are in danger of making mistakes in identifying educational needs and interests. Needs that may seem obvious to a professional health personnel or to a social worker may not seem real to the adults in the neighborhood. On the other hand, if the program is limited to needs recognized by adults, it is likely to remain underdeveloped or to grow slowly. Collaboration among different agencies is very much possible, provided that agencies concerned would focus on providing the best care possible instead of getting too stuck with agency competition. Agencies must also learn to identify with the mission, vision and identities of their counterparts, to gain more understanding on the strengths and weaknesses of each. Collaboration between NHS and social service can be done well, provided that they allow themselves to have unity in direction and diversity in contribution. References: Oliver, M. (1998) Theories in health care and research: Theories of disability in health practice research. BMJ. 1998. 317. p1446-1449. Thomas Lovitt, 1995, Learning Disabilities, p.27, Allyn and Bacon James Tamm, Ronald Luyet, 2004, Radical Collaboration, p.21-50, Collins Deborah Deutsch Smith, 1994, Teaching Students with Learning and Behavior Problems, p.48-50, Prentice Hall Seden, J. and Reynolds, J. (2003) Managing Care in Practice. Routledge: London. Thompson, T. and Mathias, P. (1998) Standards & Learning Disability. 2e Bailliere Tindall: London Thompson, J. and Pickering, S. (2001) Meeting the Health Needs of People Who have a Learning Disability. London: Bailliere Tindall . Read More