Working in Partnership in Health and Social Care - Research Paper Example

Working in Partnership in Health and Social Care Introduction There are different philosophies that have been generated for the purpose of facilitating partnerships between different healthcare institutions in the health and social care sector (Glasby and Dickinson, 2008). These philosophies include factors such as interdependence, empowerment, power-sharing, respect, and autonomy (Glasby and Dickinson, 2008). For partnerships to be successful there has to be excellent communication in the multi-disciplinary groups that are functioning together.  This will then result in the creation of the high quality services which are well co-ordinated across diverse care settings (Freeman and Peck, 2006). Service users are the ones who experience inconveniences due to such realities. In future, agencies in the health and social care sectors may seek to improve service delivery in order to make the best use of limited resources, and in order to improve their responsiveness. There are different types of barriers that may be encountered by organizations that seek to enter into partnerships in the health and social care sectors (Stafford, Nazroo, Popay, and Whitehead, 2008). Structural barriers may include factors such as the fragmentation within organizational boundaries of service responsibilities. There may also be procedural barriers such as differences in the way the parties involved each determine their budget as well as planning cycles. Financial barriers may include differences in resource flows as well as funding mechanisms where each of the organizations involved are concerned (Glasby and Dickinson, 2008). Some of the most common barriers, however, develop as a result of differences in matters concerning values, ideologies, and professional interests. (LO 1.1- Explain the philosophy of working in partnership in health and social care) There are different ethical dilemmas that confound corporations in the social and healthcare sectors which opt to enter into joint partnerships. Though the healthcare sector has always been plagued by ethical concerns, the increase in partnerships between organizations in the social and healthcare sector has merely served to increase the ethical problems. The main ethical issue, as revealed by the Staffordshire scandal. The Francis Report revealed that the reason why the hospital experienced organizational degradation was because of systemic causes. The report also revealed that the main fundamental causes of the collapse of service provision functions centered around basic uncorrected faults in the institution’s culture (Glasby and Dickinson, 2008). The Francis Report also revealed that there were serious weaknesses being experienced by NHS operations which were meant to deal with factors such as accountability, oversight, and the provision of quality care to patients. From this report, it is evident that the principal concern has to do with whether the organizations involved in partnership can retain their cultural, as well as communal objectives once they enter into partnerships with other organizations either in social or healthcare sectors which may not have identical values. It is a recognized fact that organizations in the social and health care sectors have different methods of achieving seemingly similar objectives. These differences are important because they are the ones that define any organization’s unique culture. When a partnership is forged between institutions in the social as well as healthcare sectors, such differences in organizational culture will inevitably present considerable ethical challenges. For instance, partnerships have the potential of generating the undermining of the cultural strengths of both parties involved. In addition, other realities such as financial pressures can result in staffing reductions or other adverse job changes within the companies involved. From the workers’ point of view, this is quite unethical as the employees have a right to be treated with respect, integrity, and fairness. In addition, the individuals who take part in forging partnerships may be overly concerned about the importance of providing fair deals for the parties that are involved and so may over think the contract, which could cause additional problems (Hudson, 2004). There are also ethical issues that may be attached to employee preferences. For instance, workers may want to work with a given medical institution because they like its focus on delivering quality health care, or admire its reputation. A partnership will not just affect their perception of their employer, but also impact working relationships. The British health and social care department of government has made serious steps into fostering partnerships in the recent past. In the healthcare sector, partnerships refer to joint projects centred on mutual interest that are created by two agencies, individuals, or even government organisations. Current service systems in institutions in the social and healthcare sectors may not be able to function well in mutual alignment due to the existence of a basic underlying division between firms in different sectors, which may have completely different ways of working and priorities. It is the central government which is in a position of power which helps in changing the way these firms operate. There are different legislations that support the formation of partnerships in the health and social care sectors (Gov. UK., 2014). These legislations are centred on encouraging the active involvement of service-users, establishing the need to gain patient consent prior to carrying out life-saving practices like surgeries, and regulating the provision of services related to health and social care in conjunction with state as well as government authorities (Glasby and Dickinson, 2008). Philosophies of Working Partnerships In regards to empowerment, the healthcare-related organisations in question have to seek to empower each other’s abilities to coordinate functions. This is important because it helps the partners to be able to realise their targeted goals (Glasby and Dickinson, 2008). When health-related organisations function as partners, they have to rely on each other for social and economic support. This type of interdependence also contributes to information sharing, where significant decisions have to be made. For example, in the healthcare sector, an institution, which specialises on social care can work together with a charity organisation which furnishes it with health items for the care of geriatrics (Hudson, 2004). According to Midstaff Public Inquiry (2014) any kind of partnership between individuals or organisations will require the existence of mutual respect, which works to enable the smooth flow of different operations; thus generating a better inter-organisational relationship. Mutual respect is necessary for making informed decisions that will be advantageous for the partners. For example, an institution that provides medical establishments like clinics with drugs has to constantly deliver them at the opportune time in order to avoid the prospect of shortages within the establishment. From the Mid Staffordshire NHS Foundation Trust inquiry, it is evident that organisational partnership relations in the health and social care sectors have not worked well or had much of a positive impact on the delivery of healthcare services. For example, the Mid Staffordshire NHS Foundation Trust inquiry provided proof that the needs of the majority of elderly people were ignored because the health workers felt that they were ‘someone else’s problem’ (The Health foundation, 2014). According to The Gaurdian (2013) when legitimate complaints were launched, the hospital even refused to acknowledge their veracity. The reality is that responsibilities in the hospital were often passed down the hierarchy, with different levels of workers, from the operational managers, to the senior as well as junior nurses refusing to personally take responsibility for the care of different patients. There was also a lack of communication between the institutions that were expected to worked together in order to realise the objective of providing excellent patient care. (LO 1.2 Evaluate partnership relationships within health and social care services) According to The Health foundation (2014), past research studies have revealed that health networking is something that contributes to the innovation of health and social care. This has resulted in the creation, by the NHS, of 25 local networks. It is an established fact that the type of quality of healthcare services that are provided for elderly patients cannot be realised without the collaboration of healthcare organisations which work in partnership to provide the best levels of care. In health and social care joint ventures, it is necessary for institutions to collaborate before integrating. (LO 2.1 Analyze models of partnership working across the health and social care sector) There are different types of partnerships that characterise the health and social care sector. These include ethical partnerships, project partnerships, ideological partnerships, and problem-orientation partnerships (Stafford, Nazroo, Popay, and Whitehead, 2008). Partnerships generally have different qualities within the healthcare sector. There are some which advocate for the separation of companies with legal identities. There are others that support the formation of virtual organisations in which the partners in question will form separate identities that have no legal measures involved. According to Freeman and Peck (2006), there is the co-allocation of workers from partnering organisations, and the formation of steering groups that are compelled to deliver coordinated services across corporate boundaries (Freeman and Peck, 2006). There are different types of partnerships that can be created between organizations in the social and health care sectors. These include the theoretical, practical, and unified models. The practical model is centred on meeting the requirements of a multiplicity of partners. The practical model also seeks to impact an institution’s environment, as well as its capacity to take part in partnerships. The theoretical model of partnership is mainly focused on incorporating fundamental aspects for the purpose of increasing the healthcare sector’s capacity in order to effect improvements in an environment that is increasingly being exposed to resource constraints (Midstaff Public Inquiry, 2014). The theoretical model usually uses a set of elements that endorse the system of reflecting on how to use different mechanisms to effect positive large-scale changes. The unified model of partnership, on the other hand, is based on a holistic interpretation of all the different facets involved in social as well as healthcare institutions. This theory does not just develop the organizations in question, but also the surrounding community. (LO 2.2 Review current legislation and organizational practices and policies for partnership working in health and social care) Legislation and organisational practices and policies There are different legislations as well as organizational policies that directly impact partnerships in matters concerning social as well as health care. There is the Equality Act of 2010, the Disability Discrimination Act of 2005, and the Care Standard Act of 2000. The Equality Act was enacted to do away with any kind of indirect or direct discrimination; including incidents of harassment and victimization. The Care Standards Act, which was passed in 2000, caters to matters concerning the administration of different care institutions such as independent hospitals, children's homes, residential care homes, and nursing homes. It officially replaced parts of the 1989 Children’s Act, as well as the 1984 Registered Homes Act; both of which dealt with the care of children. The Disability Discrimination Act, which was passed in 2005, bans discrimination on the basis of disability, among other factors. From the case of the Staffordshire Hospital, it is evident that the national regulations that govern the dispensation of health care practices were not used. The White Paper stipulated that any licensing scheme used by social care employees also had to be used for the support of healthcare workers. While this was attempted to some extent by the beleaguered hospital, the existing differences in culture seem to have worked against its successful realization. The Francis Report revealed the existence of a menacing, and negative culture that permitted the existence of poor standards within the hospital. The report also revealed that the difference in cultures also resulted in a disengagement in terms of leadership and managerial responsibilities. LO 2.3 Explain how differences in working practices and policies affect collaborative working The health and social care sectors have a number of assorted workers. There are hospital staff, who make up approximately 40% of the workforce, carers who perform social work activities, and other personnel involved in human health activities. Even though partnerships have always existed between structures in these different sectors, they have not always been efficient in the provision of services. This is because for effectiveness to be achieved in partnerships there would have to be policy reforms that are geared towards pooling budgets and establishing joint commission services. It would also be necessary for new models of service provision to be created in order to ameliorate some of the hardships encountered in working across boundaries How Working Practices and Policies influence Collaborative Operations Differences in terms of working practices have resulted in many inter-organisational conflicts in the past. This is something that hinders the effective delivery of social and healthcare services to healthcare service users. According to The Guardian News Blog (2014), differences in assessment techniques are also factors that could result in low productivity. Partnerships in any sector are a challenging undertaking. This is because the parties that are engaged in shared projects have to share so many resources. The Francis public inquiry which investigated the Mid Staffordshire Hospital scandal revealed that the staff perpetrated errors of omission, rather than commission. This means that the existing partnerships between social and health sector personnel, where the elderly are concerned, were not based on mutual understanding. According to The Guardian (2013) some of the hospital’s personnel would assert that the situation in the hospital was worsened by the lack of adequate communication mechanisms between different health-related institutions. According to The Guardian (2013) partner institutions which worked together to care for patients in the Staffordshire hospital were engaged in turf wars, and health practitioners regularly displayed territorial behaviours. It was evident that the reputation of the medical workers was more important, in many instances, than the care given to the patients. There was also a lot of mutual stereotyping which adversely affected the communication between different levels of medical workers. Moreover, partnerships in the social and health care sector also have many advantages. For example, they can find ways of offering high quality services that are also well-coordinated. In the health and social care sectors, partnerships also encourage the creation of additional employment as well as training opportunities for medical practitioners such as doctors and nurses while also benefiting social workers. According to The Guardian News Blog (2014), the Francis Inquiry proved that safety cultures are a natural result of partnerships between different institutions in the health and social care sectors. (LO 3.2 Analyze Potential Barriers to Partnerships in the Health and Social Care Sector) Potential Barriers to Partnerships in Health and Social Care Services Most workers who held special positions in their own organizations may fear that their legitimacy will be challenged if the partnership is successfully effected. They feel that their status will be undermined and so do not support the partnership fully. There may also be a lack of proper incentives to encourage workers to embrace the partnership. According to The Guardian News Blog (2014) one of the reasons why conflicts arise in partnerships is because of the non-existence of clear organisational boundaries. For example, in a partnership between a non-governmental organisation and a hospital, there will be definite conflicts if the organisations in question do not clearly define each partner’s responsibilities. In addition, both partners have to be committed to realising mutual goals and not individual interests. The reluctance to commit to fulfilling the goals of partner organisations is something that has led to underperformances in the cases of hospitals such as the Staffordshire hospital. According to Gov. UK (2014), the Francis Inquiry established that the social care centres that worked in league with the hospital were not eager to take on more patients owing to the reality of limited financial resources for their care. This means that there might have been financial responsibilities that were meant to be met by the hospital, but were not forthcoming. The reluctance to share information also resulted in poor coordination between these two organisations. According to BBC News (2013), the Francis Report revealed that this was not an intentional result on the part of the Staffordshire hospital, or its social care partners, but rather the outcome of inadequate preparation mechanisms such as the allotment of time necessary to overcome initial problems encountered in preserving the partnership. If workers are not well informed about the fact that partnerships take time to create, they will be easily discouraged when all operations do not go according to plan once the partnership is agreed upon. This could result in lagged operations which are carried out by staff who do not believe that the partnership is viable. There are other factors such as inadequate funding, the influence of political elements that are not eager for partnerships for one reason or the other, and the existence of inhospitable cultures in the different organisations. In the Francis Report, it was also revealed that factors such as the constant re-organisation of functions result in delays in the partnership process (BBC, 2013). (LO 3.3 Strategies to improve Outcomes for Partnership Working in the Health and Social Care Sector) Improving partnerships between different agencies in the health and social care sector is something that can only happen if the existing barriers are identified and swiftly removed. This may call for workers in different agencies to encourage the use of factors such as multi-disciplinary teams, deal with areas of duplication of duties as well as overlap which negatively affects efficiency, make sure that there are working discharge processes, improve communication systems, and improve out-of-hours support arrangements (Freeman and Peck, 2006). Another way in which organizations that enter into partnerships can improve their success is by emphasizing on the importance of realizing high quality care services from the lower levels, to the uppermost levels. This cannot be achieved without real emphasis being placed on the importance of concentrating on other objectives rather than individual development. The Francis Report revealed that the lack of a culture that was centered on delivering good and timely services to patients was the main cause of the Staffordshire Hospital’s shocking lack of care. One way to counter this is by generating a culture of compassion, safety, and learning, which is based on openness and cooperation between workers in the different organizations that are in partnership (The Guardian News Blog, 2014). In the first place, any organizations, such as the Staffordshire hospital, which have experienced a serious lapse in image, have to try and convince stakeholders such as service users, patients, and their families, that they are welcome to any part of the organization. In addition, the hospital can hire talented and skilled frontline staff who can stimulate change by altering their values as well as behaviors, and operating in strong teams. There is also a need for the leaders of the organizations that are involved in partnerships to exercise their responsibilities in ensuring that their branches provide specialized and personalized care. In addition, external structures such as regulators, local scrutiny firms, commissioners, and the local government have to be inspired to seek to ensure that hospitals such as the Staffordshire deliver adequate care to all patients. This can be achieved by creating benchmarks, setting methods of accountability, and maintaining structures (BBC, 2013). Recommendations The Francis Report revealed that apart from the problems caused by negative culture, there was also a lack leadership witnessed at different levels of leadership within the hospital, as well as organizations in the social care sector that had partnered with it. According to the Francis Report, there were failures in leadership from the upper-most levels of management which are usually involved in decision-making and the creation of rules, decision, and incentives, to the lower levels, identified as the frontlines, which provide care for the patients. This lack was due to the absence of collective leadership agreements at all levels of the hospital’s management. Such collective leadership is also important because it integrates leadership properties across the firms involved in partnership. Integrated care is not an easy thing to achieve, for even the best of hospitals. To attain it, there has to be a visible distribution of responsibilities of leadership on all levels of management within healthcare organizations. In most partnerships in the healthcare sector, the roles of followership and leadership change as a result of depending on requirements that are constantly changing. When accurately implemented, collective leadership stimulates a culture in which compassionate and high-quality care is provided beyond the limits of specific medical establishments. This results in the generating of an inter-dependent system of organizations that operate in sync in order to supply high-quality care to service users as well as patients. Conclusion The aim of partnerships in the health and social care sectors is to function in multifaceted arrangements between two or more health related firms with the aim of improving the performances of the organisations that comprise the partnership. Partnerships are always complicated affairs that involve activities like employee training, planning, the assessment of service provision practices, and the generation of genuine relationships with the service users. Owing to the innate sensitivity of the enterprise, a joint venture can easily be forced into being under productive owing to different complications. To avoid such possibilities, any partnership should create certain regulations which will determine the moment-by-moment progress of operations. References Allouche, J. ed., 2006. Corporate social responsibility, Volume 1: concepts, accountability and reporting. Basingstoke: Palgrave Macmillan. BBC News., 2013. 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About the Francis Inquiry, [online] Available at: http://www.health.org.uk/areas-of-work/francis-inquiry/about-the-francis-inquiry/ [Accessed 5 June 2014]. Read More