A before and after study of integrated training sessions for children's health and care services

Abstract

Recent UK policy drivers such as the National Collaboration for Integrated Care and Support and Making Every Contact Count prioritise integrated care, an approach that seeks to provide more coordinated and seamless health and social care. In children's services, despite many partners, there are challenges around integrating care. A deprived borough of London ran short training and networking sessions for services supporting children and young people. This study examined whether intersectoral training would improve participants' knowledge of local services and joint working (including communication, navigation and confidence in collaboration). As part of a service evaluation, the study utilised a pre-post Likert scale survey design for each training session, a 1-month follow-up survey, and telephone interviews with a subsample of participants. The educational intervention was three sets of 1.5 hr educational workshops from December 2016 to February 2017. There were 302 attendances from 202 individuals from the health (n = 99), education (n = 145), social care (n = 39) and voluntary (n = 19) sectors. The pre and post surveys found significant increases in self-assessed knowledge of health/education/social care/voluntary services and in some elements of joint working. However, these increases were not sustained in any domain after 1 month of follow-up. There was also no difference in self-assessments amongst those who attended three sessions compared to those who attended one or two. Telephone interviewees highlighted networking as being helpful and suggested that informative tasks and diverse attendance would be beneficial in future. To conclude, this study suggests that although short-learning sessions may seem to improve immediate knowledge and some elements of joint working in the short term, any gains are not sustained in the long term. The cost effectiveness of such schemes is in doubt but may be improved by a more targeted delivery of content.

How can we define social care and what are the levels of true integration in integrated care? A narrative review

“…Social care as patching fragmentation of systems. Of the 33 initiatives selected, 3 aimed at improving fragmentation in health and social care systems (Bussu and Marshall, 2020;Murphy et al, 2017;Alexander et al, 2018). These included a service integration training package targeting clinicians' literacy around social services when conducting early interventions with children and their families (Alexander et al, 2018); an initiative that identified collaborative approaches and services for all sectors of society and age groups (Murphy et al, 2017) in the context of integrated care in the UK; and a novel system introducing care navigators who support complex adults and help them navigate the health and social care system (Bussu and Marshall, 2020).…”

“…In total, 27 initiatives reporting having health and social care staff integrated in practice, with a strong role description and mapping, along with clear integrated governance (Aredes et al ., 2021; Terracciano et al ., 2021; Pruitt et al ., 2018; Cammy, 2017; Moretti, 2017; Bussu and Marshall, 2020; Perman et al ., 2021; Pauley et al ., 2016; Moon et al ., 2021; Mateo-Abad et al ., 2020; Eastwood et al ., 2020; Talbot et al ., 2020; Vestjens et al ., 2019; Spoorenberg et al ., 2019; Elston et al ., 2019; Ismail et al ., 2020; Wong et al ., 2020; Sadarangani et al ., 2019; Tong et al ., 2020; Doheny et al ., 2020; White et al ., 2021; Aboutanos et al ., 2019; Chng et al ., 2021; Janse et al ., 2016; Murphy et al ., 2017; Sohanpal et al ., 2017; Alexander et al ., 2018).…”

“…The top 3 countries reporting health and social care initiatives in the literature are the UK ( n = 13), followed by the USA ( n = 7) and the Netherlands ( n = 4). Studies focussed on providing social care for older adults ( n = 13) (Terracciano et al ., 2021; Aredes et al ., 2021; Pruitt et al ., 2018; Perman et al ., 2021; Mateo-Abad et al ., 2020; Vestjens et al ., 2019; Spoorenberg et al ., 2019; Elston et al ., 2019; Wong et al ., 2020; Sadarangani et al ., 2019; Tong et al ., 2020; Doheny et al ., 2020; Janse et al ., 2016), followed by initiatives targeting social care for multimorbidity ( n = 14) (Melvin and Gipson, 2019; Collins et al ., 2017; Moretti, 2017; Davenport, 2021; Zarnegar et al ., 2017; Eastwood et al ., 2019; Talbot et al ., 2020; de Vries McClintock et al ., 2016; Ismail et al ., 2020; White et al ., 2021) and corresponding social needs (Aboutanos et al ., 2019; Cammy, 2017; Van Dijk et al ., 2016; Pauley et al ., 2016), initiatives addressing fragmentation of systems more broadly ( n = 3) (Bussu and Marshall, 2020; Murphy et al ., 2017; Alexander et al ., 2018) and initiatives aimed at community outreach in the context of integrated care ( n = 3) (Moon et al ., 2021; Chng et al ., 2021; Sohanpal et al ., 2017).…”

Workforce Development in Integrated Care: A Scoping Review

“…RELEVANT STUDIES Scale up existing competencies among all practitioners to deliver more integrated care [15,30,13,36] Incorporate integrated care concepts organically, so that they are fundamental to delivering care Create a working environment that values wellness and creates a climate of respect and work-life balance [14,36] Engage faculty teaching staff who convey joy in their work and provide trainees with education around work-life balance, self-reflection and self-improvement [14] Embed structures to support collaboration and interprofessional learning among colleagues and professions across services, strengthening multisector relationships; multi-organisation training [33,47,48,11,36] Incorporate simulation-based scenarios using actors from the local community with lived experiences [49] Incorporate education and support for caregivers, including prevention of health problems and improving quality of life. For example, implement a weekly meeting for caregivers to discuss topics related to the experiences of the patients' healthcare and their self-care needs [37] Allow more time for networking, interprofessional education and opportunities for individual service presentations and diverse attendance, including the social care and voluntary sectors [47,50,36] Case studies, exercises and simulations are encouraged to allow students to interact with the content in as realistic a venue as possible [42] Focus on soft skills, such as communication, teamwork and relationship building [5,34,13,41] Focus on skills to build durable relationships with patients, other professionals and caregivers [5,34] Focus on self-management promotion and skills, including the use of motivational interviewing techniques [34] Skills to navigate the health and social care systems and work on individualised care plans and assessments [30,34,47,13] Ongoing mentorship [38,…”

Making Every Contact Count and Healthy Conversation Skills as very brief or brief behaviour change interventions: a scoping review

“…Facilitators included (1) high staff engagement (Chisholm et al 2019;Wills and Ion 2014), (2) the perception that staff are advocates for healthy lifestyles and initiating discussions (Keyworth et al 2019), (3) the professional-patient relationship to facilitate healthrelated discussions (Keyworth et al 2019;Wills and Ion 2014), and (4) incentives to create staff buy-in (Nelson et al 2013).…”