Partnership work is essential when providing person centred support and it also the only way to address some of the govements most challenging long term social objectives. The national services frame work for older people 2001 (24-25) also outlines expectations around integrated working bet between health services and social care agencies working towards a single assessment process and joint commissioning. The health act reinforces the importance of joint working
The white paper July 2012 also state about working together long term paths and goals for a single assessment proses all working together to ensure all needs are met and people are in control know where to go and how to access making it easier to get what you need and when preventing delays lack of support the wrong support etc.
Change work in partnership and provide the services people need and want in a streamlined and readily accessible manner. When organisations work closely together it has a positive impact on peoples lives. When they develop shared protocols and co-ordinated interventions, people are able to access and use services more easily and effectively. It requires innovation and leadership and leads to reduced time, cost and duplication as well as simplified and accessible services, which improve wellbeing. Successful partnerships need will address the tensions between structures and cultures particularly in relation to national targets.
They need to face the challenges associated with integrating services that are based on fundamentally different principles of governance and different types of central and local government accountability. The outcome is always to improve the quality of life and improved health and emotional wellbeing for all individuals using or needed services. At a time when the whole of the public sector must find significant savings, reports are saying: that integrated working across health and social care offers opportunities for efficiencies and improvements to services. Without it there is a risk of duplication and cost shunting where savings made by one organisation or sector create costs for others. And a lack of integrated working means that people are less likely to receive the best care.
Some of the Befits of good partnership working
Being able to offer a whole informed service
Being able to tap in to resource which other agency hold which leads to a better outcome for the service user
Assistance and help from appropriate people single assessment approach… helping the individual reduce the need to repeat their story to different professionals
Clear roles and responsibilities
Being able to put in place effective and safe practices around confidentiality and information sharing services user has a legal and moral right to know what information is being shared regarding them
The sharing of knowledge and good work practices
Services user and staff know when to access further support and how to gain that it in turn providing both with more confidence and better service provision and better outcomes for the services user
Benefits for people
Services designed to meet people’s needs
Improved choice and control
Independence and inclusion
Benefits for partnerships
Sharing of knowledge and understanding
Reduced cost, time and duplication
Strong local ownership
Benefits for organisation
Increased capacity to deliver community services
Increased satisfaction with the service
Improved performance assessment
Improving information sharing between professionals.
Improving the efficiency of the care system as a whole.
Co-ordinating the provision of care.
Improving the planning and commissioning of care so that health and social care services complement rather than disrupt each other.
Some of the general Problems with partnership working
Despite the introduction of government legislation and initiatives during this time to promote closer multi-agency partnership working there is still:
A lack of information sharing across agencies and services
Duplicated assessments to identify needs and subsequent provision
Poorly co-ordinated integrated activities across agencies
Too much ‘buck passing’ and referring on of clients between agencies
A lack of continuity and inconsistent levels of service provision
Despite longstanding support for joint working, it has been beset by problems across all client groups that have been found. Delayed discharges from hospital, mainly of older people. These involve cases when a patient cannot leave hospital because of the unavailability of health or social care services in the community or because of administrative issues within hospitals. NHS cuts to continuing healthcare. This has led to disputes between NHS and social care professionals and shunted costs on to councils, who often have to fund care packages for people no longer fully funded by the NHS. The break-up of community mental health teams. In some areas of England councils have withdrawn social care staff from mental health teams, run by mental health trusts, because of cost pressures or concerns over trusts’ approach to issues including adult safeguarding and the personalisation of care. A lack of NHS engagement in child protection and a lack of co-ordination of health and social care services for children. Pooled budgets have not translated into improved outcomes.
Formal partnership arrangements in some areas have been scrapped following disagreements between partners. More generally, barriers to good partnership working include: Health and social care agencies facing different government performance regimes. Health and social care agencies using different IT systems. Cuts in one budget creating demand pressures in the other. Health and social care staff being on different terms and conditions in integrated teams. Policy and legislation on joint working
Some of the agency challenges
Financial resources: conflicts within or between agencies, a general lack of funding, concerns about sustainability, staffing.
Roles and responsibilities: understanding the roles of others, conflicts over areas of responsibility, the need to move beyond existing roles.
Non-financial resources: Time, staff, Communication, Being able to talk to the right person at the right time, All parties getting the information, Build the communication link up, Getting the right people together.
Professional and agency cultures: Polices and procedure, training, ways of working, finances knowledge
Management: how the management work, how they train and inform the staff the working philosophy, support, structure Government plans and initiatives towards partnership working Under section 75 of the NHS Act 2006, NHS bodies and local authorities in England can pool budgets, join together their staff and management structures or delegate commissioning responsibilities to each other. The Local Government and Public Involvement in Health Act 2007 require primary care trusts and local authorities to produce joint strategic needs assessments of the health and well-being of their populations.
This should shape joint planning of services. The Health and Social Care Bill would establish health and well-being boards in every local authority area to co-ordinate the The 10-year plan for social services, published in 2011, also includes plans to drive integration, for instance by requiring councils and health boards to jointly commission and arrange enablement services, to support people to regain independence. Good practice in joint working
The while paper
Outcomes inspected by CQC…. etc.
What is working in partnership and why is it important
Partnerships are about a way of working together rather than about a way of meeting together they involve the dissolution of organisational service and sometimes geographical boundaries and are about overcoming the constraints that these can place around effective outcomes and behaviour Partnership is therefore about focusing on objectives and outcomes that require considerable mutual understanding and trust in order to achieve them, including an awareness of the way in which they can contribute to the objectives of each organisation Crucially, this is likely to mean that the activities of individual members and member organisations will be carried out in a way that contributes wider benefits and longer term gains than if they were carried out in isolation.
Partnership working is perhaps best seen as a spectrum, ranging from informal networking forums, consulting and sharing an information and intelligence, through to formal strategic alliances where partners come together to achieve common goals by changing the way that they work. It is critical for partnerships to understand where they lie on this spectrum as it will shape the way the partners work together, the commitment required and the achievements expected.
There can often be confusions among partners about the nature of the partnership and this can seriously undermine progress. Partnerships should focus on doing those things that only they can do by working together – and that no-one else can do better or more efficiently on their own. They should ensure that all the required members are round the table and that they are represented at the right level, and that they have ways of drawing on a much wider range of insights, experience, perspectives and expertise.
Organisations should encourage and support partnership working across all their staff. They should offer opportunities to develop partnership skills and they should recognise and reward effective partnership behaviour.
Good training and information on partnership working to staff so they can ensure good partnership working that they have the knowledge to support the services users and their families to ensure on going best support and practises. The more partnership working we as an organisation can do the more effective safe and services user focused sevice we can deliver. Partnerships need to maintain a strong connection to clients in terms of:
Being able to draw on the service user experience of support and the extent to which this helps them make progress in their lives Creating ways of involving service user in the design of services Capturing the difference that services user perceive in the accessibility, quality and coherence of services.
Courtney from Study Moose
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