Health Service Focus

30.11.15

A better partnership approach for integrated health and social care

Source: NHE Nov/Dec 15

Sharon Allen editSharon Allen OBE, chief executive of Skills for Care and the National Skills Academy for Social Care, talks to NHE about tackling cultural issues to deliver integrated services.

Delivering integrated health and social care services effectively will depend on partnerships rather than structural reorganisation, according to the chief executive of Skills for Care. 

Sharon Allen OBE told NHE that there are still large cultural issues to overcome to deliver a seamless experience for the patient and service user. 

“There is a massive cultural issue we have got to address, and I think the early evaluation of the work that has gone into the Integration Pioneer sites shows this very clearly and that the cultural issues are very often what trips us up,” she said. “But they are things we can address by learning together, by sharing information and by working from a basis of mutual respect and starting from the position of ‘how are we going to support the person in the community together’, rather than saying ‘my organisation needs me to do this, and mine does this’.” 

Most evidence suggests that while integration does indeed provide better outcomes and can reduce hospital admissions, it is not necessarily able to deliver the huge financial savings sometimes envisioned. 

But Allen told us of a project in Bath and North East Somerset where local nurses worked with care staff across three residential care homes. She said: “We skilled those staff up so they could undertake some of the more basic tasks, which might previously have been seen as a nursing task only.” 

An independent evaluation confirmed that project did save money, with the savings arising out of the workforce changes and reduced hospital admissions.  

Looking at the workforce 

The Integration Pioneers and the vanguards are already forcing new thinking about the workforce and what roles will be needed. 

Allen said: “We need to look at this both from the perspective of new roles that we might need – so people are looking at hybrid worker roles such as a care navigator – and thinking about how we use the current workforce, which is going to still be with us in 20 years’ time.” 

Allen, who has worked in social care across the public and voluntary sectors for nearly 30 years, said it is easy to think there just needs to be lots of new roles. Instead, there should be a mix of work and looking at how roles are best used. For example, can having a social worker in health teams enhance their capabilities and reach? 

Wellbeing fundamentals 

Allen is also an advocate of place-based integrated services to deliver and promote wellbeing for patients. 

“I don’t know how you can talk about promoting wellbeing if someone doesn’t have somewhere safe, affordable and secure to live,” she said. “Housing, social care and health, I would suggest, are the three absolute essentials if we are talking about wellbeing.” 

But having a fulfilled life also requires good access to things like leisure, transport and skills development, she added. 

Funding 

The funding gap for social care is estimated to grow by a minimum of £700m a year, chiefly as a result of rising demand, exacerbated by the introduction of the National Living Wage. Hitting NHS efficiency targets by 2020 will be impossible if social care is not properly funded, NHS England boss Simon Stevens says. 

Allen told us: “Obviously, what we are all trying to do is keep people out of hospital. And when people do need to go into hospital, we get them back home again as quickly as possible. But you can only do that if you have the services available locally, and we can only provide those services if you can recruit and retain a quality workforce.” 

The Spending Review had not yet happened when we spoke to Allen, but she said everybody was hoping to see a better settlement for social care. “This would mean that local authorities can fulfil their duties under the Care Act and they can work in true partnership with providers of social care, which are predominantly in the independent sector. [It would mean] work in partnership with their colleagues in health so we are not fighting over budgets but are actually using the resources we have together to produce good outcomes for citizens,” she said. 

We asked Allen to describe how the health and social care landscape could look by 2020. She said: “The ambition is that we will stop talking about the whole health and social care system and we will just have a system from the point of view of citizens. 

“I don’t think that this necessarily has to involve lots of structural integration. In fact, I think people are weary of reorganisation and structural change – but what we can do is have a much better partnership approach.”

Tell us what you think – have your say below or email opinion@nationalhealthexecutive.com

Comments

There are no comments. Why not be the first?

Add your comment

 

national health executive tv

more videos >

latest healthcare news

RCGP: Comprehensive plan for handling winter pressures ‘vital’

14/07/2020RCGP: Comprehensive plan for handling winter pressures ‘vital’

With annual winter pressures and a potential second wave of the coronavirus risking coinciding, the Royal College of GPs (RCGP) has called f... more >
Manchester University NHS FT health innovation campus takes forward steps

14/07/2020Manchester University NHS FT health innovation campus takes forward steps

A world-leading health innovation and precision medicine campus being established in Manchester, as part of a joint venture between Manchester Un... more >
NHS Confederation partner in new report to level up health in Yorkshire

14/07/2020NHS Confederation partner in new report to level up health in Yorkshire

NHS Confederation, Yorkshire & Humber Academic Health Sciences Network (AHSN) and Yorkshire Universities have combined their expertise to pub... more >

editor's comment

26/06/2020Adapting and Innovating

Matt Roberts, National Health Executive Editorial Lead. NHE May/June 2020 Edition We’ve been through so much as a health sector and a society in recent months with coronavirus and nothing can take away from the loss and difficulties that we’ve faced but it vital we also don’t disregard the amazing efforts we’v... read more >

last word

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad, president of the Association of the British Pharmaceutical Industry (ABPI), sits down with National Health Executive as part of our Last Word Q&A series. Would you talk us th... more > more last word articles >

the scalpel's daily blog

NHS at 72: Managing mental health services going forward

03/07/2020NHS at 72: Managing mental health services going forward

Sean Duggan, Chief Executive of the Mental Health Network Let’s take this opportunity to reflect on the amazing achievements of our health system over the past few months. But as we recognise the best of the NHS and its response to the Covid-19 crisis we must not forget that for mental health the peak has yet to come. Covid-19 has placed enormous pressure on the entire health and care system. Despite the very real hardships f... more >
read more blog posts from 'the scalpel' >

comment

NHS England dementia director prescribes rugby for mental health and dementia patients

23/09/2019NHS England dementia director prescribes rugby for mental health and dementia patients

Reason to celebrate as NHS says watching rugby can be good for your mental health and wellbeing. As the best rugby players in the world repr... more >
Peter Kyle MP: It’s time to say thank you this Public Service Day

21/06/2019Peter Kyle MP: It’s time to say thank you this Public Service Day

Taking time to say thank you is one of the hidden pillars of a society. Being on the receiving end of some “thanks” can make communit... more >
Nurses named as least-appreciated public sector workers

13/06/2019Nurses named as least-appreciated public sector workers

Nurses have been named as the most under-appreciated public sector professionals as new research reveals how shockingly under-vauled our NHS, edu... more >
Creating the Cardigan integrated care centre

10/06/2019Creating the Cardigan integrated care centre

Peter Skitt, county director and commissioner for Ceredigion Hywel Dda University Health Board, looks ahead to the new integrated care centre bei... more >
Helpforce to launch training programmes for NHS volunteers

10/06/2019Helpforce to launch training programmes for NHS volunteers

Kay Fawcett OBE, clinical advisor and education lead at Helpforce, and Lynn Twinn, talent development consultant, outline the new national traini... more >

interviews

Matt Hancock says GP recruitment is on the rise to support ‘bedrock of the NHS’

24/10/2019Matt Hancock says GP recruitment is on the rise to support ‘bedrock of the NHS’

Today, speaking at the Royal College of General Practitioners (RCGP) annual conference, Matt Hancock highlighted what he believes to be the three... more >
NHS dreams come true for Teesside domestic

17/09/2019NHS dreams come true for Teesside domestic

Over 20 years ago, a Teesside hospital cleaner put down her mop and took steps towards her midwifery dreams. Lisa Payne has been delivering ... more >
How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

24/10/2018How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

A dedicated national social care service could be a potential solution to surging demand burdening acute health providers over the winter months,... more >
RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

24/10/2018RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

The president of the Royal College of Physicians (RCP) has told NHE that the college’s new headquarters based in Liverpool will become a hu... more >
Duncan Selbie: A step on the journey to population health

24/01/2018Duncan Selbie: A step on the journey to population health

The NHS plays a part in the country’s wellness – but it’s far from being all that matters. Duncan Selbie, chief executive of Pu... more >