Working in Partnership in Health and Social Care - Case Study Example

Working in partnership in health and social care Introduction: Recently, there has been a shift in labour’s social policy with a need to build and strengthen partnership and collaboration between health delivery and social care delivery (Glasby & Dickinson 2008).Social care refers to health services that a patient requires but is not medical such as helping in dressing, bathing, and feeding among other services that a person may not render themselves due to medical complications. This paper is a report of the evaluation of Francis report about the mid Stafford shire NHS foundation trust. The report has it that many patients die in the hospital as a result of failure and neglect caused by management or agencies. This paper is a report of the evaluation of Francis report about the Mid Stafford shire NHS foundation trust. The report revealed that many patients die in the hospital as a result of failure and neglect caused by management or agencies. In this case, the partnership between health care and social care will be evaluated in order to see how the cases such as that of Mid Stafford shire NHS foundation trust can be mitigated. Section A: The philosophy of working in partnership in relation to Robert Francis inquiry and Healthcare Commission reports Recently, there has been a shift in labour’s social policy with a need to build and strengthen partnership and collaboration between health delivery and social care delivery (Davey et al. 2005). It is important to note that when health and social care work together, the lives of vulnerable children and adults are improved and safeguarded. Health delivery and social care partnership comes with a package of advantages. For example, the partnership streamlines assessment and ensures that families do not duplicate information to different health professionals. This way, a health and social care professional will share information regarding a patient’s condition and this ensures that there is no contradiction in the methodologies and approaches they use to handle a situation (Asthana & Halliday 2003). The Robert Francis inquiry report of February 2013 and the Healthcare Commission of 2008 revealed massive failure at Stafford hospital because of over-worked and unqualified nurses who between 2005 and 2008 did not handle the hospital equipment as required because of their limited skills (Smith 2009). Social care comes in to ensure doctors concentrate with medical issues and social care givers concentrate with social care. However, if the medical doctors are left to give both, they are overworked and exhausted and their skills will not only be limited because of lack of specialisation, but also their experience will be wanting. If there was such a partnership at Stafford hospital there would not have been cases of negligence that led to massive loss of lives. In addition collaboration between health providers and social care workers will ensure information sharing between professional for the benefit of professionals. In the case of Mid Stafford shire NHS foundation trust, if there were partnerships between the health providers and social care workers, the health providers would have less time to evaluate a patient. A lot of time is taken when a patient moves from home where a social care worker has been handling him only to be referred to a hospital to a health professional; who starts the diagnoses all over again. If the health professional was to start from where the social care worker stopped; this would ensure efficiency, effectiveness and accuracy in diagnoses and treatment approaches (Asthana & Halliday 2003). For example, the Robert Francis inquiry report of February 2013 revealed that at Stafford hospital patients were neglected for hours in dirty bedclothes while reception staff was supposed to judge the seriousness of accident and emergency cases. The judgment for the seriousness of an emergency condition should be done and can accurately be done by a social care provider rather than a receptionist. If there were partnership between health and social care at the hospital, much of the negligence would not have arisen. Moreover, social care would provide even first aid services like dressing and cleaning bedclothes. At Stafford, what lacked at the time the shocking deaths were recorded was social care. It seems doctors and the professional staff concentrated on medical care and forgot social care which is extremely important for both adult and children patients. Evaluate the effectiveness of partnership relationships within Health and Social care Partnership between health and social care ensure health service efficiency in the whole health care system. This is because when the two work together, they are able to coordinate and provide care to patients together (Crawford 2011). For example in the Healthcare Commission report of 2008 revealed that at Stafford shire NHS foundation trust, patients were left to drench in their own urine while others were left thirsty to drink themselves from vases. These are social care services which if there was a [partnership between health and social care, some of these gaps could have not existed and people’s lives could have been saved. In some instances, lack of collaboration between health and social care results to health and social care disrupting each other. Where there is a partnership, the care is well planned and commissioned care services. It is not shocking for Francis inquiry report to reveal that at Stafford, some patients were given wrong medication; others were not given medication at all (Smith 2009). Without the collaboration between health care and social care, health care givers do not have enough background for patient’s sickness. They can do a misjudgment and end up messing their patients. This is also so because health providers work under pressure because many patients are waiting in line. However, if they had collaboration with social care, some patients would be easy to handle and help. For example, a patient who has been at home under social care had a simple case and handling known by the social care giver. The social care giver knows the best medication that worked and that which never worked. If such an advice can be heeded by a medical practitioner, cases of incorrect medication and wrong prescription would not arise. Where partnership is lacking, the doctor is likely to have no background information and is likely to end up giving ineffective medication, wrong medication or delay in giving medication so as to generate their own history so as to accurately judge the case in their hands. Therefore, defining health care and social care is significant in coming up with the best methodology for integrated health care and social care. The cause of most healthcare appeals and disputes are errors of defining care needs in the UK (Scragg 2006). There are patients such as elderly sick, children and those under palliative care who require extensive nursing care at the hospital. Some require 24 hours care but are dismissed as needing social care alone. If the healthcare and social care are integrate, patients would be served effectively and efficiency would come back to the hospitals. Section B: Analyse models of partnership working across the health and social care sector Today, there are various models of partnership working across the health and social sector for a common goal. For example, multidisciplinary services and or teams which include health and social care professionals like community mental health teams or child and adolescent mental health services may come together to form a one working network in which they compliment their services. These multidisciplinary team models ensure they compliment one another in a way that the patient benefits (Glasby &Dickinson 2008). The model is effective because the patient’s case is given a specialised approach at each level and not one particular time a certain service will be rendered by a non professional. The Healthcare Commission and the Francis inquiry reports revealed that at Stafford hospital and other places under the trust unqualified nurses were left to mishandle patients and hospital equipment while doctors with no experience were left to handle complex cases such as surgery (Smith 2009). With a multidisciplinary approach, no such cases would arise. This is because the model provides and room for wide consultation within various departments and specialisations. The same would happen if the social care and healthcare work in a partnership. Social care givers would advice doctors on what has been working for the patients, which case should be handled as emergency and which ones needs to undergo nursing awaiting treatments and so on. Another model that has been there is the joint commissioning by local authorities as well as primary care trusts and NHS boards. This model ensures that relevant stakeholders are involved in equal partnership to oversee and supervise health service provision in a given country. An example of a partnership born of such coordination is the multi-agency locality joint mental health planning group (Glasby &Dickinson 2008). Moreover, the same partnership between councils and NHS organisations ensures they pool budgets for the benefit of patients. There can also be a partnership in which working is integrated across community health services. In this case, the senior health and social care managers, teams and staff develop joint policies, and work together to ensure they target a common organisational objectives of health and social care provision in which they target the patient, not any other set objectives outside the patient (Asthana & Halliday 2003). This would ensure that the patient is at the centre of healthcare and social care. For example, the massive failure and negligence at the Stafford hospital and other trust centers was attributed partly to the hospital working to meet government requirements. Since the government had put a four hour mark for trusts to attain, the care providers were more into meeting the government set standards at the cost of offering poor and substandard healthcare (Smith 2009). The report also blamed the trust for working tirelessly to save £10 million from its annual budget; which would accrue to its PR and neglecting patient’s plight. This way, if they had established an integrated partnership where they work together, they would not have been duped into PR and marketing and forgotten their professional duty to their patient first before any other person or body; including the government and need for marketing. Review current legislation and organizational practices and policies for partnership working in health and social care There are various legislations in the UK that point for partnerships working between healthcare and social care. The first one is the mental health act which establishes a collaborative working health and five local authorities (Rutter et al. 2004). The health act establishes a situation in which health and five authority consortiums bring their resources together for the purpose of implementing mental health act by jointly training teams from health and social care. The partnership also ensures joint legal consultation services in line with the best interest of all professionals across the partnership relationship. There is also the mental capacity act that establishes a joint working between health and five local authorities (Rutter et al. 2004). Through the act the partners pool resources to develop on going multi-agency joint training packages. The act also develops a memorandum of understanding between health and five local authorities in relation to mental capacity act. The act also requires the partners to jointly appoint and commission a project manager to implement the act by ensuring collaboration working across health and social care. Another one is the deprivation of liberty act which establishes a pooled budget for implementing the best interests for patients requiring social care and healthcare. The act also requires provision of training across multi agencies in which the social and health care; especially independent mental capacity advocacy is effective and just for patients (Davey et al. 2005). Legislation is on mental health adults where a joint adult mental health strategy is established with collaboration between health and social care. The requirement ensures that health and social care work together in monitoring and commissioning third sector level agreements without considering the organisation that does the funding for the services. The legislation also ensures that joint health and social care provide appropriate socially inclusive 24 hour care for adult and older mental health services to needy patients. Other policies include the substance misuse, learning disabilities, and older adult mental health. All these legislation and policies ensure that health care and social care services partner and offer their services together so as to achieve the sole objective of serving the patient as their first priority. Explain how differences in working practices and policies affect collaborative working The difference in working practices and policies can affect collaborative working between health and social care professionals. These differences can inhere from various factors which are worth identifying and discussing. For example, there are organisational issues in which the professional’s policies and practices may be aiming at different objectives. The value of partnering between health and social care is anchored on the understanding each other’s objectives and aims. As such, it becomes a challenge when it comes to establishing a common and shared objective for the partners. Studies have proved that there is always lack of understanding of the philosophies, aims and objectives of partnering among the integrated health professionals (Clarkson et al. 2011; Glasby, Martin & Regen 2008). When the partners fail to understand aims and objectives, they struggle to establish their purpose at operational level and this poses another challenge of who should make decisions and who should take responsibility. These differences affect specific elements of practice within the partnership initiative (Scragg 2006; Rutter et al. 2004). Since the aim of the collaborative initiative is to provide healthcare and social care integration, these differences are felt by the patient. Section C: Possible outcomes of partnership working for users of services, professionals and organisations Partnership between healthcare providers and social care providers has possible outcomes some of which have proved to be measurable and attainable. The partnerships commit health and social care professionals and agencies to putting resources together so as to provide a collaborative health and social care packages in support of their patients at home and at hospital. For example, the Healthcare Commission findings revealed that in Stafford hospital, patients were not provided with social care services such as washing their beddings and the rooms they were accommodated (Smith 2009). Such services could have been provided with a partnership between health and social care professions. There is usually confusion in the UK as to the difference between healthcare and social care. For example, social and nursing care is supposed to be provided for free. This way, the doctors may feel that they are not supposed to be providing free services while there are paid healthcare services. Partnering with social care professionals will ensure no service provision is neglected and that patients benefit from the collaborative initiatives. Moreover, partnership working between health and social care professionals ensures shared work processes. For example, partnering will ensure assessment and allocation is done by a certain group and the other does the rest of the part. This means the teams and groups will appreciate the role of the other and work towards making their service provision better and successful for the benefit of patients. This is possible when there is clear cut line management for different professional teams. Partnership also brings together different and shared visions, objectives and aims so that the patient gets a comprehensive service which is multidisciplinary and multi-strategic (Asthana & Halliday 2003). The outcome of shared vision and development through new service models is better health and social care provision. In this case, all staff at all levels are involved and continuously engaged. For example, there will be no patients without an attendant. Most negligence at hospitals is noted when some patients have no one to attend to them. Therefore, partnering will ensure every patient has a professional to attend to, medical equipment has skilled and qualified persons to handle and this will ensure cases of unnecessary deaths are limited. Potential barriers to partnership working in health and social care services There were many barriers to partnership working in health and social care than can be enumerated and each day, different challenges are coming up. For example, studies have proved that lack of understanding on the new initiatives after partnering could result to unclear roles and responsibilities among the agencies and professionals involved (Douglas 2008). This may also be as a result of the new procedures and policies that are established when the parties agree to work together in such a partnership. Another barrier to partnership working in health and social care is the organisational difference. This is where for instance; there are cases of competing organisational visions at strategic level of management. Lack of agreement on the organisation that need to lead and the one which should take instructions is known to undermine partnerships. Some studies have linked failure of some partnerships to differences in resource as well as spending criteria between the local authorities and NHS partners (Glasby & Dickinson 2008). This is also made worse by the fragmentation of services that makes it not uniform when location differences come into play. For instance, where the partners are at different locations which are far away from each other, referrals processes could be complex. In addition, location distance challenges make the professionals to struggle in their response to programs of care (Pollard et al. 2009). This way, the organisational differences and location of the partnering sides becomes an impediment to collaborative healthcare and social care provision. Another barrier to partnership working is lack of proper communication across the professional or agency boundaries. Communications, whereas it can be linked again to the issue of distance and location of the partnering institutions, can result from lack of strong management and professional support. If such cases arise, the health professionals and social care professionals feel unsupported and neglected (Pollard et al. 2009). There are also cultural and professional issues such as negative assessment and professional stereotypes. These factors can undermine joint working at management and operational level. These factors, if not considered when having joint training and team building undermines the partnership and the professionals fail to get opportunity to inform professionals about new services under the policies and procedures established. Strategies to improve outcomes for partnership working in health and social care services In order for the partnership between health and social care services to work successfully, there is need for strategies that can improve the outcome of such collaboration. For example, all health and social care practitioners should reconcile their professional values and roles so as to work towards a common objective under the joint initiative. This can be done by also ensuring that the outcomes for service users and careers are defined clearly from the start in order to ensure every practitioner appreciate the benefits of the partnership to their clients. There is also a need at organisational level to ensure new partnerships and their collaborative services are developed and that every stakeholder understands the aims and objectives (Asthana & Halliday 2003). This should be done and communicated in a way that every partner also appreciates the relevance of the initiative to their context. If this is done, no organisation will feel short charged or undermined in terms of service delivery or decision making. Another strategy to ensure partnerships work well is to define outcomes that matter to service users and carers. This is important because service user outcomes may be different from the policy and practices established and this helps the professionals to get first hand information from the people who use the services. Therefore, promoting user involvement, choice and control is significant in ensuring partnerships work successfully and sustainably. In conclusion, working in partnership between health and social care is an inevitable phenomenon in the medical service profession given the Francis report of 2013 and Healthcare Commission report of 2008 on the failures and neglect that patients undergo where services are not all round. Partnerships with health and social care providers have been proved to be effective in giving comprehensive and multidisciplinary approaches to health care. The paper has also discussed some models pf partnerships that have worked across the health and social care sector in the UK. There are also legislations that have been mentioned in connection to giving integrated and collaborated health and social care. The way differences in working practices affect collaborative working between health and social care has also been highlighted. Although there are successes of health-social care partnerships, there are also barriers to such working but there are strategies that can be employed to mitigate the barriers. Reference List Asthana, S. & Halliday, J. 2003. “Intermediate care: its place in a wholesystems approach”, Journal of Integrated Care, vol 1, no 6, pp 15−24. Clarkson, P. et al. 2011. “Integrating assessments of older people: examining evidence and impact from a randomized controlled trial”, Age and Ageing, vol 40, no 3, pp 388−391. Crawford, K. 2011. Interprofessional Collaboration in Social Work Practice. (Sage Library of Educational Thought & Practice), Sage Publications Ltd, London. Davey, B. et al. 2005. “Integrating health and social care: implications for joint working and community care outcomes for older people”, Journal of Interprofessional Care, vol 19, no 1, pp 22−34. Douglas, A. 2008. Partnership Working (The Social Work Skills Series), 1st edn, Routledge, London. Glasby, J., Dickinson, H. 2008. Partnership Working in Health and Social Care (Better Partnership Working), Policy Press, Bristol. Glasby, J., Martin, G. & Regen, E. 2008. “Older people and the relationship between hospital services and intermediate care: results from a national evaluation”, Journal of Interprofessional Care, vol 22, no 6, pp 639−649. Pollard, K., Thomas, J. & Miers, M. 2009. Understanding Interprofessional Working in Health and Social Care: Theory and Practice, Palgrave Macmillan, Basingstoke. Rutter, D. et al. 2004. “Internal vs. external care management in severe mental illness: randomized controlled trial and qualitative study”, Journal of Mental Health, vol 13, no 5, pp 453−466. Scragg, T. 2006. “An evaluation of integrated team management”, Journal of Integrated Care, no 14, no 3, pp 39−48. Smith, R. 2009. NHS targets may have led to 1,200 deaths in Mid-Staffordshire. Accessed from . Read More